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Roger Perry
09-23-2010, 11:08 AM
Several key consumer protections under the nation's new health law begin taking effect Thursday - six months after its enactment.
Insurers (http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#) can no longer set a dollar limit on the amount of care they'll provide over a person's lifetime or deny coverage to sick children. Young adults can stay on their parents' health plans until age 26. And consumers get greater rights to appeal insurers' decisions


Read more: http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#ixzz10MiBoDpV

Anyone here see a problem with the new laws a on health care that took effect today? Do any of you think you will benefit from the new health care laws?

sometimes a great notion
09-23-2010, 11:17 AM
I will certainly benefit from this. I have stage 4 colon cancer and have used up a lot of my benefits already, this will now allow me to be able to finish up the chemotherapy and any surgeries that I will need. I have a plan that I pay part from my paycheck and the rest is covered along with a deductible. I have met that already this year and now my treatment costs me nothing out of pocket but now no more limits, I can finish. I have had to skip chemo therapy several times in order to land my deductions at the right time.
I still had a 1700 dollar bill from the hospital from Janurary that I just got done paying off, I have to pay this out to the hospital so that the illegal immigrants can get their free health care. :(

ducknwork
09-23-2010, 12:16 PM
Several key consumer protections under the nation's new health law begin taking effect Thursday - six months after its enactment.
Insurers (http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#) can no longer set a dollar limit on the amount of care they'll provide over a person's lifetime or deny coverage to sick children. Young adults can stay on their parents' health plans until age 26. And consumers get greater rights to appeal insurers' decisions


Read more: http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#ixzz10MiBoDpV

Anyone here see a problem with the new laws a on health care that took effect today? Do any of you think you will benefit from the new health care laws?

Will that cause everyone's rates to go up because the insurance company will obviously be paying out more money now?

I can't wait to see what my rates are going to be when we have open enrollment in November. They have gone up considerably in the last few years.

2005-Not married, paying for insurance only for myself, approx. $20/week.
2006-Got married, paying assoc. +1, approx. $30/week.
2007-Had a baby, paying family rate (max rate), approx $45/week. (this is the last increase that was MY fault.)
2010-Still paying family rate (2 kids later) but now the rate has jumped to approx. $75/week. That's $120/month MORE than I was paying 3 years ago. In the famous words of Joe Biteme, 'This is a big f-----g deal!'
2011-Scared to find out what it will be. I am sure it will increase and have an impact on my non-necessity spending, which will also have a negative effect on the economy, as I won't be the only one who can't afford what I used to be able to afford.

YardleyLabs
09-23-2010, 12:21 PM
Will that cause everyone's rates to go up because the insurance company will obviously be paying out more money now?

I can't wait to see what my rates are going to be when we have open enrollment in November. They have gone up considerably in the last few years.

2005-Not married, paying for insurance only for myself, approx. $20/week.
2006-Got married, paying assoc. +1, approx. $30/week.
2007-Had a baby, paying family rate (max rate), approx $45/week. (this is the last increase that was MY fault.)
2010-Still paying family rate (2 kids later) but now the rate has jumped to approx. $75/week. That's $120/month MORE than I was paying 3 years ago. In the famous words of Joe Biteme, 'This is a big f-----g deal!'
2011-Scared to find out what it will be. I am sure it will increase and have an impact on my non-necessity spending, which will also have a negative effect on the economy, as I won't be the only one who can't afford what I used to be able to afford.
2010 - Paying $575/month just for me. Reduced coverage two years ago to get premiums down from $720/month. Family coverage at that time was $2200/month.

ducknwork
09-23-2010, 12:25 PM
2010 - Paying $575/month just for me. Reduced coverage two years ago to get premiums down from $720/month. Family coverage at that time was $2200/month.

I am sorry you pay so much. I am fairly certain that you make a good bit more money than I do as well, so the ratio of cost to income may not be that much different.

Will your rates go up or down as a result of this healthcare legislation?

YardleyLabs
09-23-2010, 12:27 PM
I am sorry you pay so much. I am fairly certain that you make a good bit more money than I do as well, so the ratio of cost to income may not be that much different.

Will your rates go up or down as a result of this healthcare legislation?
I'm guessing they will be completely unaffected since the policy already provides coverage for children to age 26 and has no lifetime limit on benefits. By the way, I wouldn't make bets on the income. I have been semi retired for years and live primarily from savings.

WaterDogRem
09-23-2010, 12:36 PM
Don't agree that Young adults should be allowed to cling on parents insurance till 26 y.o.! The only way I could agree with that is if full-time enrollment in college/school can be proven.
I agree this will help some people, however, companies should not have to be limited to the coverage plans offered. Unlimited lifetime amounts of course will & should cost more, but I should have the option to choose. I can weigh the cost to benefits myself, and don't need big brother to tell me what I need!
Will these mandates not increase health insurance costs for everyone?

M&K's Retrievers
09-23-2010, 12:43 PM
Several key consumer protections under the nation's new health law begin taking effect Thursday - six months after its enactment.
Insurers (http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#) can no longer set a dollar limit on the amount of care they'll provide over a person's lifetime or deny coverage to sick children. Young adults can stay on their parents' health plans until age 26. And consumers get greater rights to appeal insurers' decisions


Read more: http://www.azcentral.com/news/articles/2010/09/22/20100922health-law0922.html#ixzz10MiBoDpV

Anyone here see a problem with the new laws a on health care that took effect today? Do any of you think you will benefit from the new health care laws?

Insurance companies have always been able to sell limited benefit policies to those who chose a less expensive coverage. That doesn't mean that's all they sell or available. Every policy I've sold for the past 20 years have unlimited lifetime maximums, individuals/groups cannot be terminated except for non payment of premium and dependents are eligible to age 24, 25 or 26 depending on the state. Consumers have always had the right to appeal insurers decisions to their state insurance department which oversees insurance regulations and of course they have always had the right to litigate.

The only thing that has changed for those who have purchased coverage from legitimate carriers through licensed insurance professionals is the premiums are increasing to cover other provisions of the bill which make it almost impossible for carriers to make a profit (that's still OK isn't it?). Oh, because of Obamacare, my compensation will probably be reduced 50% on individual policies in force 1/1/11. We don't know about group policies yet. Because of this, the public will see a reduction in independent agents. Why does that matter? Primarily, independent agents represent more than one company so the consumer can get several quotes for shopping comparison, help with claim disputes, service, etc. Consumers will be left to purchase policies from salaried employees who represent one company.

I could go on, but I would be beating a dead horse. You have your liberal something for nothing mind made up. I don't know what you do for a living but I can't help but wonder how you would react if the government told you how to make your widgets, what your widgets should do, the design of your widget, how much to charge and how much you can make. My guess is you wouldn't like it very much. What you would probably like is the government forcing the public to buy your widgets only they really don't have to buy it until you can't charge enough to produce it.

There is an article in the Washington Examiner today about how after 6 months, Obamacare is already costing much more than predicted. Look it up if your a mind - but I doubt it.

enjoy what you asked for regards,

Mike Whitworth

Eric Johnson
09-23-2010, 12:58 PM
Children will be allowed to remain on parent's plans until age 26....only if they were already on the parent's plan. If they were un-insured and now seek to join the parent's plan, they can be refused apparently.

Also....

http://www.washingtonexaminer.com/opinion/Obamacare-is-even-worse-than-critics-thought-960772-103571664.html#ixzz10N84ui58

http://tinyurl.com/36a53dm

Examiner Editorial: Obamacare is even worse than critics thought
September 22, 2010

Six months ago, President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi rammed Obamacare down the throats of an unwilling American public. Half a year removed from the unprecedented legislative chicanery and backroom dealing that characterized the bill's passage, we know much more about the bill than we did then. A few of the revelations:

-more-

Our single biggest hope is that one section will be declared unconstitutional because then the whole 2000+ page bill will be tossed. The idiots in Congress were rushing so much to pass it that they reportedly forgot to add a severability clause.

Eric

dnf777
09-23-2010, 01:13 PM
Don't agree that Young adults should be allowed to cling on parents insurance till 26 y.o.! The only way I could agree with that is if full-time enrollment in college/school can be proven.
I agree this will help some people, however, companies should not have to be limited to the coverage plans offered. Unlimited lifetime amounts of course will & should cost more, but I should have the option to choose. I can weigh the cost to benefits myself, and don't need big brother to tell me what I need!
Will these mandates not increase health insurance costs for everyone?

I agree with you. Unless full-time enrollment as you say, or I would also add disabled/mentally retarded situations as well. But for Jethro who just wants to live in the Clampett mansion............get a life!

WaterDogRem
09-23-2010, 01:16 PM
Examiner Editorial: Obamacare is even worse than critics thought
September 22, 2010

Six months ago, President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi rammed Obamacare down the throats of an unwilling American public. Half a year removed from the unprecedented legislative chicanery and backroom dealing that characterized the bill's passage, we know much more about the bill than we did then. A few of the revelations:

-more-

Our single biggest hope is that one section will be declared unconstitutional because then the whole 2000+ page bill will be tossed. The idiots in Congress were rushing so much to pass it that they reportedly forgot to add a severability clause.

Eric

Can't forget to add something you didn't know wasn't in there. Doubt they, including the POTUS, still haven't read the bill!

M&K's Retrievers
09-23-2010, 01:24 PM
Don't agree that Young adults should be allowed to cling on parents insurance till 26 y.o.! The only way I could agree with that is if full-time enrollment in college/school can be proven.
I agree this will help some people, however, companies should not have to be limited to the coverage plans offered. Unlimited lifetime amounts of course will & should cost more, but I should have the option to choose. I can weigh the cost to benefits myself, and don't need big brother to tell me what I need!
Will these mandates not increase health insurance costs for everyone?

That's how most state insurance laws read and some include handicapped regardless of age.

WaterDogRem
09-23-2010, 01:31 PM
That's how most state insurance laws read and some include handicapped regardless of age.

Yup, as they should. Does ObamaCare?

M&K's Retrievers
09-23-2010, 02:17 PM
Yup, as they should. Does ObamaCare?

I hope so but don't know. I'm not sure if they know.

depittydawg
09-24-2010, 03:42 AM
You have your liberal something for nothing mind made up.
Mike Whitworth

Ok, how is paying for your kids health insurance getting something for nothing?

The only one getting something for nothing in the health industry is the HEALTH INSURANCE COMPANY.

ducknwork
09-24-2010, 07:04 AM
Does ObamaCare?

Sadly, I don't think he does...:(;)

ducknwork
09-24-2010, 07:07 AM
The only one getting something for nothing in the health industry is the HEALTH INSURANCE COMPANY.

How do you figure? The insurance company is providing a service that we purchase. Not really any different than buying a product at WalMart.

It's gambling. Sometimes we win, most of the time they win. We are betting that we'll get sick and need a doc, they are betting that we won't.

badbullgator
09-24-2010, 07:35 AM
Ok, how is paying for your kids health insurance getting something for nothing?

The only one getting something for nothing in the health industry is the HEALTH INSURANCE COMPANY.


If your insurance is provided through your job, even if you pay all or part for your kids it stll cost your employer money. We are a small business with about 15 people. Each year our renewal is sent to us and the amount per person is listed. This is our renewal month and the 4 dependant children that are on our group policy all went up 20%. We happen to pay 30% of coverage for spouses and children.
Our business also takes insurance and when the SGA passes this year we will be reducing the number of people we have, We will have no other option as the insurance reimbursments will drop from the already tiny amount they pay to even less.

badbullgator
09-24-2010, 07:58 AM
The only one getting something for nothing in the health industry is the HEALTH INSURANCE COMPANY.

What I don’t think a lot of people relies is that insurance is who sets the price for healthcare…..not the evil rich doctors. You can bill whatever you want but insurance only pays what they say. You pay in your premiums and they invest that money to make more and then reduce the amount they pay out by setting prices that benefit them. They get away with it because if you don’t take what they give you cannot survive. Here are a few examples of what they do, these are first hand knowledge on my part.
United healthcare one of the largest around
Urinalysis $3.50
Semen analysis $6.00
Embryo transfer $132
Microbiology culture $8
Antibiotic sensitivity $8

Lets look at each one. Urinalysis, someone must verify it was collected properly, log in patient information, aliquot the sample into a test cup used on the automated analyzer (cup cost about 20 cents and the analyzer is over 50K not to mention cost to operate and maintain). The test reagents are about $2 per test. The results must be verified by a licensed lab tech and reported, The results must be placed in the patients chart and any treatment initiated, All this for $3.50! Keep on mind that federal and state law requires that the lab do QC/QA on all testing. There is ZERI money being made on this and in fact it is a loosing proposition for many.
How about an embryo transfer, the cost of the catheter alone is $50. Other disposables come up to another $30 bringing the total to $80 for disposable good alone, this leaves $52 to cover the time of the physician, embryologist, and usually a medical assistant who preps and helps with the patient.
For once I have to agree with dippy Health Insurance is the only one getting anything out of this.

Julie R.
09-24-2010, 08:01 AM
I have a standard bare-bones policy like most self employed. Mine just went up this month from $265 to $440 a month. Biggest increase to date, yet I've never had a claim because I have a high deductible.

road kill
09-24-2010, 08:08 AM
When my wife passed and my kids moved away I was paying $550 a month....for just me!!
With a $2,500 deductible.
(insane)
$30 copay on office visits.
Annual cost befor I got to insurance?
$9,100 +!

Annual check up---$500
(blood work etc.)
Monthly Chiro visit--$30 cash ($360 annual)

Where is the other $9,000?????


I get VA benefits, so if I get cancer or a heart attack or something major, that's where I'll go.


Healthcare in America is excellent.
Health Insurance is NUTZ!!!

Let's GIVE more of it away, so those who can and do pay can pay MORE!!!



RK

M&K's Retrievers
09-24-2010, 11:53 AM
What I don’t think a lot of people relies is that insurance is who sets the price for healthcare…..not the evil rich doctors. .

Insurance companies do not set the the fees providers receive for their services. They do establish "reasonable and customary" limits for charges in a given area. These R&C limits are determined by the going rate for a procedure in that area. This prevents providers from gouging patients by charging more than they should. They also establish PPO networks which providers may join in order to increase patient load. For this increased patient load, they must discount their fees to a predetermined amount. The providers do not have to join these PPO's but do so to increase activity. They would not join these if they were going to lose money by doing so.

Over my career in this business, I have witnessed many instances where providers charged substantially more for treatment when the patient had insurance than they do for those who do not. One specialty (which will remain nameless) in particular is famous for this practice. On the other hand I have seen hospitals offer deep discounted "package deals" for those who are willing to pay cash for a procedure.

Many years ago when my company was paying claims for several insurance companies, we were instructed to audit any hospital bill over a certain dollar amount before full reimbursement was to be made. We would pay 50% of the bill with the balance pending the results of the audit or the hospital could get 80% of the billed amount with no audit. They almost always settled for the 80% because they got paid quicker but they also knew that discrepancies would be found which would not be allowed.

