If you like Your healthcare!!

[Emma]

The regulations and taxes will kill the health insurance industry .That is the point though.

They ain't going anywhere.

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COV4
ERAGE DEFINED.—Subject to the succeeding provisions of
5 this section, for purposes of establishing acceptable cov6
erage under this division, the term ‘‘grandfathered health
7 insurance coverage’’ means individual health insurance
8 coverage that is offered and in force and effect before the
9 first day of Y1 if the following conditions are met:
10 (1) LIMITATION ON NEW ENROLLMENT.—

Really if they cant sign up new members how will they grow or continue?
http://waysandmeans.house.gov/media/pdf/111/AAHCA09001xml.pdf

There's nothing that says private insurance can't sign new members.

Back up to page 102 and read the big bold letters starting with 'Title I'. Now read paragraph (a) underneath.

Now go down to page 18 (2) and keep reading.

What this does is state that current plans are grandfathered in without required changes until they sign on new members. THEN they must comply with the regulations (no exclusions for pre-existing conditions, renewal, non-discrimination in benefits, for example).

 

[Mr.Fitnah]

They ain't going anywhere.

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COV4
ERAGE DEFINED.—Subject to the succeeding provisions of
5 this section, for purposes of establishing acceptable cov6
erage under this division, the term ‘‘grandfathered health
7 insurance coverage’’ means individual health insurance
8 coverage that is offered and in force and effect before the
9 first day of Y1 if the following conditions are met:
10 (1) LIMITATION ON NEW ENROLLMENT.—

Really if they cant sign up new members how will they grow or continue?
http://waysandmeans.house.gov/media/pdf/111/AAHCA09001xml.pdf

There's nothing that says private insurance can't sign new members.

Back up to page 102 and read the big bold letters starting with 'Title I'. Now read paragraph (a) underneath.

Now go down to page 18 (2) and keep reading.

What this does is state that current plans are grandfathered in without required changes until they sign on new members. THEN they must comply with the regulations (no exclusions for pre-existing conditions, renewal, non-discrimination in benefits, for example).

Yeah it goes on with 20 pages or more regulations and gobbliy goop .
I dont have time to read it right now.
The fact is ,once the government becomes the competition, the competition goes away.
Fedex and UPS where not around before the post office not the other way around.

 

[Mr.Fitnah]

Big government programs enslave people.

 

[Emma]

Fedex and UPS where not around before the post office not the other way around.

 

[johnrocks]

So did the tobacco and auto industries.

And we saw what cowering little wimps those execs turned into, when push came to shove.

How is it again that corporations control da gubmint??

Eh, we disagree.

I don't read this (or anything else) as a sign that private insurance is going to disappear. Quite the contrary; I feel making plans available nation-wide will actually increase the number of people buying into private insurance.

That said, I will be surprised if this passes. This is the best chance we've ever had to do so, and I don't believe it will. If it doesn't, I'm going to be royally pissed.

Of course you disagree....You're taking people who can't be trusted at their word, and I'm not.

So true. All one has to do is read the original Social Security Act or any other peice of govt. legislation to see how it grows and morphs into something totally opposite of what the original "promise" was.

 

[PoliticalChic]

As I've already 'splained to you, the mere use of the term "grandfathering" presumes that private insurance will eventually....shall we say....wither on the vine.

No. It means that private plans will be available through the exchange. A great idea, IMO.

- President Obama promises that "if you like your health plan, you can keep it," even after he reforms our health-care system. That's untrue. The bills now before Congress would force you to switch to a managed-care plan with limits on your access to specialists and tests.
And as soon as anything changes in your contract -- such as a change in copays or deductibles, which many insurers change every year -- you'll have to move into a qualified plan instead (House bill, p. 16-17).

The House bill outline would “prohibit insurers from excluding pre-existing conditions or engaging in other discriminatory practices.”

“Caps total out-of-pocket spending in all new policies to prevent bankruptcies from medical expenses.” This would raise premiums for new policies.

The House bill outline says it would “prohibit plans [from] rating (charging higher premiums) based on gender, health status, or occupation and strictly limits premium variation based on age.”