Reputable insurance companies are not the evil money grubbing organizations they are made up to be. If it were such a cash cow, there would be more of them competing for your business. Unfortunately there are companies out there that offer programs that have inside limitations, play games with claims,etc and are just attracting folks with cheap premiums. These programs are usually direct marketed by telemarketers or salaried employees without a professional insurance agent.

Oh, as far as the "evil rich doctors" are concerned, I have several that are clients. Many of those over 50 are considering getting out of the game due to Obamacare. Don't need the hassle.

Big print giveth, small print taketh away regards,

ducknwork
09-24-2010, 11:57 AM
It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.


One specialty (which will remain nameless) in particular is famous for this practice.

I'm guessing chiropractors...

M&K's Retrievers
09-24-2010, 11:58 AM
It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.



I'm guessing chiropractors...

Me and Sgt Schultz know nothing....

M&K's Retrievers
09-24-2010, 12:10 PM
It's difficult for me to evaluate what other people are paying for coverage because age, sex, location, plan design, the insurance company and previous medical history figure in to the equation. I can tell you that my wife and I in Dallas pay $532 a month for a $3500 deductible. I'm 62 and she is 59. We are increasing to $577 11/1 and will go up again next March when she hits 60 (I'm guessing $700ish). We will probably increase our deductible to $5M at that time. I'd go bitch to my worthless agent but it wouldn't do any good 'cause it's me.;)

ErinsEdge
09-24-2010, 12:16 PM
Will that cause everyone's rates to go up because the insurance company will obviously be paying out more money now?

I can't wait to see what my rates are going to be when we have open enrollment in November. They have gone up considerably in the last few years.

2005-Not married, paying for insurance only for myself, approx. $20/week.
2006-Got married, paying assoc. +1, approx. $30/week.
2007-Had a baby, paying family rate (max rate), approx $45/week. (this is the last increase that was MY fault.)
2010-Still paying family rate (2 kids later) but now the rate has jumped to approx. $75/week. That's $120/month MORE than I was paying 3 years ago. In the famous words of Joe Biteme, 'This is a big f-----g deal!'
2011-Scared to find out what it will be. I am sure it will increase and have an impact on my non-necessity spending, which will also have a negative effect on the economy, as I won't be the only one who can't afford what I used to be able to afford.
$300 a month for a family is unbelivably cheap-I wouldn't complain. Chances are your work is picking a lot of it up? I keep taking a higher duductible to stay near $500 a month. I am now at $3500 deductible. 5 years ago I was at $500 deductible. Every year it has gone up $60-$120 a month.

M&K's Retrievers
09-24-2010, 12:20 PM
It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.



.

Dave will have another take on this as he should. Providers and insurance companies are not enemies. They are both forced to work within state and federal regulations that make it difficult to make a profit. Some of these regs are good while many suck by making all involved jump through hoops.

Cody Covey
09-24-2010, 01:58 PM
Children will be allowed to remain on parent's plans until age 26....only if they were already on the parent's plan. If they were un-insured and now seek to join the parent's plan, they can be refused apparently.

Also....

http://www.washingtonexaminer.com/opinion/Obamacare-is-even-worse-than-critics-thought-960772-103571664.html#ixzz10N84ui58

http://tinyurl.com/36a53dm

Examiner Editorial: Obamacare is even worse than critics thought
September 22, 2010

Six months ago, President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi rammed Obamacare down the throats of an unwilling American public. Half a year removed from the unprecedented legislative chicanery and backroom dealing that characterized the bill's passage, we know much more about the bill than we did then. A few of the revelations:

-more-

Our single biggest hope is that one section will be declared unconstitutional because then the whole 2000+ page bill will be tossed. The idiots in Congress were rushing so much to pass it that they reportedly forgot to add a severability clause.

Eric
This isn't true at all. I haven't been on my parents insurance for over a year and she recently got a letter stating that i would be eligible to go back on her insurance starting on 1/1/2011. They are required to allow you back on to your parents insurance. Your parent still has to pay so its not like you are getting something for nothing...

ducknwork
09-24-2010, 10:17 PM
$300 a month for a family is unbelivably cheap-I wouldn't complain. Chances are your work is picking a lot of it up? I keep taking a higher duductible to stay near $500 a month. I am now at $3500 deductible. 5 years ago I was at $500 deductible. Every year it has gone up $60-$120 a month.

I forgot to mention that work pays 50%. So the total cost is around $600. Thank goodness for work place insurance!

My point was that the prices have already increased significantly and I am not looking forward to seeing what happens this November during open enrollment.

depittydawg
09-24-2010, 10:38 PM
How do you figure? The insurance company is providing a service that we purchase. Not really any different than buying a product at WalMart.

It's gambling. Sometimes we win, most of the time they win. We are betting that we'll get sick and need a doc, they are betting that we won't.

The primary purpose of Insurance is to distribute risk over a large percentage of the population, NOT to make profit. When Profit became the single objective of Health Insurance Companies, our costs began to go through the roof and our healthcare rankings began a freefal that continues to this day. Profit in insurance is not needed. maximizing Profit for insurance to the healthcare equation adds 30% more cost, and deprives millions of coverage when they need it.

dnf777
09-24-2010, 11:30 PM
I forgot to mention that work pays 50%. So the total cost is around $600. Thank goodness for work place insurance!

My point was that the prices have already increased significantly and I am not looking forward to seeing what happens this November during open enrollment.


Call me socialist, but I'm beginning to wonder if "promote the general welfare" should be construed to mean the gov't should manage health insurance or financing? We all accept the socialist structure of the gov't "providing the common defense" as necessary, when it is such a huge beast. Is healthcare not just as large? Like the DoD, should a DoH similarly run contracting and oversight of private providers? (health contractors...like defense contractors)

I'm sure I'll take some jabs for my opening line, but has the thought crossed anyone elses mind, in the context of the current system is failing, and a half-assed reform bill is not likely to salvage it? If the dire predictions are true, then NOBODY should be comfortable even if they have insurance at the moment.

And if you reject that notion, and want to repeal the health law........what are ya gonna do instead? Please note, insurance rates were increasing exponentially BEFORE this law ever took effect or was even a twinkle in anyone's eye.

Gerry Clinchy
09-25-2010, 12:43 AM
Profit in insurance is not needed.

Not sure what business you're in ... but I think that a farmer might take exception to the fact that profit in food is not needed, since it might deprive some people of food they need.

Your statement would imply that any service or product that is considered a "need" should be non-profit, i.e. paid for by taxes and overseen by the govt? We could start with health care, include food, clothing, home heating, electricity, public transportation ... probably a lot of other things people could add to the list.

M&K's Retrievers
09-25-2010, 12:50 AM
Please note, insurance rates were increasing exponentially BEFORE this law ever took effect or was even a twinkle in anyone's eye.

I'm afraid you aint seen nothing yet. Those of us dumb enough to still be in the business are just now starting to get emails from our carriers laying the groundwork for major rate increases in the offing due to Obamacare mandates. They can't do this crap for free. My guess is after the first of the year we will see companies withdrawing from the health care industry by either canceling their business or selling it to other companies. In either case the result will be less carriers competing for your business. The remaining companies-mainly The Blues and United Health Care- will hang around awhile hoping for a shot at administering the only game left in town - the government health plan. Me and thousands like me will be out of business not to mention thousands of support people from insurance companies, agencies, state insurance departments, etc who will be jobless. Don't forget the loss of state income in the form of premium taxes. And Dave, you will be a salaried government employee working long hours and being underpaid for your services.

Someone said earlier "Does Obamacare?" No. He doesn't but we had better care or an outcome similar to the one described above will ensue.

Pretty picture regards,

depittydawg
09-25-2010, 01:47 AM
Not sure what business you're in ... but I think that a farmer might take exception to the fact that profit in food is not needed, since it might deprive some people of food they need.

Your statement would imply that any service or product that is considered a "need" should be non-profit, i.e. paid for by taxes and overseen by the govt? We could start with health care, include food, clothing, home heating, electricity, public transportation ... probably a lot of other things people could add to the list.

Not at all. The decision on whether or not to a service should be profit or non-profit rests solely on the merit of selecting the most effective method of delivery. Most countries in this world do not have profit driven health insurance industries. They deliver a better product at a lower cost. Examples are Canada, England, France, Germany, Japan ....
We have public roads. We have a Public Military. We have Public Schools. We have Public Police, fire etc. etc. We have had all of these for more years than any of us have been alive. And we still have a Private Economy.

The models of public healthcare in almost every other modern country have evolved. Ours has not. We spend the most, by far, on healthcare of any nation on the planet and we rank 32nd, (last time I looked) in delivery. What benefit has Profit driven health insurance provided to America?

Gerry Clinchy
09-25-2010, 01:50 AM
Some other Obamacare facts:
http://www.pbs.org/newshour/rundown/2010/09/as-health-reform-law-hits-six-month-mark-consumer-protection-changes-begin.html

Free preventive care: New policies must cover preventive care -- such as immunizations, mammograms and colonoscopies -- without charging a deductible or co-payment. (Even a modest co-pay would help keep costs down).

The provisions will go into effect for plans issued or renewed after Sept. 23. So you'll see the changes the next time you buy a new plan, or when your new policy year begins. For many large employers, that's Jan. 1. For others, it could be sooner or later than that.

Higher annual limits on coverage: Plans will still be allowed to place annual dollar limits on coverage, but those annual limits must be at least $750,000. Annual limits will be banned completely by 2014.

Are there any exceptions to some of these rules?
Yes. Some of the changes will not apply to "grandfathered" plans -- plans that existed before the law was signed on March 23 and that haven't made significant changes since then. This is particularly true for individual insurance plans.

For both group and individual grandfathered plans, the changes providing free access to preventive care and expanded access to ob-gyn's and emergency care will not apply. Individual plans that are grandfathered do not have to accept children regardless of pre-existing conditions, and also do not have to comply with the new $750,000 minimum for annual limits.

Even if your plan is a grandfathered one, however, there's a good chance it won't stay that way long. That's because in order to keep the status, the plans cannot make any significant changes, such as raising premiums, co-pays or deductibles.
"Over time plans are going to need to do those things to keep up with inflation," says Sara Collins, vice president of the Commonwealth Fund. By 2013, she says, the government estimates that 60 percent of large employer plans and 45 percent of small employer ones will lose their grandfathered status. (So, it's not quite true that if you like your present plan, you can keep it. Small changes in the plan could trigger requiring the plan be changed to conform to the new law.)

The government also estimates that up to 88 million people will be affected by the provisions that mandate free access to preventive care, more access to emergency care, and a more extensive appeals process.

These numbers all come from estimates prepared by the Department of Health and Human Services as part of regulations issued for the new law.

http://spectator.org/archives/2010/09/23/obamacare-at-six-months
A perfect example is the uproar over recent reports that insurers were citing the new health care law as part of their rationale for raising premiums.

In response to the news, Health and Human Services Secretary Kathleen Sebelius sent a threatening letter to the insurance industry lobby, America’s Health Insurance Plans (AHIP), warning that there will be “zero tolerance for this type of misinformation and unjustified rate increases.” Sebelius also added that, “I want AHIP's members to be put on notice: the Administration, in partnership with states, will not tolerate unjustified rate hikes in the name of consumer protections.” (Seems to me that when more services are expected to be coverred, it would be "justified" to raise rates to cover those costs?)

It’s no surprise that the new health care law, which requires insurers to offer more generous benefits, would make premiums go up. In the pre-ObamaCare health care system, state regulators already created over 2,000 benefits that insurers were mandated to cover, according to the Council for Affordable Health Insurance -- and those benefits drove up the cost of health insurance by 20 percent to 50 percent. It’s one reason why coverage in highly-regulated New York costs more than double what it does in neighboring Pennsylvania, according to data from eHealthInsurance.com.

ObamaCare adds a raft of new mandates on top of existing state mandates. The Congressional Budget Office determined that an earlier version of the law would increase premiums in the individual market by 10 percent to 13 percent over where they would be without the law’s passage.

http://health.usnews.com/health-news/managing-your-healthcare/healthcare/articles/2010/09/22/new-health-law-benefits-4-ways-to-prepare-for-the-changes.html

Also not necessarily covered: family planning services like a vasectomy or insertion of an intrauterine device; weight loss counseling, and smoking cessation programs. These may be covered at some point in the future after a federal health board comes up with recommendations on mandatory coverage. (Kind of interesting what's not covered.)

Watch out for rising premiums. While the health reform law makes it tougher for insurance companies to hike up premiums, they can still implement rate increases when justifiable and, yes, premiums may rise on employee group plans to absorb extras like adding in your co-workers' college-age kids.

Don't assume it's cheaper to add a grown child to your plan. It may cost you more to add, say, your 23-year-old daughter to your plan than to buy her an individual policy. "Our latest report shows that the average premium for individual adults ages 19 to 24 is about $107 per month," McLean says. If your premiums rise by more than that when you add a child, it may better to explore other options. (I guess you could have done that before Obamacare as well if you had the $ and wanted to provide that for your kid?)

http://blog.heritage.org/2010/09/23/morning-bell-six-months-closer-to-repeal/?utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell

Before Obamacare was passed six months ago today, former President Bill Clinton promised a leftist horde at the Netroots Nation convention: "The minute the president signs the health care reform bill, approval will go up, because Americans are inherently optimistic." Fast forward to last Sunday, when, after Meet the Press host David Gregory played a clip of Clinton's promise, the former President responded: "I was wrong."

Doctors: In order to make a trillion dollar new entitlement look deficit neutral, you have to game the system. Obamacare accomplished this by pretending to cut doctor Medicare reimbursement by 23%. Congress already added to the deficit by delaying these cuts through this December. But a massive pay cut is just the beginning of the pain Obamacare has inflicted on physicians. The law also makes it next to impossible for doctors to establish their own hospitals, burdens them with thousands of hours of new reporting requirements and overburdens emergency rooms. Then there is the massive expansion of Medicaid which reimburses doctors at only 56% the rate in private practice. No wonder studies show that Obamacare will be 300,000 nurses and 100,000 doctors short of what is needed by 2020.

Consumers: Remember President Obama's promise, "If you like your health care plan, you can keep your health care plan"? Don't believe it. Do you like your health savings account (HSA) or flexible spending accounts (FSAs)? Well those provide you with too much economic health care freedom for Obamacare to work, so Obamacare regulates both out of existence. Do you like your current employer coverage? Sorry, studies show that Obamacare's regulations are likely to incentivize employers to dump 35 million Americans out of their current health care plan. And once they are in the new marketplace, other Obamacare regulations and mandates are already sending health insurance premiums through the roof.

States: Medicaid spending already represents on average about 21 percent of the typical state budget. Obamacare will significantly expand that number. Of the 34 million Americans who gain health insurance through Obamacare, over half (18 million) will receive it through the welfare program, Medicaid. This impending state budget crisis was what the Cornhusker Kickback was all about. Obamacare attempted to appease states by bailing them out through 2016. But by 2017, state taxpayers will be on the hook for an ever-expanding share of Medicaid dollars. If state Medicaid spending increases by 41 percent as projected, then by next year Medicaid could end up consuming nearly 30 percent of the average state budget. Already, 44 states report that they have exceeded projected Medicaid enrollment and spending targets for this year, and Obamacare will only make those numbers worse.

Seniors: : The President's own Medicare Actuary projects that the record-breaking payment reductions due to hit hospitals, home health agencies and nursing homes will make 15 percent of these providers unprofitable and possibly "jeopardize" seniors’ access to care. On top of that, payment cuts to Medicare Advantage plans will hit seniors especially hard. Enrollment in these plans is expected to drop from 14.8 to 7.4 million. By 2017, the average annual per-capita cuts for Medicare Advantage enrollees will be about $3,700 -- a 27 percent reduction from today’s levels.

Gerry Clinchy
09-25-2010, 01:52 AM
And more ...

http://blogs.forbes.com/merrillmatthews/2010/09/22/tough-questions-for-obama-about-obamacare/?boxes=Homepagechannels

At least ABC News White House Correspondent Jake Tapper is doing his job.

Tapper asked President Obama how he reconciled his claim before ObamaCare passed that reform would lower health care costs with the fact that a new government report—plus, I might add, every news story on the topic—says health care costs are rising.

Good question that; wish the answer had been also. The president replied, “I said at the time, it wasn’t going to happen tomorrow, it wasn’t going to happen next year.”

No, Mr. President, that’s not what you said. You claimed repeatedly that by the end of your first term a family health insurance policy would cost $2,500 less.


Obama added, “as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that.” But what you said last March was, “[M]y proposal would bring down the cost of health care for millions—families, businesses, and the federal government.” Unfortunately, Tapper didn’t get to follow up and demand that the president answer the question truthfully, but maybe other journalists will.

Is the health insurance mandate a tax or not? In a lively exchange, ABC’s George Stephanopoulos asked President Obama last fall if the mandate to have health insurance was a tax. “[F]or us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” the president replied. And the legislation concurs; it never refers to the mandate as a tax.

Except that the Obama Justice Department now says it absolutely is a tax. At least it’s making that claim before judges considering the constitutionality of the mandate.

The reason Justice is calling the mandate a tax is Congress has the constitutional authority to levy taxes; it does not have any constitutional authority to tell people they have to buy health insurance.

So if the administration can convince the judges—and eventually the Supreme Court—the mandate is a tax, the mandate may have a better chance of being ruled constitutional.

But it would sure be nice if someone in the media would ask the president, yes or no, whether he still believes the mandate is not a tax. And if it isn’t, why is he letting Justice claim it is? (Catch 22?)

For one thing, some health insurers are dropping out of the traditional health insurance market. Others are dropping some of their current offerings. For example, Wellpoint, Cigna and CoventryOne have decided to stop offering child-only policies because of new rules going into effect this week forcing them to accept any child applicant (separate from a family policy).

There's no such thing as a free lunch. If you're going to require insurers to cover more expensive customers and provide more benefits, it's going to cost more -- and those costs are going to be passed on to customers in the form of higher premiums. When New York implemented many of these same insurance rules in 1983, premiums rose by nearly $500 per policy -- resulting in nearly 500,000 New Yorkers dropping their insurance. (Dropping coverage won't be an option with Obamacare, though.)

Today, the president will almost certainly highlight projections that health-care reform will eventually provide coverage to some 30 million more Americans. He won't note that that's years off -- or that roughly half of those newly insured are merely being dumped into the Medicaid system, with all its problems in access and quality.

You also won't hear much about the fact that the government's own actuaries have now concluded that the health-care law will actually increase health-care spending, contrary to the president's promises before the bill passed. Nor will you hear that outside experts now predict that ObamaCare will cost as much as $2.7 trillion over its first 10 years of actual operation, adding more than $350 billion to the deficit over that period despite massive new taxes.

For example, we've now learned that college students receiving limited-benefit policies via their universities won't be able to keep those. (I guess it's a good thing they'll be able to go back on their parents' plan.) Similarly, at least a million seasonal workers will lose their plans because they fail to meet the government's new benefit requirements.

http://www.heritage.org/Research/Reports/2010/09/Obamacare-Increases-Health-Insurance-Premiums


Individuals who do not have co-payments or deductibles lack “skin in the game” and thus have less incentive to economize on their use of health care services. This results in higher premiums for their health insurance. The CBO concludes that a 10 percent decrease in cost-sharing typically increases health care spending by 1–2 percent.[3]

The average 60-year-old consumes about six times as much health care as the average 20-year-old, but Obamacare mandates that insurers charge the oldest individuals in the risk pool no more than three times the lowest rate. As a result, young individuals will pay much more than the actuarially fair amount for their premiums. Management consulting firm Oliver Wyman estimated that premiums will rise by 45 percent for those age 18–24, 35 percent for those age 25–29, and 26 percent for those age 30–34.[4]

According to an analysis by Wellpoint, a health benefits company, the guarantee issue provisions in Obamacare will be mostly responsible for the rise in premiums.[6] Furthermore, a recent academic paper found that the existence of guarantee issue regulations more than doubled premiums for individual policies and nearly doubled premiums for family policies.[7]

Obamacare is set to reduce the reimbursements doctors and hospitals receive for Medicare. A 2006 Health Affairs piece finds that a 1 percent relative decrease in the average Medicare price is associated with a 0.17 percent increase in the corresponding price paid by privately insured patients.

The study found that cost shifting from Medicare and Medicaid to private payers accounted for 12.3 percent of the total increase in the price of private insurance from 1997 to 2001.[8]
Proponents of Obamacare argue that the individual mandate is the glue that holds the legislation together. Because the mandate was so unpopular, however, Congress gave the IRS limited ability to enforce it. It is unlikely, therefore, that the mandate will be effective at encouraging healthy individuals to purchase coverage and cross-subsidize the premiums for the old and the sick.

According to Oliver Wyman, a weak mandate would cause “the average medical claims of members in the reformed individual market [to] be 50 percent higher than the average in the market today (not including medical inflation). This would translate into premium increases of approximately $1,500 for single coverage and $3,300 for family coverage in today’s dollars.”[11]




Increased Demand for Health Care
The expansion of insurance coverage through Obamacare will increase the amount of health care that previously uninsured people demand. CBO predicts that a major coverage expansion would cause total demand for health care services to increase by 2–5 percent.[12] Oliver Wyman estimates that the average uninsured will use about 20 percent more in health care services than the average individual, which will raise premiums in the individual market.[13]

Gerry Clinchy
09-25-2010, 02:03 AM
Most countries in this world do not have profit driven health insurance industries. They deliver a better product at a lower cost. Examples are Canada, England, France, Germany, Japan ....


You may want to re-check some of this ... UK is having problems with its health care system. Lack of timely care has been a problem for a long time; and more recently denial of care if it can't give at least "x" amount of time of life extension. Lack of timely care has also been a problem in Canada. I'm not up-to-date on France, Germany and Japan.

In all of these countries, those who can pay for care privately get care in a more timely fashion ... or they have the $ to go to another country where they can get care.

There were some articles in the NY Times quite a while ago about how US seniors are finding care in Mexico. Yet other articles also note that indigents (illegal immigrants here to the US) from Mexico don't want to go back home for dialysis because they say that it would be a death sentence.

Many millions are being spent giving free care to illegal immigrants who can't get care in their home countries. As far as I know, Obamacare will not change that. Especially since illegal immigrants will not be able to get subsized coverage ... and there seems to be little effort by the govt to send illegals home. Catch 22?

depittydawg
09-25-2010, 02:27 AM
You may want to re-check some of this ... UK is having problems with its health care system. Lack of timely care has been a problem for a long time; and more recently denial of care if it can't give at least "x" amount of time of life extension. Lack of timely care has also been a problem in Canada. I'm not up-to-date on France, Germany and Japan.

In all of these countries, those who can pay for care privately get care in a more timely fashion ... or they have the $ to go to another country where they can get care.

There were some articles in the NY Times quite a while ago about how US seniors are finding care in Mexico. Yet other articles also note that indigents (illegal immigrants here to the US) from Mexico don't want to go back home for dialysis because they say that it would be a death sentence.

Many millions are being spent giving free care to illegal immigrants who can't get care in their home countries. As far as I know, Obamacare will not change that. Especially since illegal immigrants will not be able to get subsized coverage ... and there seems to be little effort by the govt to send illegals home. Catch 22?

No system is perfect. I'm sure they have problems. And no doubt they will solve their problems So do we. And by the numbers, we pay more, and get less. For 30 years I've paid healthcare premiums. Now, I'm over 50 and no insurance company will sell me a policy. I'm lucky. I have a job with a group plan.
Couple of years ago I was sweating bullets, not for myself, but for my family. I was unemployed and using half my unemployment money to pay for COBRA. At that time it was about 600 a month for my family. Now its well over a thousand.
There is also the fact that the most common cause of bankruptcy in the US is healthcare costs. And more often than not, those going bankrupt have insurance.
People allowed themselves to be duped by the millions the industry threw into (and continue to) a media blitz of mis-information. Here it is in its simplest form.
Heard a testimony from an American living in England. Same job, same company, different country. His paycheck has a deduction for health insurance. According to him, it's about the same as his deduction was here in the US. In England his healthcare deduction goes to the government. In the US it goes to an Insurance Company.
The difference is, when he got sick, broken leg I believe. He had the surgery and all the follow up care. Never spent a dime of his own money. Everything, medications, hospitalization, surgery, physicians services, all of it was 100% covered. Remember, same deduction from his paycheck.
I had a nasty broken leg a few years ago. I also had a very good policy here. I got great treatment. 25K for the surgery, lots of meds, physical therapy, etc. Besides my insurance premiums I also had to fork out several thousand for co-pays, deductibles, medications, etc. In this case, same services, only mine cost me a lot more. Why? So United Healthcare could make their profit. An anecdote to this story is that the year I broke my leg, the CEO of United Healthcare received compensation of about half a billion dollars.

dnf777
09-25-2010, 07:20 AM
I'm afraid you aint seen nothing yet. Those of us dumb enough to still be in the business are just now starting to get emails from our carriers laying the groundwork for major rate increases in the offing due to Obamacare mandates. They can't do this crap for free. My guess is after the first of the year we will see companies withdrawing from the health care industry by either canceling their business or selling it to other companies. In either case the result will be less carriers competing for your business. The remaining companies-mainly The Blues and United Health Care- will hang around awhile hoping for a shot at administering the only game left in town - the government health plan. Me and thousands like me will be out of business not to mention thousands of support people from insurance companies, agencies, state insurance departments, etc who will be jobless. Don't forget the loss of state income in the form of premium taxes. And Dave, you will be a salaried government employee working long hours and being underpaid for your services.

Someone said earlier "Does Obamacare?" No. He doesn't but we had better care or an outcome similar to the one described above will ensue.

Pretty picture regards,

I hear what you're saying. I already am essentially a gov't employee. Over half of my income is derived from medicare or state med-assist...and a few private insurance carriers.....all of whom pattern compensation off medicare rates. Why not just eliminate the middle man? The defense industry seems quite happy indeed with their arrangement. And due to the sheer size and overall dollar amount of the health care industry, its almost on par with the defense industry. There will always be a demand and market for private pay health care and insurance. But to ensure the masses have some form of care, maybe a two-tiered, gov't run health industry would be the way to go. Just a thought.

M&K's Retrievers
09-25-2010, 10:10 AM
The primary purpose of manufacturing is to distribute a product over a large percentage of the population, NOT to make profit. When Profit became the single objective of manufacturing Companies, our costs began to go through the roof and our product rankings began a freefal that continues to this day. Profit in manufacturing is not needed. maximizing Profit for the manufacturing equation adds 30% more cost, and deprives millions of product when they need it.

There I fixed it.

subroc
09-25-2010, 10:33 AM
Call me socialist...


gladly, you are a socialist!

M&K's Retrievers
09-25-2010, 10:49 AM
No system is perfect. I'm sure they have problems. And no doubt they will solve their problems So do we. And by the numbers, we pay more, and get less. For 30 years I've paid healthcare premiums. Now, I'm over 50 and no insurance company will sell me a policy. I'm lucky. I have a job with a group plan.
Couple of years ago I was sweating bullets, not for myself, but for my family. I was unemployed and using half my unemployment money to pay for COBRA. At that time it was about 600 a month for my family. Now its well over a thousand.
There is also the fact that the most common cause of bankruptcy in the US is healthcare costs. And more often than not, those going bankrupt have insurance.
People allowed themselves to be duped by the millions the industry threw into (and continue to) a media blitz of mis-information. Here it is in its simplest form.
Heard a testimony from an American living in England. Same job, same company, different country. His paycheck has a deduction for health insurance. According to him, it's about the same as his deduction was here in the US. In England his healthcare deduction goes to the government. In the US it goes to an Insurance Company.
The difference is, when he got sick, broken leg I believe. He had the surgery and all the follow up care. Never spent a dime of his own money. Everything, medications, hospitalization, surgery, physicians services, all of it was 100% covered. Remember, same deduction from his paycheck.
I had a nasty broken leg a few years ago. I also had a very good policy here. I got great treatment. 25K for the surgery, lots of meds, physical therapy, etc. Besides my insurance premiums I also had to fork out several thousand for co-pays, deductibles, medications, etc. In this case, same services, only mine cost me a lot more. Why? So United Healthcare could make their profit. An anecdote to this story is that the year I broke my leg, the CEO of United Healthcare received compensation of about half a billion dollars.

There are always those who want something for nothing hence your attitude on health care. You will find that you will be getting much less for much more. For you, I think it's funny. For the rest of the country, it blows.

luvmylabs23139
09-25-2010, 11:22 AM
Not at all. The decision on whether or not to a service should be profit or non-profit rests solely on the merit of selecting the most effective method of delivery. Most countries in this world do not have profit driven health insurance industries. They deliver a better product at a lower cost. Examples are Canada, England,?

Screw the british system. They decided my grandmother should die,because it was cost effective. If she had been in the US she probably would have lived.
She was 71 had a heart attack and was given no real treatment, stuck in a ward with muliple beds ansd basically left to die. Those are the facts. This was in the mid 80's. NO CCU, no this no that.

depittydawg
09-25-2010, 11:24 AM
There are always those who want something for nothing hence your attitude on health care. You will find that you will be getting much less for much more. For you, I think it's funny. For the rest of the country, it blows.

Try reading it again. Read slowly. You pay insurance who takes a huge piece for profit and does all they can do deny claims; or you pay government who insures everyone for NO PROFIT. Now, once again, READ IT OUT LOUD. Where does it say you're getting SOMETHING FOR NOTHING??????? Please show me.

depittydawg
09-25-2010, 11:25 AM
Screw the british system. They decided my grandmother should die,because it was cost effective. If she had been in the US she probably would have lived.
She was 71 had a heart attack and was given no real treatment, stuck in a ward with muliple beds ansd basically left to die. Those are the facts. This was in the mid 80's. NO CCU, no this no that.