.The House bill outline appears to parallel the Kennedy-Dodd draft: “Phases-in requirements to benefit and quality standards for employer plans.” This means that new plans will be more expensive than old plans. It also means they’re creating a bifurcated system with all sorts of perverse unintended consequences for employment flexibility.
Understanding the House Democrats’ health care bill*|*KeithHennessey.com

For a health plan to count as "qualified," it has to meet all the restrictions listed in the legislation and whatever criteria the Secretary of Health and Human Services imposes after the bill becomes law. You may think you're in a "qualified" plan, but the language suggests that only plans with managed-care controls such as the "medical home" will meet the definition (sections 3101 and 2707).

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following

 

[Emma]

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

Other than covering kids up to age 26, good.

 

[Political Junky]

You seem to be on a roll. That is not outlawing private insurance. Those are the regulations regarding grandfathering in current plans. Private insurance will still be available.

No they wont outlaw it , just make it unprofitable and unmanageable .
Nice snip.

A business that can't compete deserves to fail.

 

[PoliticalChic]

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

Other than covering kids up to age 26, good.

Since the price of healthcare can vary depending on what and who is covered, what do you suppose items like "children” up to age 26" and "pre-existing conditions, " and some of the other add-ons will do to both the costs of healthcare for those who do not opt for the 'public option' and to the profits of a non-government healthcare company?

Right, there will not be private healthcare.

If you can't see that, you don't want to see it.

 

[Old Rocks]

As I've already 'splained to you, the mere use of the term "grandfathering" presumes that private insurance will eventually....shall we say....wither on the vine.

Of course it will. It offers inadaquete health care at double the cost of the same care in other nations. Of course, should the Health Care industry decide to emulate the private health care companies in other industrial nations, they will probably not be able to pay the parasite at the top a 100 million plus package. Poor babies.

 

[Old Rocks]

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

Other than covering kids up to age 26, good.

Since the price of healthcare can vary depending on what and who is covered, what do you suppose items like "children” up to age 26" and "pre-existing conditions, " and some of the other add-ons will do to both the costs of healthcare for those who do not opt for the 'public option' and to the profits of a non-government healthcare company?

Right, there will not be private healthcare.

If you can't see that, you don't want to see it.

Well, given the ripoff that private health care has been, I will not mourn it's passing.

 

[PoliticalChic]

As I've already 'splained to you, the mere use of the term "grandfathering" presumes that private insurance will eventually....shall we say....wither on the vine.

Of course it will. It offers inadaquete health care at double the cost of the same care in other nations. Of course, should the Health Care industry decide to emulate the private health care companies in other industrial nations, they will probably not be able to pay the parasite at the top a 100 million plus package. Poor babies.

"The U.S., then, seems to be paying far more to insure a smaller share of its population—to be paying more for less.
There are several flaws in this reasoning, first and foremost its claim that a dollar spent is a dollar wasted. America’s health-care sector is larger partly because, unlike Canada’s, it includes for-profit corporations. Consider the benefit: companies invest billions each year developing innovative, life-saving drugs and devices. Are these expenses really something to lament? Similarly, is it a disadvantage that the U.S. has 11 percent more practicing doctors per capita than Canada? Or 15 percent more nurses? Is it a problem that the United States has almost four times as many MRI scanners per capita as Canada does, or that we preventively test more of our population for common cancers? Hardly. The fact that America’s health-care system is larger, more advanced, and better staffed than a system with rationed care is an advantage. To pretend otherwise is just a tactic to make the reform pill easier to swallow."
Bigger Is Healthier by David Gratzer, City Journal 22 July 2009

 

[Emma]

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

Other than covering kids up to age 26, good.

Since the price of healthcare can vary depending on what and who is covered, what do you suppose items like "children” up to age 26" and "pre-existing conditions, " and some of the other add-ons will do to both the costs of healthcare for those who do not opt for the 'public option' and to the profits of a non-government healthcare company?

Right, there will not be private healthcare.

If you can't see that, you don't want to see it.

I think it will go down. Bigger base of clients to spread out the cost, and as I said in the other thread there will be long-term savings for us all.

 

[Emma]

I wish people would just stop with the "rationed care" scare tactic.

That's what we have now. That's what we've had since the advent of insurance coverage.

 

[PoliticalChic]

I wish people would just stop with the "rationed care" scare tactic.

That's what we have now. That's what we've had since the advent of insurance coverage.

Absolutely untrue.

I find that one as familiar with the system as you are would fabricate to enforce the leftist view.


No government official stands between you and healthcare today.