Fortunately that never happens in America. What are we up to now.. 50 MILLION uninsured!

dnf777
09-25-2010, 11:30 AM
Screw the british system. They decided my grandmother should die,because it was cost effective. If she had been in the US she probably would have lived.
She was 71 had a heart attack and was given no real treatment, stuck in a ward with muliple beds ansd basically left to die. Those are the facts. This was in the mid 80's. NO CCU, no this no that.

And I just saw a lady in her 50s come in with advanced breast cancer, that in a country such as our, NEVER should happen. She didn't have insurance, and didn't want to run up bills, so never went to the doctor. She never got a chance to have a heart attack at 71. She died of a treatable disease, for lack of basic health care.

Subroc: I knew that was coming! ;) And well deserved for my comments, I admit. But what is so bad about some aspects of gov't and society being socialized? We gladly accept a socialist system for our "common defense". Why not for another giant elephant that affects all Americans at one point or another? I'm not asking why you called me a socialist in this regard.....rather, why is that so bad in this case?

road kill
09-25-2010, 11:44 AM
And I just saw a lady in her 50s come in with advanced breast cancer, that in a country such as our, NEVER should happen. She didn't have insurance, and didn't want to run up bills, so never went to the doctor. She never got a chance to have a heart attack at 71. She died of a treatable disease, for lack of basic health care.


I would like some proof of that.

It doesn't pass the smell test.



RK

depittydawg
09-25-2010, 11:53 AM
I hear what you're saying. I already am essentially a gov't employee. Over half of my income is derived from medicare or state med-assist...and a few private insurance carriers.....all of whom pattern compensation off medicare rates. Why not just eliminate the middle man? The defense industry seems quite happy indeed with their arrangement. And due to the sheer size and overall dollar amount of the health care industry, its almost on par with the defense industry. There will always be a demand and market for private pay health care and insurance. But to ensure the masses have some form of care, maybe a two-tiered, gov't run health industry would be the way to go. Just a thought.

There are many things we could try. We know two things to be self evident.
1. What we are doing is too costly and produces bad results to consumers.
2. Any change that is proposed will be met with fierce resistance from the health insurance industries in the interest of protecting their current profit streams.

dnf777
09-25-2010, 11:57 AM
I would like some proof of that.

It doesn't pass the smell test.



RK


Poor choice of words, RK. Advanced and inflammatory breast cancer, once in erodes through the skin, is quite malodorous. The smell is what sometimes forces these women to seek care.

luvmylabs23139
09-25-2010, 12:02 PM
And I just saw a lady in her 50s come in with advanced breast cancer, that in a country such as our, NEVER should happen. She didn't have insurance, and didn't want to run up bills, so never went to the doctor. She never got a chance to have a heart attack at 71. She died of a treatable disease, for lack of basic health care.



Would like like an even better example?
My dad had an accident while in the UK. Long story short, a young retriever jumped on him as he was jumping from the house barge to the shore, knocked him off balance and he ended up getting squished between the barge and the dock, shattering his shoulder.
They "fixed" his shattered shoulder in the UK. When he got home to the US they had to totally redo the job done in the UK.
As for isnurance, he was covered under the UK system because he had paid in for many years. He also had a great US employer policy. Basically he was double insured. He got half ass treatment in the UK compared to the US. They basically had to redo the next week anything that was done in te UK.

dnf777
09-25-2010, 12:05 PM
I would like some proof of that.

It doesn't pass the smell test.



RK

http://caonline.amcancersoc.org/cgi/content/full/58/1/9


Advances in the prevention, early detection, and treatment of cancer have resulted in an almost 14% decrease in the death rates from all cancers combined from 1991 to 2004 in the overall US population, with remarkable declines in mortality for the top 3 causes of cancer death in men (lung, colorectal, and prostate cancer) and 2 of the top 3 cancers in women (breast and colorectal cancer). However, not all segments of the population have benefited equally from this progress, and evidence suggests that some of these differences are related to lack of access to health care. Lack of adequate health insurance appears to be a critical barrier to receipt of appropriate health care services. This article provides an overview of systems of health insurance in the United States, demographic and socioeconomic characteristics associated with health insurance coverage, and economic burdens related to health care among individuals and families.

dnf777
09-25-2010, 12:07 PM
Would like like an even better example?
My dad had an accident while in the UK. Long story short, a young retriever jumped on him as he was jumping from the house barge to the shore, knocked him off balance and he ended up getting squished between the barge and the dock, shattering his shoulder.
They "fixed" his shattered shoulder in the UK. When he got home to the US they had to totally redo the job done in the UK.
As for isnurance, he was covered under the UK system because he had paid in for many years. He also had a great US employer policy. Basically he was double insured. He got half ass treatment in the UK compared to the US. They basically had to redo the next week anything that was done in te UK.

I'm not arguing the quality of care. I know personally that the best doctors in the world are in the US. Its great...for those who have access, no doubt.

luvmylabs23139
09-25-2010, 12:09 PM
http://caonline.amcancersoc.org/cgi/content/full/58/1/9


Advances in the prevention, early detection, and treatment of cancer have resulted in an almost 14% decrease in the death rates from all cancers combined from 1991 to 2004 in the overall US population, with remarkable declines in mortality for the top 3 causes of cancer death in men (lung, colorectal, and prostate cancer) and 2 of the top 3 cancers in women (breast and colorectal cancer). However, not all segments of the population have benefited equally from this progress, and evidence suggests that some of these differences are related to lack of access to health care. Lack of adequate health insurance appears to be a critical barrier to receipt of appropriate health care services. This article provides an overview of systems of health insurance in the United States, demographic and socioeconomic characteristics associated with health insurance coverage, and economic burdens related to health care among individuals and families.

Why should taxpayers pay to extend the life and mooching of the non taxpayers?
Lets see, I pay for them to live longer and as a result STEAL MORE OF MY HARD EARNED MONEY. That makes no sense to me.

M&K's Retrievers
09-25-2010, 12:16 PM
Try reading it again. Read slowly. You pay insurance who takes a huge piece for profit and does all they can do deny claims; or you pay government who insures everyone for NO PROFIT. Now, once again, READ IT OUT LOUD. Where does it say you're getting SOMETHING FOR NOTHING??????? Please show me.

Once again you botch and moan because of some past experience one of your relatives had. When I pointed out what happened and offered some advice , you had no response. And it's not 50 Million uninsured it's 37M of which 20M choose not to buy insurance. The 17M that either can't afford or are uninsurable due to health conditions should indeed be taken care of. Don't foul up the best health care delivery system in the world when you only need to provide for those who can't provide for themselves. As for the 30M that chose not to buy coverage, that's surely their right. Just don't let them into any government sponsored system once they become uninsurable while chosing not to buy coverage. That is a no win situation for insurance companies and a government plan as well.

Perhaps you should stay out of a discussion for which you are ill prepared and quit confusing your opinions for fact.

Unfortunately, there are too many people in this country that believe the bilge your putting out. Fortunately, the majority do not.

Don't quit your day job regards,

dnf777
09-25-2010, 12:17 PM
Why should taxpayers pay to extend the life and mooching of the non taxpayers?
Lets see, I pay for them to live longer and as a result STEAL MORE OF MY HARD EARNED MONEY. That makes no sense to me.

I don't know. Why should I accept what your insurance company offers to pay me for services rendered? Its never what we charge. Why don't docs collect like other professionals do....payment, IN FULL, when services are rendered? Sounds like the medical profession is giving away services at discounted rates to mooching, non-bill-paying people?

Of course, I don't believe that....it was stated to make a point. People always tend to think they do it all on their own, with no help from anyone. I hear all the time people griping about gov't giveaways as I flip to their cover sheet and see they're medical assist pay. They get the same quality care as the paying customers, but just really ironic and hypocritical in the process of accepting THEIR handouts.

Buzz
09-25-2010, 12:58 PM
Would like like an even better example?
My dad had an accident while in the UK. Long story short, a young retriever jumped on him as he was jumping from the house barge to the shore, knocked him off balance and he ended up getting squished between the barge and the dock, shattering his shoulder.
They "fixed" his shattered shoulder in the UK. When he got home to the US they had to totally redo the job done in the UK.
As for isnurance, he was covered under the UK system because he had paid in for many years. He also had a great US employer policy. Basically he was double insured. He got half ass treatment in the UK compared to the US. They basically had to redo the next week anything that was done in te UK.

Nothing like that EVER happens here.:rolleyes::rolleyes:

I have a story that supplies anecdotal evidence, but its a waste of effort.

charly_t
09-25-2010, 01:24 PM
Yeah we have a great country but there are many people who are not asking for a hand-out who can NOT afford health care and are just a little too proud to ask for help. Those people do need help with health care insurance. We do not need to provide it for everyone. I have a friend who is separated from her husband and is not able to work because of her health. She has no health insurance.

depittydawg
09-25-2010, 01:42 PM
Once again you botch and moan because of some past experience one of your relatives had. When I pointed out what happened and offered some advice , you had no response. And it's not 50 Million uninsured it's 37M of which 20M choose not to buy insurance. The 17M that either can't afford or are uninsurable due to health conditions should indeed be taken care of. Don't foul up the best health care delivery system in the world when you only need to provide for those who can't provide for themselves. As for the 30M that chose not to buy coverage, that's surely their right. Just don't let them into any government sponsored system once they become uninsurable while chosing not to buy coverage. That is a no win situation for insurance companies and a government plan as well.

Perhaps you should stay out of a discussion for which you are ill prepared and quit confusing your opinions for fact.

Unfortunately, there are too many people in this country that believe the bilge your putting out. Fortunately, the majority do not.

Don't quit your day job regards,

I guess you need someone to read these post to you MK. You seem to have confused what I wrote with with what was written by Luvmylabs. I didn't mention any relatives experiences on this thread. He did. The rest of your drivel isn't worth much comment. BTW, how about a link to your claim that 20 million Ameircans CHOOSE not to buy health care. Please demonstrate that they were eligible for private healthcare plans, and could aford them. LINK PLEASE.

luvmylabs23139
09-25-2010, 02:43 PM
I guess you need someone to read these post to you MK. You seem to have confused what I wrote with with what was written by Luvmylabs. I didn't mention any relatives experiences on this thread. He did. The rest of your drivel isn't worth much comment. BTW, how about a link to your claim that 20 million Ameircans CHOOSE not to buy health care. Please demonstrate that they were eligible for private healthcare plans, and could aford them. LINK PLEASE.


Dippity,
Some people just can't be bothered to turn in forms. At one point in time I was the HR manager for a company that paid 100% of family medical coverage. We had employees that were not covered simply because they couldn't make the effort to fill out the forms and turn them into HR on time.
Employees haad babies and were to lazy to go to HR, get a form , fill it out, and turn it in within the allowed timeframe of the birth. Add that child to the list of uninsured strickly due to the parent not doing their part. Remember this was 100% employer paid family medical. You can't fix stupid!

luvmylabs23139
09-25-2010, 02:45 PM
I guess you need someone to read these post to you MK. You seem to have confused what I wrote with with what was written by Luvmylabs. I didn't mention any relatives experiences on this thread. He did. The rest of your drivel isn't worth much comment. BTW, how about a link to your claim that 20 million Ameircans CHOOSE not to buy health care. Please demonstrate that they were eligible for private healthcare plans, and could aford them. LINK PLEASE.
Dippity,

MY gripes were about the British system that you praise so highly, not the system in the US:rolleyes:>

M&K's Retrievers
09-25-2010, 02:57 PM
I guess you need someone to read these post to you MK. You seem to have confused what I wrote with with what was written by Luvmylabs. I didn't mention any relatives experiences on this thread.

It was in one of your previous rants on another thread. Your memory is either short or selective.

Buzz
09-25-2010, 03:02 PM
Dippity,
Some people just can't be bothered to turn in forms. At one point in time I was the HR manager for a company that paid 100% of family medical coverage. We had employees that were not covered simply because they couldn't make the effort to fill out the forms and turn them into HR on time.
Employees haad babies and were to lazy to go to HR, get a form , fill it out, and turn it in within the allowed timeframe of the birth. Add that child to the list of uninsured strickly due to the parent not doing their part. Remember this was 100% employer paid family medical. You can't fix stupid!

If I was in management there, I would have taken disciplinary action against the employees who failed to get their paperwork in on time, and against employees in HR for neglecting their responsibility to get employees to file their paperwork correctly and on time.

luvmylabs23139
09-25-2010, 03:26 PM
If I was in management there, I would have taken disciplinary action against the employees who failed to get their paperwork in on time, and against employees in HR for neglecting their responsibility to get employees to file their paperwork correctly and on time.

Sure blame HR for people being stupid. You can only send so many nicely phrased reminder emails to the 2nd highest ranking executive in the company!:rolleyes:
We had check off lists during open enrollment and did follow up when it got near the deadline.
Often Hr was not aware if a guy's wife had a baby. If we didn't know about it how could we follow up.
Disiplinary action? simple not tickie no insurance. People need to take responsibility. It is not a babysitting service.

depittydawg
09-25-2010, 03:42 PM
It was in one of your previous rants on another thread. Your memory is either short or selective.

Oh. You mean the "rant" conerning my nephew who needs a liver. He still needs it. He's on the waiting list. His family will fork out the quarter million on debt if one comes availavble. The insurance company will only pay half. That was only after they took them to arbitration. Their first response was they would have nothing of the procedure. Called it pre-existing I believe. I guess the procedure cuts to deep into their profits. You're an expert on health insurance. With the new changes to the industry, can they still claim pre-existing conditions? He is now 18 year old and is still under his parents policy.

Say a prayer for him and his family.

depittydawg
09-25-2010, 03:49 PM
Dippity,
Some people just can't be bothered to turn in forms. At one point in time I was the HR manager for a company that paid 100% of family medical coverage. We had employees that were not covered simply because they couldn't make the effort to fill out the forms and turn them into HR on time.
Employees haad babies and were to lazy to go to HR, get a form , fill it out, and turn it in within the allowed timeframe of the birth. Add that child to the list of uninsured strickly due to the parent not doing their part. Remember this was 100% employer paid family medical. You can't fix stupid!

Unfortunately you can't. I had some recent similar experiences. New employees were given their orientation and all the forms that required completion. Several had to be followed up with continually to get the documentation done. Most men had to take it home for their wives to complete. Then there would be something missing, or they would leave it in their locker. I agree. You can't fix stupid. And yes, it costs us a heck of a lot of money and time, at every turn.

M&K's Retrievers
09-25-2010, 05:33 PM
Oh. You mean the "rant" conerning my nephew who needs a liver. He still needs it. He's on the waiting list. His family will fork out the quarter million on debt if one comes availavble. The insurance company will only pay half. That was only after they took them to arbitration. Their first response was they would have nothing of the procedure. Called it pre-existing I believe. I guess the procedure cuts to deep into their profits. You're an expert on health insurance. With the new changes to the industry, can they still claim pre-existing conditions? He is now 18 year old and is still under his parents policy.

Say a prayer for him and his family.

As I guessed back then it apparently is a preexisting condition and it sounds like the carrier is willing to pay some rather than incur further legal expenses in court only to lose in the jury trial then win on appeal. Looks to me like your lucky. Both parties agreed to settle. Most carriers would fight it to the end when they are right.

It's a shame that he got caught up in a preexisting condition but that language is in policies to protect the carriers from adverse selection i.e. folks buying insurance after something is diagnosed. If you were right and the evil insurance company is wrong, why did you settle?

Prayer said....

M&K's Retrievers
09-25-2010, 05:42 PM
, can they still claim pre-existing conditions?


They never have when a group or individual moves from one company to another. Individuals get credit for the time they were insured by the prior carrier. Prex applies to new applicants with no prior coverage. Under Obamacare , carriers will lose this protection. This will be reflected in everyone's rates as will the other mandates OC requires.

Employee Benefits 101 is over regards,

dnf777
09-25-2010, 06:09 PM
They never have when a group or individual moves from one company to another. Individuals get credit for the time they were insured by the prior carrier. Prex applies to new applicants with no prior coverage. Under Obamacare , carriers will lose this protection. This will be reflected in everyone's rates as will the other mandates OC requires.

Employee Benefits 101 is over regards,

That is contrary to numerous experiences I have dealt with in both patients and family members. I know of several retirees who lost their company provided coverage, and cannot find anything with their diabetes, pacemakers, and renal failure.

Having said that, unless there is universal coverage mandated, I do not see how PREX can be protected for the very reason you mentioned. Just like buying car insurance right after you get in a wreck.

Gerry Clinchy
09-25-2010, 06:42 PM
Originally Posted by depittydawg http://www.retrievertraining.net/forums/images/buttons/viewpost.gif (http://www.retrievertraining.net/forums/showthread.php?p=681115#post681115)
You pay insurance who takes a huge piece for profit and does all they can do deny claims; or you pay government who insures everyone for NO PROFIT. Now, once again, READ IT OUT LOUD. Where does it say you're getting SOMETHING FOR NOTHING??????? Please show me.


Why is "profit" a dirty word? Are we really sure that in a govt-run plan there is no waste that could equal the "profit" of private insurors? Afterall, govt employees do get a great deal on their pensions (part of the cost that goes into a govt plan).

Bill Gates created new wealth ... and became rich. He also provided a lot of jobs and health insurance for the workers at Microsoft. What kind of lasting/growing wealth has a govt program ever created? Oops ... forgot Gore invented the Internet :-)

Presumably, "the rich" get the same plan as everyone else in the UK & Canada? But if the best practitioner for a given health problem is not part of the govt program, the rich can go wherever they want to get the care they need.

To distribute existing wealth, and not create additional wealth, everybody has to get a smaller piece of the pie. The only case I can point to where that wasn't the case was in those loaves and fishes a couple of thousand years ago (and there are some on the forum who would not subscribe to that actually occurring anyhow).

Obamacare will NOT include our Congressman. Not sure about the rest of govt employees. We already know that Fed employees aren't part of SS, and that exemption can also apply to other govt entities (like states, counties, cities).

How many millions (billions) could be saved by not allowing Congresspeople to retire on full pay after serving only one term (2, 6 or 8 years)? We could insure a lot of presently uninsured for those dollars.

depittydawg
09-25-2010, 06:43 PM
As I guessed back then it apparently is a preexisting condition and it sounds like the carrier is willing to pay some rather than incur further legal expenses in court only to lose in the jury trial then win on appeal. Looks to me like your lucky. Both parties agreed to settle. Most carriers would fight it to the end when they are right.

It's a shame that he got caught up in a preexisting condition but that language is in policies to protect the carriers from adverse selection i.e. folks buying insurance after something is diagnosed. If you were right and the evil insurance company is wrong, why did you settle?

Prayer said....

Its not my case. I don't know all the details. I'm sure a long drawn out legal battle was about the last thing they wanted. Hopefully a liver becomes available for the young man. It's a long waiting list.

depittydawg
09-25-2010, 06:52 PM
Why is "profit" a dirty word? Are we really sure that in a govt-run plan there is no waste that could equal the "profit" of private insurors? Afterall, govt employees do get a great deal on their pensions (part of the cost that goes into a govt plan).

Bill Gates created new wealth ... and became rich. He also provided a lot of jobs and health insurance for the workers at Microsoft. What kind of lasting/growing wealth has a govt program ever created? Oops ... forgot Gore invented the Internet :-)

Presumably, "the rich" get the same plan as everyone else in the UK & Canada? But if the best practitioner for a given health problem is not part of the govt program, the rich can go wherever they want to get the care they need.

To distribute existing wealth, and not create additional wealth, everybody has to get a smaller piece of the pie. The only case I can point to where that wasn't the case was in those loaves and fishes a couple of thousand years ago (and there are some on the forum who would not subscribe to that actually occurring anyhow).

Obamacare will NOT include our Congressman. Not sure about the rest of govt employees. We already know that Fed employees aren't part of SS, and that exemption can also apply to other govt entities (like states, counties, cities).

How many millions (billions) could be saved by not allowing Congresspeople to retire on full pay after serving only one term (2, 6 or 8 years)? We could insure a lot of presently uninsured for those dollars.

I don't think profit is a dirty word. I do think when the main objective of a health insurance company is profit and not delivering healthcare, it creates a very bad situation for consumers. i.e. the mess we have today. For those of you who are experts on this, the US used to have a pretty good system of private insurers, mostly public hospitals and private providers providing adequate healthcare and making some profit in the process. What happened to it?

If we could somehow turn the clock back about 30 or 40 years our Private Healthcare system would be very acceptable to me, and I'm sure most Americans. As a kid I don't remember my parents ever discussing pre-existing conditions, hi cost of medicine, premiums that matched their house payment, etc. What happened to our Private Insurance Industry? How did it get so screwed up?

luvmylabs23139
09-25-2010, 07:29 PM
If we could somehow turn the clock back about 30 or 40 years our Private Healthcare system would be very acceptable to me, and I'm sure most Americans. As a kid I don't remember my parents ever discussing pre-existing conditions, hi cost of medicine, premiums that matched their house payment, etc. What happened to our Private Insurance Industry? How did it get so screwed up?

Back then almost every insurance plan was an 80/20 with a deductable that had to be met before anything was covered. People expected to pay the doctor when they went. In many ways the introduction of PPO's and HMO's directly influenced the changes. People no longer considered whether or not they actually needed to go to the doctor. Oh, it will just cost me $10 so I'll go see doc for the sniffles.

YardleyLabs
09-25-2010, 07:41 PM
The reality is that there is no "free market" capitalism in the delivery of health care now, and the providers of services are the ones who desire it least. Free market economics works wonderfully in "regulating" production and consumption to balance consumer desires against the costs of producing the goods they want and the abilities of consumers to pay. No centrally planned process has ever been as effective as the decentralized decision making of buyers and sellers. However, the market mechanism is only effective when a true market exists. This involves several conditions:
Buyers and sellers are competently informed about the nature of the goods involved, the costs of production, and the availability and pricing of competing products.
There is real competition among both buyers and sellers. That is, no markets are dominated by a single or small group of providers, and no buyers dominate purchases.
Society at large has no stake in whether the goods/services are purchased or not. That is, from a social perspective we are indifferent to the outcomes of the transactions and are not concerned with the impact of these transactions on either the buyers or sellers.
The decision making agents are actually the beneficiaries of the decisions made. That is, those making product and sales decisions are the ones that benefit or suffer from the consequences of their decisions and those making purchase decisions are likewise the ones who pay for the goods and benefit or lose from the purchase or failure to purchase.Few goods fit perfectly into this competitive model. For example, to the extent that society passes laws requiring that people wear clothes, the government is interfering in the decisions of individuals on whether or not to pay the price. However, the free market process is pretty effective as long as condition remain relatively close to those required for an effective market.

Unfortunately, health care doesn't even come close. As a consequence, the "production" of services and the cost of those services is many times greater than it would have been in the absence of those distortions. We have heard complaints about the death or threatened death of people who have failed to receive potentially life saving treatment because the cost was not paid by a third party -- the insurance company or a national health service. However, those services might well have been available had the people been able and wiling to pay the cost themselves. In fact, if you took away the Medicare and Medicaid systems, the range of life saving health services available today would simply not be there. Medical transplants did not become readily available until third parties began paying the bills -- few individuals were willing and able to pay the costs themselves, and the total amounts that the wealthy pad were not enough rto support development of the technologies. Take away Medicare and Medicaid reimbursement of prescription drugs and 30-40% of the funds available to support the pharmaceutical industry would go away as well.

Our health care system, since the 1930's has depended more and more each year on the fact that consumers do not actually pay anything near the full cost of the care they receive. Everybody consuming medical services is benefiting from this structure. However, for reasons that I do not understand, we continue to pretend that only those without coverage or those with public coverage (Medicaid and Medicare) are the free loaders.

We are almost all the freeloaders. The decision to exclude a small percentage of working people from the population receiving benefits based on the fact that they are not poor enough, or not lcky enough to work for an employer who subsidizes benefits, is completely arbitrary. It is has nothing to do with capitalism -- under capitalism, we would all lose our insurance subsidies and make our own financial arrangements with individual medical providers. Personally, I would be prepared to vote for a return to complete free market capitalism for health care. Eliminate all employer and government subsidies. People can choose to purchase insurance individual and pay the full cost, or they can go without.

No one will need to worry about access to technologies such as transplants or fertility treatments -- there won't be any. Alternatively, we need to accept the reality that subsidies of care distort both prices and volume of services consumed. As a result, other mechanisms will be needed to control costs and profiteering. That is what happens when we interfere with the free market. We then need to interfere some more to counter the bad effects of what we have done.

dnf777
09-25-2010, 08:13 PM
The reality is that there is no "free market" capitalism in the delivery of health care now,

However, for reasons that I do not understand, we continue to pretend that only those without coverage or those with public coverage (Medicaid and Medicare) are the free loaders.


No one will need to worry about access to technologies such as transplants or fertility treatments -- there won't be any.

Agree.

Agree.

Disagree.

If any sort of gov't run system emerges (or evolves, its already got its foot in the door) there most certainly will be a curtailing of services that many consider "necessary medical procedures" that actually aren't. Does anyone think Viagra will be paid for? Should it be? Will reconstructive surgery be paid for? Should it be?

The answer will probably be, some will, some won't. The other answer is that for those with the means and willingness to pay, there will be ALL the services, including transplant and fertility, available to those with cash in hand.

depittydawg
09-25-2010, 08:33 PM
Agree.

Agree.

Disagree.

If any sort of gov't run system emerges (or evolves, its already got its foot in the door) there most certainly will be a curtailing of services that many consider "necessary medical procedures" that actually aren't. Does anyone think Viagra will be paid for? Should it be? Will reconstructive surgery be paid for? Should it be?

The answer will probably be, some will, some won't. The other answer is that for those with the means and willingness to pay, there will be ALL the services, including transplant and fertility, available to those with cash in hand.

I don't know about your plan, but mine doesn't cover viagra. I know. I checked :D:D

luvmylabs23139
09-25-2010, 08:39 PM
I don't know about your plan, but mine doesn't cover viagra. I know. I checked :D:D

The new healthcare plan from the dums will cover Viagra for sex offenders. :rolleyes:

YardleyLabs
09-25-2010, 08:52 PM
Agree.

Agree.

Disagree.

If any sort of gov't run system emerges (or evolves, its already got its foot in the door) there most certainly will be a curtailing of services that many consider "necessary medical procedures" that actually aren't. Does anyone think Viagra will be paid for? Should it be? Will reconstructive surgery be paid for? Should it be?

The answer will probably be, some will, some won't. The other answer is that for those with the means and willingness to pay, there will be ALL the services, including transplant and fertility, available to those with cash in hand.
My comment about some technologies not being available was as a by-product of my hypothetical scenario if all public and employer subsidies for medical coverage were eliminated. Given that approximately 90% of all health care costs are now paid by employers and/or the government, and only 10% (according to Federal statistics) is paid by individuals, there is already rationing by bureaucrats and that will continue.

Gerry Clinchy
09-25-2010, 09:21 PM
Would it make any sense for Obamacare to cover fertility stuff for those whose health insurance costs are being subsidized? Or on Medicaid programs? Seems like if you can't pay for the cost of health insurance, and you already have at least one child, it's a losing proposition to provide fertility treatments in such a situation.

There would seem no reason to provide fertility treatment costs to anyone ... it's not a matter of life and death if a couple doesn't have a child. Taking care of children already born & in need of health care seems more important.

dnf777
09-25-2010, 10:05 PM
My comment about some technologies not being available was as a by-product of my hypothetical scenario if all public and employer subsidies for medical coverage were eliminated. Given that approximately 90% of all health care costs are now paid by employers and/or the government, and only 10% (according to Federal statistics) is paid by individuals, there is already rationing by bureaucrats and that will continue.

Oh absolutely! I used to scream when tea-partiers would threaten that democrats will "ration your health care". Unless there's enough of something to go around and everyone gets as much as they want, there is already rationing. To what degree is the question.

With Obama's healthcare plan being partially implemented last week, our hospital beefed up security out of fears that the "death squads" were being deployed. We had extra security posted at all patient rooms that contained "grandmas", since they have been rumored to be at the top of the hit list. So far, no sightings. Do they always wear black with dark sunglasses? :cool:

YardleyLabs
09-25-2010, 10:31 PM
Would it make any sense for Obamacare to cover fertility stuff for those whose health insurance costs are being subsidized? Or on Medicaid programs? Seems like if you can't pay for the cost of health insurance, and you already have at least one child, it's a losing proposition to provide fertility treatments in such a situation.

There would seem no reason to provide fertility treatment costs to anyone ... it's not a matter of life and death if a couple doesn't have a child. Taking care of children already born & in need of health care seems more important.
I don't think so and terminated coverage for fertility treatments under my company's health plan after paying out some pretty large claims for the combination of fertility treatment and then extraordinary costs for complex, multi child pregnancies that resulted. However, most employer sponsored plans seems to provide such coverage.

M&K's Retrievers
09-26-2010, 02:15 AM
I don't think profit is a dirty word. I do think when the main objective of a health insurance company is profit and not delivering healthcare, it creates a very bad situation for consumers. i.e. the mess we have today. For those of you who are experts on this, the US used to have a pretty good system of private insurers, mostly public hospitals and private providers providing adequate healthcare and making some profit in the process. What happened to it?

If we could somehow turn the clock back about 30 or 40 years our Private Healthcare system would be very acceptable to me, and I'm sure most Americans. As a kid I don't remember my parents ever discussing pre-existing conditions, hi cost of medicine, premiums that matched their house payment, etc. What happened to our Private Insurance Industry? How did it get so screwed up?

Insurance companies do not deliver health care. They reimburse insureds or their providers for covered expenses incurred while insured.