If you have a private plan and they decline after hearings, you can decide that you will pay for healthcare youself.

We do not have rationed healthcare. It is not like Canada, where you would have to leave the country to purchase care that they would either not give you, or you do not wish to wait the prolonged time for treatment.

Please retract.

 

[Emma]

I wish people would just stop with the "rationed care" scare tactic.

That's what we have now. That's what we've had since the advent of insurance coverage.

Absolutely untrue.

I find that one as familiar with the system as you are would fabricate to enforce the leftist view.


No government official stands between you and healthcare today.

If you have a private plan and they decline after hearings, you can decide that you will pay for healthcare youself.

We do not have rationed healthcare. It is not like Canada, where you would have to leave the country to purchase care that they would either not give you, or you do not wish to wait the prolonged time for treatment.

Please retract.

Absolutely not. Our current public plans ration, deny, and restrict reimbursement for services. Same with private insurance. Sure, technically someone has the option of paying out of pocket, but how many of us can afford that? You're well versed in healthcare, it seems. Certainly you are aware of the costs of even the most routine care.

On a personal note, I had surgery 4 years ago to remove an ovarian tumor. I was in the hospital 4 days. The hospital bill alone was over $30K. The surgeon's bill was over $10K. The anesthesiology bill was over $2K. Radiology... I can't recall offhand.

So we're talking over $42,000 for one 4 day hospital stay. I wasn't on a specialized unit. No complications, nothing untoward. A fairly routine stay. No way in hell I could have afforded to pay that bill.

Having the "option" to private pay means nothing if you can't afford it.

 

[Emma]

My mother's bill from UVA for her first surgery (discharged her 2nd postop day) was pushing $150K. I know for certain my parents couldn't have paid out of pocket.

 

[PoliticalChic]

Other than covering kids up to age 26, good.

Since the price of healthcare can vary depending on what and who is covered, what do you suppose items like "children” up to age 26" and "pre-existing conditions, " and some of the other add-ons will do to both the costs of healthcare for those who do not opt for the 'public option' and to the profits of a non-government healthcare company?

Right, there will not be private healthcare.

If you can't see that, you don't want to see it.

I think it will go down. Bigger base of clients to spread out the cost, and as I said in the other thread there will be long-term savings for us all.

So your premise is that adding the following, which are just some clauses that we know of,

1. have guaranteed issue and renewal

2. no exclusions for pre-existing conditions

3. , no lifetime or annual limits on benefits,

4. family policies would have to cover “children” up to age 26.

5. to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.
6. compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430).

7. prohibits engaging in other discriminatory practices. cover smokers, parachute jumpers, and race car drivers.

8. Caps total out-of-pocket spending


and the result wil be that the cost of private healthcare "I think it will go down"?

Perhaps we should insist that every policy owner must get a birthday cake and a pot of gold, then healthcare costs would really go down!

 

[Oddball]

I wish people would just stop with the "rationed care" scare tactic.

That's what we have now. That's what we've had since the advent of insurance coverage.

Absolutely untrue.

I can go get fee-for-service treatment any time I want.

 

[Emma]

Since the price of healthcare can vary depending on what and who is covered, what do you suppose items like "children” up to age 26" and "pre-existing conditions, " and some of the other add-ons will do to both the costs of healthcare for those who do not opt for the 'public option' and to the profits of a non-government healthcare company?

Right, there will not be private healthcare.

If you can't see that, you don't want to see it.

I think it will go down. Bigger base of clients to spread out the cost, and as I said in the other thread there will be long-term savings for us all.

So your premise is that adding the following, which are just some clauses that we know of,

1. have guaranteed issue and renewal

2. no exclusions for pre-existing conditions

3. , no lifetime or annual limits on benefits,

4. family policies would have to cover “children” up to age 26.

5. to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.
6. compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430).

7. prohibits engaging in other discriminatory practices. cover smokers, parachute jumpers, and race car drivers.

8. Caps total out-of-pocket spending


and the result wil be that the cost of private healthcare "I think it will go down"?

Perhaps we should insist that every policy owner must get a birthday cake and a pot of gold, then healthcare costs would really go down!

I do believe I've explained myself in several posts why I feel this way.

IMO the initial costs will go up, but in the long term it will decrease. I'm looking ahead and at the bigger picture, not running around with my hair on fire about how much it's going to cost us at startup.