What happened to it? How did it get so screwed up? Government mandates which required coverage for preventative benefits, routine checkups, normal maternity, invetro fertilization, abortions , drug abuse and alcoholism and other self inflicted injuries, co-pays for office visits and prescription drugs. Insurance is for protecting individuals against catastrophic losses, not routine medical costs. These mandates have increased the cost of insurance. Add to it the requirement that insurance companies can't protect themselves with underwriting and prex limitations. Did I forget to mention the cost of litigation, punitive damage awards, doctors malpractice insurance. Oh, then there are PPO networks, mandatory second opinions, covering kids until they have gray hair.

Class closed regards,

M&K's Retrievers
09-26-2010, 02:16 AM
Back then almost every insurance plan was an 80/20 with a deductable that had to be met before anything was covered. People expected to pay the doctor when they went. In many ways the introduction of PPO's and HMO's directly influenced the changes. People no longer considered whether or not they actually needed to go to the doctor. Oh, it will just cost me $10 so I'll go see doc for the sniffles.

Womb to tomb coverage. We can't afford it no more than we can afford the rest of the Dem's Socialist programs.

road kill
09-26-2010, 07:27 AM
Quote:
Originally Posted by dnf777
And I just saw a lady in her 50s come in with advanced breast cancer, that in a country such as our, NEVER should happen. She didn't have insurance, and didn't want to run up bills, so never went to the doctor. She never got a chance to have a heart attack at 71. She died of a treatable disease, for lack of basic health care.

Posted by road kill:
I would like some proof of that.

It doesn't pass the smell test.



RK


YOUR ANSWER:




http://caonline.amcancersoc.org/cgi/content/full/58/1/9


Advances in the prevention, early detection, and treatment of cancer have resulted in an almost 14% decrease in the death rates from all cancers combined from 1991 to 2004 in the overall US population, with remarkable declines in mortality for the top 3 causes of cancer death in men (lung, colorectal, and prostate cancer) and 2 of the top 3 cancers in women (breast and colorectal cancer). However, not all segments of the population have benefited equally from this progress, and evidence suggests that some of these differences are related to lack of access to health care. Lack of adequate health insurance appears to be a critical barrier to receipt of appropriate health care services. This article provides an overview of systems of health insurance in the United States, demographic and socioeconomic characteristics associated with health insurance coverage, and economic burdens related to health care among individuals and families. My challenge is that you claim you know someone and just saw her as a patient.

Baloney, you can not support that personal claim.
Your link has nothing to do with a 50 year old woman you claim you saw.


Prove it, not some made up anecdote.:cool:


RK

dnf777
09-26-2010, 08:19 AM
YOUR ANSWER:



My challenge is that you claim you know someone and just saw her as a patient.

Baloney, you can not support that personal claim.
Your link has nothing to do with a 50 year old woman you claim you saw.


Prove it, not some made up anecdote.:cool:


RK

Even a fifth grader knows I can't divulge names or identity. Where have you been? And you know I can't, so you will now counter and take advantage of that I suppose. I don't expect you to know or understand what goes on in certain realms.

Seeing a patient with advanced, neglected disease is not uncommon. At least not as uncommon as it should be in the USA.

Short of violating HIPPA laws, I showed you a study that describes exactly what I'm talking about. Do you think CA is a liberal propaganda tool that just fabricated the entire premise?

I think you're just being silly. Normally you're better than this.

road kill
09-26-2010, 08:30 AM
Even a fifth grader knows I can't divulge names or identity. Where have you been? And you know I can't, so you will now counter and take advantage of that I suppose. I don't expect you to know or understand what goes on in certain realms.

Seeing a patient with advanced, neglected disease is not uncommon. At least not as uncommon as it should be in the USA.

Short of violating HIPPA laws, I showed you a study that describes exactly what I'm talking about. Do you think CA is a liberal propaganda tool that just fabricated the entire premise?

I think you're just being silly. Normally you're better than this.
Yeah, well this "5th Grader" just exposed you again.
You have a female patient with undiagnosed breast cancer who passed and you can mention that, but no facts to support it, because even though she was noones patient the Dr. Patient confidentiality exists.
You should get your fabrications straight, they are a little mixed up.
You fabricated (not CA, a well known liberal propaganda tool) a situation, not thinking anyone would question it, to use as a liberal propaganda tool
.
I don't have to be better than this to show what you are.:rolleyes:


You are full of it!!


RK

Gerry Clinchy
09-26-2010, 08:48 AM
I don't think so and terminated coverage for fertility treatments under my company's health plan after paying out some pretty large claims for the combination of fertility treatment and then extraordinary costs for complex, multi child pregnancies that resulted. However, most employer sponsored plans seems to provide such coverage.

I think that this points to an issue that we overlook.

As Mike points out, insurance should be for the unexpected, catastrophic costs. That's exactly why you have a 'deductible" on your car insurance.

I'm not exactly sure when health insurance began, but since the 1930s a lot has changed in the world of medicine. Who dreamed of an organ transplant in the 1930s?

The medical professionals who devised things like transplants may have been motivated by a "challenge" or by an altruistic desire to improve or extend someone's life. Providing that new technology is expensive ... new training techniques, new equipment, etc. Which person would say, "No, it's too expensive, so I won't do it,"?

Are the equipment manufacturers, doctors, and hospitals expected to provide the services & products with no "profit"? What about the compensation, pensions, and health care of their employees? Profits also go toward providing new research and advancements in care. Should doctors only be compensated to the level that provides for their "basic" needs ... or should their unique skills be compensated in recognition that not everybody could have the talent & be willing to invest the time and effort it takes to become a brain surgeon? (etc)




I do think when the main objective of a health insurance company is profit and not delivering healthcare,


We have mutated into thinking that health insurance should provide for EVERY medical situation. Why shouldn't we expect to pay $60 for an office visit for a non-recurring problem?

Doctors and farmers have the same needs and aspirations as the rest of us ... a home; some amenities; send kids to college; be able to retire some day. (Medical care and food, basic needs). I think that the majority of doctors try to do their best for their patients, and put in long hours, and have levels of stress that the rest of us may not be able to imagine. Doctors are usually well compensated, but I have no doubt that many of them still give away a fair amount of care.

dnf777
09-26-2010, 09:29 AM
Yeah, well this "5th Grader" just exposed you again.
You have a female patient with undiagnosed breast cancer who passed and you can mention that, but no facts to support it, because even though she was noones patient the Dr. Patient confidentiality exists.
You should get your fabrications straight, they are a little mixed up.
You fabricated (not CA, a well known liberal propaganda tool) a situation, not thinking anyone would question it, to use as a liberal propaganda tool
.
I don't have to be better than this to show what you are.:rolleyes:


You are full of it!!


RK

RK,
You're really sounding childish making things up when you have NO IDEA what you're talking about.

First, medical textbooks are FULL of case presentations and even photos, with identifying features blacked out for confidentiality. It is common every day event for docs to discuss patients and cases in anonymous fashion, so that the disease or situtation may be discussed without breaching confidentiality.

I think you know that, but just want to argue. Do you think I made that up? I showed you an article that deals specifically with lack or delay of care in the poor and uninsured. Surely you don't deny that happens?

Sometimes I just don't get you. You seem hell-bent for an argument some days.

road kill
09-26-2010, 10:17 AM
RK,
You're really sounding childish making things up when you have NO IDEA what you're talking about.

First, medical textbooks are FULL of case presentations and even photos, with identifying features blacked out for confidentiality. It is common every day event for docs to discuss patients and cases in anonymous fashion, so that the disease or situtation may be discussed without breaching confidentiality.

I think you know that, but just want to argue. Do you think I made that up? I showed you an article that deals specifically with lack or delay of care in the poor and uninsured. Surely you don't deny that happens?

Sometimes I just don't get you. You seem hell-bent for an argument some days.

You think, deflect and spin all you want.

You made up a scenario to support your mistaken idea.
Argue all you want, your still full of it.

You should never (and would not have) brought it up due to confidentiality if it were true, you didn't think it thru, and I being one of the few people that actually read your bleeding heart liberal crap called you on it.

You can not prove it is a real life situation you encountered.



RK

depittydawg
09-26-2010, 10:45 AM
Insurance companies do not deliver health care. They reimburse insureds or their providers for covered expenses incurred while insured.

What happened to it? How did it get so screwed up? Government mandates which required coverage for preventative benefits, routine checkups, normal maternity, invetro fertilization, abortions , drug abuse and alcoholism and other self inflicted injuries, co-pays for office visits and prescription drugs. Insurance is for protecting individuals against catastrophic losses, not routine medical costs. These mandates have increased the cost of insurance. Add to it the requirement that insurance companies can't protect themselves with underwriting and prex limitations. Did I forget to mention the cost of litigation, punitive damage awards, doctors malpractice insurance. Oh, then there are PPO networks, mandatory second opinions, covering kids until they have gray hair.

Class closed regards,

I don't recall these mandates being in force until last week. In fact I would argue that two things drove up the cost of medical care.

1st is a lack of government action and regulation of insurance.

2nd is probably medicare. Once the government coffers were opened to cover the costs of the biggest healthcare spenders (the elderly), the cat was out of the bag. Costs have skyrocketed ever since.
I tend to agree with Yardley. I'd be willing to support a complete free market for healthcare. No Government intervention in any form for any thing. Want to see cost plummet. I think that would do it. Also get rid of the AMA. Their stranglehold on the number of physicians that are allowed to practice forces an unbalanced market of supply and demand. There are many things a person can do for themselves that do not require an MD. But because of laws and restrictions we are not allowed to.

I often think of Veterinary Medicine as a role model. In many respects our vet's can deliver extremely good service for a tiny fraction of the cost. Why? I can buy pretty much any drug my animals might need. I can administer it myself. It ain't rocket science. When I'm in doubt I see the Vet and he tells me what to do and a gives me the drugs.

YardleyLabs
09-26-2010, 11:05 AM
You think, deflect and spin all you want.

You made up a scenario to support your mistaken idea.
Argue all you want, your still full of it.

You should never (and would not have) brought it up due to confidentiality if it were true, you didn't think it thru, and I being one of the few people that actually read your bleeding heart liberal crap called you on it.

You can not prove it is a real life situation you encountered.



RK
Confidentiality does not prevent discussion of medical problems, only the identification of the people involved. Lack of health insurance results in delays of treatment on a regular basis resulting directly in more severe illnesses and more deaths. Lack of coverage is generally credited with producing thousands of needless deaths each year. Why is that hard to understand or believe? While providers are required to provide emergency care without regard to ability to pay, they are not required to provide non-emergent care. Chemotherapy an radiation treatment, among other things, are not considered to be emergent care.

M&K's Retrievers
09-26-2010, 11:41 AM
I don't recall these mandates being in force until last week. In fact I would argue that two things drove up the cost of medical care.

1st is a lack of government action and regulation of insurance.

2nd is probably medicare. Once the government coffers were opened to cover the costs of the biggest healthcare spenders (the elderly), the cat was out of the bag. Costs have skyrocketed ever since.
I tend to agree with Yardley. I'd be willing to support a complete free market for healthcare. No Government intervention in any form for any thing. Want to see cost plummet. I think that would do it. Also get rid of the AMA. Their stranglehold on the number of physicians that are allowed to practice forces an unbalanced market of supply and demand. There are many things a person can do for themselves that do not require an MD. But because of laws and restrictions we are not allowed to.

I often think of Veterinary Medicine as a role model. In many respects our vet's can deliver extremely good service for a tiny fraction of the cost. Why? I can buy pretty much any drug my animals might need. I can administer it myself. It ain't rocket science. When I'm in doubt I see the Vet and he tells me what to do and a gives me the drugs.

That shows how little yon know about the topic. Most of those items/mandates mentioned have been around for 15+ years. Many as a result of Clinton's attempts to nationalize medicine which when failed got the ball rolling on the state level.

One of the most dramatic cause for the increase in medical costs are a direct result of state and federal regulation. Add to that new drugs and improved medical procedures and you have a formula for increased costs.

Medicare has indeed increase the costs of delivering health care in the form of paper work and reduction in provider compensation which is passed on to to the under age 65 patients which in turn is passed on to the insurance companies. See how it works?

You want government to help when in fact they are the major contributing factor in increased costs. This is true on health care and anything else they stick their nose in to.

Get it yet? regards,

road kill
09-26-2010, 11:54 AM
Confidentiality does not prevent discussion of medical problems, only the identification of the people involved. Lack of health insurance results in delays of treatment on a regular basis resulting directly in more severe illnesses and more deaths. Lack of coverage is generally credited with producing thousands of needless deaths each year. Why is that hard to understand or believe? While providers are required to provide emergency care without regard to ability to pay, they are not required to provide non-emergent care. Chemotherapy an radiation treatment, among other things, are not considered to be emergent care.

Ahhhhhh.......Big Yardley to the rescue!!!

Nicely played.

Of course his anecdote was about a specific patient, undiagnosed, who recieved no care and passed away as a result.

Not a "General Assesment.":rolleyes:


Raises the question, if she recieved NO treatment or care, then how is she a patient of anyone?

Prudence would have dictated no discussion of this fictitious character.
But he is in it too deep to get out now.






RK

dnf777
09-26-2010, 12:22 PM
Ahhhhhh.......Big Yardley to the rescue!!!

Nicely played.

Of course his anecdote was about a specific patient, undiagnosed, who recieved no care and passed away as a result.

Not a "General Assesment.":rolleyes:


Raises the question, if she recieved NO treatment or care, then how is she a patient of anyone?

Prudence would have dictated no discussion of this fictitious character.
But he is in it too deep to get out now.


RK


You're unbelievable. So you don't think diseases can go undiagnosed until advanced out of lack of preventive or early, timely care????

Just for entertainment purposes, how would you propose I go about proving this situation I relayed in a condifential manner? Secret video tape? You're hilarious!

And what pray-tell to you mean by 'prudence would dictate no discussion of this patient'???? By that reasoning, all medical and surgical textbooks should be burned. All case-reports in medical journals should be forbidden! No identifying info was given. It was relayed in the most generic of terms. Man, you are in way over your head on this one. When you're in a hole..........STOP DIGGING! Care to retract now that you've been shown the light?

I still think you're just yanking my chain. NOBODY is this dense! So have a nice day. Happy hunting if its allowed on Sundays in WI.

road kill
09-26-2010, 12:28 PM
You're unbelievable. So you don't think diseases can go undiagnosed until advanced out of lack of preventive or early, timely care????

Just for entertainment purposes, how would you propose I go about proving this situation I relayed in a condifential manner? Secret video tape? You're hilarious!

And what pray-tell to you mean by 'prudence would dictate no discussion of this patient'???? By that reasoning, all medical and surgical textbooks should be burned. All case-reports in medical journals should be forbidden! No identifying info was given. It was relayed in the most generic of terms. Man, you are in way over your head on this one. When you're in a hole..........STOP DIGGING! Care to retract now that you've been shown the light?

I still think you're just yanking my chain. NOBODY is this dense! So have a nice day. Happy hunting if its allowed on Sundays in WI.
You sited a SPECIFIC case.

I state you made it up.



Of course I know about advanced diagnosis.
Better than you, I'd wager, having lived through it and the nightmare and loss associated.

RK

dnf777
09-26-2010, 01:03 PM
You sited a SPECIFIC case.

I state you made it up.



Of course I know about advanced diagnosis.
Better than you, I'd wager, having lived through it and the nightmare and loss associated.

RK

Fine. I'm not going to compromise principles to satisfy YOU.
Frankly, I don't care what you state. If you're so dense you don't think such a scenario is possible, you're living in a fantasy land.

And please, don't act like you're the ONLY one to suffer a loss. That is absurd. We all have our personal losses, and suffer and bereave in our own ways. Or will you state I'm making that up? Do I need to cut and paste obits to prove to you that someone in my life has passed away?

You have changed. The old RK would not call me a liar for stating something so simple and common as a doc seeing a patient pass away with advanced disease. Do you hear yourself? You're being ridiculous. You may have the last word, but please, say something reasonable.

road kill
09-26-2010, 01:13 PM
Fine. I'm not going to compromise principles to satisfy YOU.
Frankly, I don't care what you state. If you're so dense you don't think such a scenario is possible, you're living in a fantasy land.

And please, don't act like you're the ONLY one to suffer a loss. That is absurd. We all have our personal losses, and suffer and bereave in our own ways. Or will you state I'm making that up? Do I need to cut and paste obits to prove to you that someone in my life has passed away?

You have changed. The old RK would not call me a liar for stating something so simple and common as a doc seeing a patient pass away with advanced disease. Do you hear yourself? You're being ridiculous. You may have the last word, but please, say something reasonable.
The "Old RK" and the one you don't like now have 1 thing in common.

STRAIGHT SHOOTERS, I am afraid you don't know what that is.


RK

2tall
09-26-2010, 01:55 PM
This is too tender a subject with me to let it go like I usually do. Insurance companies only service provided is financing. Their only profit is generated from human suffering. They gamble on how much misery you will suffer be it health, car crash, barn fire or next years crops. When you do suffer, they cut their losses and hang the customer out to dry for the rest.

I have been out of work for 2 years, unable to find anything that provided "benefits" so have been paying over $1,000 a month the entire time for COBRA coverage, without being compensated for a single claim. I spent about $1,000 total in that time for my Dr. bills, few that they were but have not had a check up in over a year because I can not afford it because of the monthly premiums. Because I was traveling, I missed a payment by 5 days. I have been cancelled completely and can not get coverage now. I am SOL, end of story. Tell me how anyone "earned" the approx $24k I paid in premiums, and what have I got to show for it?

The insurance industry is rotten to the core. Sorry to those of you employed in it. But the mafia and gestapo had their employees too. Those that are wealthy or fortunate enough to be employed at a high enough level to receive top benefits will live. The rest will be allowed to perish. Justify that.

YardleyLabs
09-26-2010, 02:55 PM
The "Old RK" and the one you don't like now have 1 thing in common.

STRAIGHT SHOOTERS, I am afraid you don't know what that is.


RK
You may be a "straight shooter", but the bullets seem to be going straight through your brain. The situation described by DNF is one seen on a regular basis by anyone working in hospital emergency rooms -- patients coming in with an emergent condition that could have been treated if seen sooner but is now life threatening. Cancer is particularly insidious because eary detection and treatment are essential. Those who do not receive regular check ups lose. There are many reasons why people do not receive such check ups. However, lack of coverage or high deductibles/copays are among the most common. The situation described is not surprising. What are you trying to gain by calling DNF a liar?

M&K's Retrievers
09-26-2010, 02:58 PM
This is too tender a subject with me to let it go like I usually do. Insurance companies only service provided is financing. Their only profit is generated from human suffering. They gamble on how much misery you will suffer be it health, car crash, barn fire or next years crops. When you do suffer, they cut their losses and hang the customer out to dry for the rest.

I have been out of work for 2 years, unable to find anything that provided "benefits" so have been paying over $1,000 a month the entire time for COBRA coverage, without being compensated for a single claim. I spent about $1,000 total in that time for my Dr. bills, few that they were but have not had a check up in over a year because I can not afford it because of the monthly premiums. Because I was traveling, I missed a payment by 5 days. I have been cancelled completely and can not get coverage now. I am SOL, end of story. Tell me how anyone "earned" the approx $24k I paid in premiums, and what have I got to show for it?

The insurance industry is rotten to the core. Sorry to those of you employed in it. But the mafia and gestapo had their employees too. Those that are wealthy or fortunate enough to be employed at a high enough level to receive top benefits will live. The rest will be allowed to perish. Justify that.

Your first statement is just not true. If you feel as if you were treated unfairly, I suggest you file a written complaint with you state insurance department. They will contact the carrier on your behalf for an explanation.

As far as your late premium payment of 5 days, you are a little misleading. You were given a 31 day grace period in which to pay your premium. You apparently went beyond that by 5 days or 36 days total. You were traveling for over a month? What's unfair about having 31 days to pay your premium?

It looks to me like you should be sore at your prior employer not an entire industry. Your bitterness is clouding your reasoning.

Get a grip regards,

dnf777
09-26-2010, 03:04 PM
This is too tender a subject with me to let it go like I usually do. Insurance companies only service provided is financing. Their only profit is generated from human suffering. They gamble on how much misery you will suffer be it health, car crash, barn fire or next years crops. When you do suffer, they cut their losses and hang the customer out to dry for the rest.

I have been out of work for 2 years, unable to find anything that provided "benefits" so have been paying over $1,000 a month the entire time for COBRA coverage, without being compensated for a single claim. I spent about $1,000 total in that time for my Dr. bills, few that they were but have not had a check up in over a year because I can not afford it because of the monthly premiums. Because I was traveling, I missed a payment by 5 days. I have been cancelled completely and can not get coverage now. I am SOL, end of story. Tell me how anyone "earned" the approx $24k I paid in premiums, and what have I got to show for it?

The insurance industry is rotten to the core. Sorry to those of you employed in it. But the mafia and gestapo had their employees too. Those that are wealthy or fortunate enough to be employed at a high enough level to receive top benefits will live. The rest will be allowed to perish. Justify that.

I'm very sorry to hear of your situation. Hopefully you will not also be called a liar. You are not alone. I wish we could just as easily punish the insurance carriers when they take more than 30 days to pay bills on behalf of their insured patients. They have no problem at all delaying payments, and expect us to thank them for it!

road kill
09-26-2010, 03:06 PM
I'm very sorry to hear of your situation. Hopefully you will not also be called a liar. You are not alone. I wish we could just as easily punish the insurance carriers when they take more than 30 days to pay bills on behalf of their insured patients. They have no problem at all delaying payments, and expect us to thank them for it!
The difference is, she didn't make her story up, you did!!


RK

M&K's Retrievers
09-26-2010, 03:09 PM
I'm very sorry to hear of your situation. Hopefully you will not also be called a liar. You are not alone. I wish we could just as easily punish the insurance carriers when they take more than 30 days to pay bills on behalf of their insured patients. They have no problem at all delaying payments, and expect us to thank them for it!

Exactly how many days should people be allowed to pay their premium? Until they have a claim?:rolleyes:

2tall
09-26-2010, 03:10 PM
M&K, I assume you are employed by the insurance industry. We have been traveling for a lot longer than a month, and our premiums were mailed timely via certified mail every time but once. We sent them certified because we knew that ANY excuse what so ever would be used to cease coverage. It was only 5 days. My entire purpose in posting is that the system is rotten to the core and there is no intent on the insurance companies' part but to make extreme profit off of a system that has fed into their hands. Human suffering should not be a basis for profit. Dr.'s earn their fees every day and deserve what they get compensated. A business that contributes nothing but another layer of potential to skim from misfortune is running our health care right now. Ok, I'm back outta here now. I've know for a long time it is dangerous to get involved here. Too much self righteousness and semantics.

YardleyLabs
09-26-2010, 03:18 PM
The difference is, she didn't make her story up, you did!!


RK
By your own yardstick, you are proving yourself a liar unless you have concrete evidence to prove your charge. Liar, liar, pats on fire. There, now we can all feel better. That makes you anything but a "straight shooter."Maybe just more of a "shooter".

YardleyLabs
09-26-2010, 03:30 PM
M&K, I assume you are employed by the insurance industry. We have been traveling for a lot longer than a month, and our premiums were mailed timely via certified mail every time but once. We sent them certified because we knew that ANY excuse what so ever would be used to cease coverage. It was only 5 days. My entire purpose in posting is that the system is rotten to the core and there is no intent on the insurance companies' part but to make extreme profit off of a system that has fed into their hands. Human suffering should not be a basis for profit. Dr.'s earn their fees every day and deserve what they get compensated. A business that contributes nothing but another layer of potential to skim from misfortune is running our health care right now. Ok, I'm back outta here now. I've know for a long time it is dangerous to get involved here. Too much self righteousness and semantics.
Carol,

I feel your pain. However, to be fair, the particular problem you are describing has more to do with your former employer and the COBRA law than with the insurance company. Under COBRA, your former employer is actually liable for your insurance premiums and must pay them at the beginning of the month. The payment you make at the end of the month is actually reimbursing the employer for the amount they already paid on your behalf. When your check is not received, they must either cancel your coverage or pay an additional month of premium. In my company, we used to make efforts to contact those who failed to pay. As a consequence, I often ended up paying up to 2-3 months of premiums for which I never received repayment. I finally instructed my staff to simply process cancellations automatically if payment was not received on the day it was due.

You might want to check to see if you can buy insurance through a professional association. I don't know if there is a writer's guild with an association plan. Otherwise, your husband may be able to join the Association of Computer Machinery (http://www.acm.org/) which at least used to have a good association plan with reasonable premiums.

M&K's Retrievers
09-26-2010, 03:35 PM
M&K, I assume you are employed by the insurance industry. We have been traveling for a lot longer than a month, and our premiums were mailed timely via certified mail every time but once. We sent them certified because we knew that ANY excuse what so ever would be used to cease coverage. It was only 5 days. My entire purpose in posting is that the system is rotten to the core and there is no intent on the insurance companies' part but to make extreme profit off of a system that has fed into their hands. Human suffering should not be a basis for profit. Dr.'s earn their fees every day and deserve what they get compensated. A business that contributes nothing but another layer of potential to skim from misfortune is running our health care right now. Ok, I'm back outta here now. I've know for a long time it is dangerous to get involved here. Too much self righteousness and semantics.

Again, if you were 5 days late that is 5 days after the 31 day grace period or 36 days. How long should you have? If you feel you were wronged, why don't you contact your insurance department instead of bellyaching about it. They will help you if you were treated unfairly.

M&K's Retrievers
09-26-2010, 03:52 PM
Carol,

I feel your pain. However, to be fair, the particular problem you are describing has more to do with your former employer and the COBRA law than with the insurance company. Under COBRA, your former employer is actually liable for your insurance premiums and must pay them at the beginning of the month. The payment you make at the end of the month is actually reimbursing the employer for the amount they already paid on your behalf. When your check is not received, they must either cancel your coverage or pay an additional month of premium. In my company, we used to make efforts to contact those who failed to pay. As a consequence, I often ended up paying up to 2-3 months of premiums for which I never received repayment. I finally instructed my staff to simply process cancellations automatically if payment was not received on the day it was due.

You might want to check to see if you can buy insurance through a professional association. I don't know if there is a writer's guild with an association plan. Otherwise, your husband may be able to join the Association of Computer Machinery (http://www.acm.org/) which at least used to have a good association plan with reasonable premiums.

Jeff, that is not correct. The employer bills, collects and remits the premium for ex employees but is not liable for the premium if the ex employee does not pay. Many employers do like you did and front the premium and wind up eating one or two months they can't collect.

road kill
09-26-2010, 03:59 PM
By your own yardstick, you are proving yourself a liar unless you have concrete evidence to prove your charge. Liar, liar, pats on fire. There, now we can all feel better. That makes you anything but a "straight shooter."Maybe just more of a "shooter".

Big Yardley rides to the rescue.

Oh, and name calling, it's who you are, it's what you do.

Odd for an intellectual elitest.
(not really)

You see, you two guys have a specific style.
You bob & weave and trick those less able to respond into losing their way and name calling.
Yet you have just fallin victim to your own tactics.

YOU call me a LAR....I win!!!:D

I have not lied about anything.

BTW--I'd rather be a "shooter" than a watcher big fella!!:D


RK

dnf777
09-26-2010, 04:23 PM
By your own yardstick, you are proving yourself a liar unless you have concrete evidence to prove your charge. Liar, liar, pats on fire. There, now we can all feel better. That makes you anything but a "straight shooter."Maybe just more of a "shooter".

To comply with Chris' request for civility, rather than engage in a name calling battle with a frustrated person (hope that's not name calling), I will now have to unfortunately add another to the ignore list. I really hate this. This person used to be a voice of reason and civility, but now is one of most offensive in that regard.

2tall,
Be careful, avoid accidents, and stay healthy. In the meantime, there may be some state offered catastrophic policies available to avoid major medical expenses in case of an accident or illness. I know Pa has a cat-fund, I would think other states do as well. I wish you the best. You were right on when you mention staying away from here, as it has indeed become very malicious.

YardleyLabs
09-26-2010, 04:28 PM
Big Yardley rides to the rescue.

Oh, and name calling, it's who you are, it's what you do.

Odd for an intellectual elitest.
(not really)

You see, you two guys have a specific style.
You bob & weave and trick those less able to respond into losing their way and name calling.
Yet you have just fallin victim to your own tactics.

YOU call me a LAR....I win!!!:D

I have not lied about anything.

BTW--I'd rather be a "shooter" than a watcher big fella!!:D


RK
You already called DNF a liar and by that standard also, you lose. No one ever called you a "LAR". Also, you called yourself a straight shooter. How does being called simply a "shooter" become an exercise in name calling. Finally, the only one bobbing (or maybe boobing or bobbling) and weaving has been you. A man told you something that he observed personally and you called him a liar without presenting any basis whatsoever for your statement.

From a substantive perspective, the facts of the situation described are actually irrelevant. Similar things happen all the time, which was the point of the article that was referenced. You then attacked DNF for violating medical ethics by citing (not "siting" as you wrote) the specific circumstances of the story. When it was pointed out that you were incorrect (what a surprise) and that medical ethics were not at issue as long as the patient was not identified, you basically said that DNF was a liar because he could not prove the event happened as described and implied that the woman was not protected by confidentiality laws since she was no one's patient (another error on your part).

All that looks like a lot of bobbing and weaving but also walks you into having called a man a liar with no proof whatsoever. By your own definition that makes you a liar since you can't prove your assertion. More importantly, it suggests that you lack basic lack of personal ethics.

With all your bobbing and weaving, you may fly like a butterfly, but you certainly don't sting like a bee -- more like an overripe banana.:rolleyes:

depittydawg
09-26-2010, 04:54 PM
That shows how little yon know about the topic. Most of those items/mandates mentioned have been around for 15+ years. Many as a result of Clinton's attempts to nationalize medicine which when failed got the ball rolling on the state level.

One of the most dramatic cause for the increase in medical costs are a direct result of state and federal regulation. Add to that new drugs and improved medical procedures and you have a formula for increased costs.

Medicare has indeed increase the costs of delivering health care in the form of paper work and reduction in provider compensation which is passed on to to the under age 65 patients which in turn is passed on to the insurance companies. See how it works?

You want government to help when in fact they are the major contributing factor in increased costs. This is true on health care and anything else they stick their nose in to.

Get it yet? regards,

So you are saying that pre-existing conditions were a creation of the Federal Government? How about Co-Pays? Which party gave us Co-Pays. How about Maximum benefits? Did the federal government design a system where the CEO's of Insurance companies make more money than anybody else in the healthcare industry? Keep on spinning bud. Is there anything you don't blame the government for?

BTW, a link please showing the restrictions put on insurance companies during the Clinton administration that you refer to. I looked for some and couldn't find any. In fact all I found was what I remember, a complete defeat of healthcare reform under the Clinton Presidency. Sorry, can't take your word for it. You need to show us the data.

depittydawg
09-26-2010, 05:02 PM
This is too tender a subject with me to let it go like I usually do. Insurance companies only service provided is financing. Their only profit is generated from human suffering. They gamble on how much misery you will suffer be it health, car crash, barn fire or next years crops. When you do suffer, they cut their losses and hang the customer out to dry for the rest.

I have been out of work for 2 years, unable to find anything that provided "benefits" so have been paying over $1,000 a month the entire time for COBRA coverage, without being compensated for a single claim. I spent about $1,000 total in that time for my Dr. bills, few that they were but have not had a check up in over a year because I can not afford it because of the monthly premiums. Because I was traveling, I missed a payment by 5 days. I have been cancelled completely and can not get coverage now. I am SOL, end of story. Tell me how anyone "earned" the approx $24k I paid in premiums, and what have I got to show for it?

The insurance industry is rotten to the core. Sorry to those of you employed in it. But the mafia and gestapo had their employees too. Those that are wealthy or fortunate enough to be employed at a high enough level to receive top benefits will live. The rest will be allowed to perish. Justify that.

Thank you for your testimony. Unfortunately, you are part of a VERY LARGE and GROWING population.

depittydawg
09-26-2010, 05:08 PM
Your first statement is just not true. If you feel as if you were treated unfairly, I suggest you file a written complaint with you state insurance department. They will contact the carrier on your behalf for an explanation.

As far as your late premium payment of 5 days, you are a little misleading. You were given a 31 day grace period in which to pay your premium. You apparently went beyond that by 5 days or 36 days total. You were traveling for over a month? What's unfair about having 31 days to pay your premium?

It looks to me like you should be sore at your prior employer not an entire industry. Your bitterness is clouding your reasoning.

Get a grip regards,

How in the hell do you propose to know what his guy went through? Your arrogance transcends all bounds on this issue. By any standards of decency, you owe 2tall an apology.

Buzz
09-26-2010, 05:28 PM
BTW, a link please showing the restrictions put on insurance companies during the Clinton administration that you refer to. I looked for some and couldn't find any. In fact all I found was what I remember, a complete defeat of healthcare reform under the Clinton Presidency. Sorry, can't take your word for it. You need to show us the data.


Didn't they force insurance companies to let people with pre-existing conditions onto health plans at new companies, allowing people to change jobs instead of being locked into life long servitude at one company if they had a pre-existing illness?

Buzz
09-26-2010, 05:45 PM
Dr.'s earn their fees every day and deserve what they get compensated. A business that contributes nothing but another layer of potential to skim from misfortune is running our health care right now. Ok, I'm back outta here now. I've know for a long time it is dangerous to get involved here. Too much self righteousness and semantics.

Hammerhead, meet nail.

Nicely put.

Some pretty over the top sheet in this thread too, wouldn't you say?

luvmylabs23139
09-26-2010, 05:53 PM
Didn't they force insurance companies to let people with pre-existing conditions onto health plans at new companies, allowing people to change jobs instead of being locked into life long servitude at one company if they had a pre-existing illness?


HIPPA went into law in 1996. As long as you don't have a break of more than 31 days an employer based plan can't refuse to cover a pre-existing condition.

luvmylabs23139
09-26-2010, 06:20 PM
Deppity.
Here's another one from the Clinton Era.


Newborns’ and Mothers’ Health Protection Act passed 1996 effective 1998

YardleyLabs
09-26-2010, 07:10 PM
Deppity.
Here's another one from the Clinton Era.


Newborns’ and Mothers’ Health Protection Act passed 1996 effective 1998
Are you citing this as a great action taken to prevent abusive medical rationing and restrictions by the insurance industry? I hope so. The bill was introduced in the Senate and the House as insurance companies began imposing coverage limitations making it difficult for patients to remain in hospitals more than 24 hours following child birth. The bill did not require that policies cover child birth, but did require that plans covering child birth create no obstacles for stays of up to 48 hours for normal deliveries and 96 hours for c-sections. The bill was adopted following the Republican takeover of Congress in 1996. It was co-sponsored in the Senate by such wild eyed liberals as Kentucky's Mitch McConnell and Alaska's Ted Stevens. It was passed in the Senate by the affirmative votes of 95 Senators. In the House, the bill passed with 269 votes -- 220 Republicans and 49 Democrats. In the house, the bill was sponsored by Republican Representative Jerry Lewis.

depittydawg
09-26-2010, 07:14 PM
Deppity.
Here's another one from the Clinton Era.


Newborns’ and Mothers’ Health Protection Act passed 1996 effective 1998

Having gone through the delivery of both my children, one by C section, one vaginal, I have no problem giving women 48 hours to recover from the ordeal. In fact both my kids were born before this act, and in both cases, my wife was allowed to stay in recovery for periods equal to those now mandated. I doubt there was much change from this law. I also know of women who had 'easy' birthing experiences who left at 24hrs since this law took affect. Nobody wants to stay in a hospital longer than they need to.

luvmylabs23139
09-26-2010, 07:18 PM
Are you citing this as a great action taken to prevent abusive medical rationing and restrictions by the insurance industry? I hope so. .

I was reponding to Deppitty "BTW, a link please showing the restrictions put on insurance companies during the Clinton administration that you refer to. I looked for some and couldn't find any. In fact all I found was what I remember, a complete defeat of healthcare reform under the Clinton Presidency. Sorry, can't take your word for it. You need to show us the data."

I made no personal comment on whether that act or HIPPA were a positive or negative. I simply provided him with the facts that he said did not exist.

luvmylabs23139
09-26-2010, 07:32 PM
This is too tender a subject with me to let it go like I usually do. Insurance companies only service provided is financing. Their only profit is generated from human suffering. They gamble on how much misery you will suffer be it health, car crash, barn fire or next years crops. When you do suffer, they cut their losses and hang the customer out to dry for the rest.

I have been out of work for 2 years, unable to find anything that provided "benefits" so have been paying over $1,000 a month the entire time for COBRA coverage, without being compensated for a single claim. I spent about $1,000 total in that time for my Dr. bills, few that they were but have not had a check up in over a year because I can not afford it because of the monthly premiums. Because I was traveling, I missed a payment by 5 days. I have been cancelled completely and can not get coverage now. I am SOL, end of story. Tell me how anyone "earned" the approx $24k I paid in premiums, and what have I got to show for it?

The insurance industry is rotten to the core. Sorry to those of you employed in it. But the mafia and gestapo had their employees too. Those that are wealthy or fortunate enough to be employed at a high enough level to receive top benefits will live. The rest will be allowed to perish. Justify that.

The COBRA option has a time limit of 18 months with a very few exceptions. That is the law. Based on reading your entire post chances are that the payment was returned because your cobra opton had exceeded the 18 months.

dnf777
09-26-2010, 07:42 PM
When I left my position in New Orleans, as required I received a COBRA letter from my employer, offering to continue my health coverage for $1400 per month. (family coverage) We are all healthy, with no chronic or pre-existing illnesses. I remember thinking to myself, had I just lost my job, without a new one, what kind of position would I be in to spend 1400 a month for something I hope NOT to have to use? Things like an apartment roof and ramen noodles would come first. Cobra is a good thing, but it doesn't help many of the people who have lost jobs due to the economy. Not that it was ever intended to, but I hear is misunderstood all the time in conversation. "oh, you lost your job? well at least you still have cobra coverage"..... Not the case.

M&K's Retrievers
09-26-2010, 08:09 PM
When I left my position in New Orleans, as required I received a COBRA letter from my employer, offering to continue my health coverage for $1400 per month. (family coverage) We are all healthy, with no chronic or pre-existing illnesses. I remember thinking to myself, had I just lost my job, without a new one, what kind of position would I be in to spend 1400 a month for something I hope NOT to have to use? Things like an apartment roof and ramen noodles would come first. Cobra is a good thing, but it doesn't help many of the people who have lost jobs due to the economy. Not that it was ever intended to, but I hear is misunderstood all the time in conversation. "oh, you lost your job? well at least you still have cobra coverage"..... Not the case.

Just so everyone knows, the premium for Cobra coverage is the same premium the employer was charged under their plan plus no more than 2% for having to collect the premium from the ex employee. I don't want anyone saying that Cobra rates are raised up to prevent people from electing the option. That's not the case.

M&K's Retrievers
09-26-2010, 08:19 PM
M&K, I assume you are employed by the insurance industry. We have been traveling for a lot longer than a month, and our premiums were mailed timely via certified mail every time but once. We sent them certified because we knew that ANY excuse what so ever would be used to cease coverage. It was only 5 days. My entire purpose in posting is that the system is rotten to the core and there is no intent on the insurance companies' part but to make extreme profit off of a system that has fed into their hands. Human suffering should not be a basis for profit. Dr.'s earn their fees every day and deserve what they get compensated. A business that contributes nothing but another layer of potential to skim from misfortune is running our health care right now. Ok, I'm back outta here now. I've know for a long time it is dangerous to get involved here. Too much self righteousness and semantics.

I know this will make too much sense but believe me insurance companies would rather not be forced into having to cover Cobra participants. Think about it. Who is going to elect Cobra? Those who can't buy coverage elsewhere due to medical conditions. Bad risks. Those who are healthy will either do without or buy a cheaper individual policy. Those who have problems will elect Cobra and more than likely have claims.

depittydawg
09-26-2010, 08:58 PM
I know this will make too much sense but believe me insurance companies would rather not be forced into having to cover Cobra participants. Think about it. Who is going to elect Cobra? Those who can't buy coverage elsewhere due to medical conditions. Bad risks. Those who are healthy will either do without or buy a cheaper individual policy. Those who have problems will elect Cobra and more than likely have claims.

Couldn't have said my case better. Insurance companies are competing on who can exclude the most high risk consumers, and collect money from the lowest risk consumers. Sounds pretty counter productive to me. Let alone unethical. Like I said several posts back. The Primary objective of Insurance Companies is to make profit. How does this help the healthcare industry, the American Citizen, the Doctors, Nurses or even pharmaceutical companies?

road kill
09-26-2010, 09:02 PM
Couldn't have said my case better. Insurance companies are competing on who can exclude the most high risk consumers, and collect money from the lowest risk consumers. Sounds pretty counter productive to me. Let alone unethical. Like I said several posts back. The Primary objective of Insurance Companies is to make profit. How does this help the healthcare industry, the American Citizen, the Doctors, Nurses or even pharmaceutical companies?

How does Obama Care help them???



RK

dnf777
09-26-2010, 09:12 PM
Just so everyone knows, the premium for Cobra coverage is the same premium the employer was charged under their plan plus no more than 2% for having to collect the premium from the ex employee. I don't want anyone saying that Cobra rates are raised up to prevent people from electing the option. That's not the case.

I didn't say that at all. I was just pointing out, that right after losing one's job, coming up with ANY amount of monthly payment for something you hope never to lose would be difficult. It would be interesting to see stats on what percentage of cobra eligible people actually take it.

depittydawg
09-26-2010, 09:27 PM
How does Obama Care help them???



RK

I have no idea. IMHO it may help some consumers by providing some basic common sense protections. It helps the Insurance Industry because there is little to nothing that mandates they change much of anything unless they feel like it. Not sure how it helps pharma; but I did notice their industry supported it. I was thoroughly disappointed at the end result of that legislation. A dysfunctional Senate and a Republican party of yes men doomed it. I think Obama should have vetoed the final bill sent to him. He didn't. So we're stuck with it, good or bad.

What was needed was wholesale change to either scrap the private insurance concept or provide for tight rules and regulations for them to operate under. We got neither. Instead we got some tickling of the fringes, and some money to buy votes for both political parties. I guess that's what happens when a Democratic Republic becomes infested with corruption.

luvmylabs23139
09-26-2010, 09:32 PM
There is a large piece of all of this that has yet to be mentioned. Many large employers are actually self insured. Your insurance card may say the name of a well known insurance provider, but they are actually nothing more than an outsource for processing claims. The actual cost of the claims is paid by the employer. Anyone that actually has this insurance is directly dinged in the next years rates by a fellow employee with an extremely large claim. Or by an employee that runs to the doctor for a cold. Sometimes it is actually your fellow employee that is directly driving up your rates.

M&K's Retrievers
09-26-2010, 09:37 PM
I didn't say that at all. I was just pointing out, that right after losing one's job, coming up with ANY amount of monthly payment for something you hope never to lose would be difficult. It would be interesting to see stats on what percentage of cobra eligible people actually take it.

Dave, never said you or anyone did. I just wanted to stop it before someone misinformed us with their expertise.

I have never seen any stats on the % of people electing Cobra. Consider this, most folks who quit a job have a job elsewhere where there is coverage provided or at least the lack of coverage was not a problem to them.. They may take Cobra for a couple of months while they are in their waiting period. Employees terminated for whatever reason that are healthy or bulletproof will not elect Cobra because they don't want to spend the money. That leaves us with the older population who is more likely to be in poorer health or at least more financially responsible that take Cobra. As a rule it is a poorer class of risk and the reason why insurance companies would rather not have to offer it.

dnf777
09-26-2010, 09:45 PM
Dave, never said you or anyone did. I just wanted to stop it before someone misinformed us with their expertise.

I have never seen any stats on the % of people electing Cobra. Consider this, most folks who quit a job have a job elsewhere where there is coverage provided or at least the lack of coverage was not a problem to them.. They may take Cobra for a couple of months while they are in their waiting period. Employees terminated for whatever reason that are healthy or bulletproof will not elect Cobra because they don't want to spend the money. That leaves us with the older population who is more likely to be in poorer health or at least more financially responsible that take Cobra. As a rule it is a poorer class of risk and the reason why insurance companies would rather not have to offer it.

Yeah, but those are exactly the people it was intended to protect from losing coverage, and not being able to find a new policy.

You're right about people moving to another job, that often will provide coverage, but lately, the middle class hasn't exactly been an upwardly mobile segment of the population. Again, I don't know the exact stats, except for the new unemployment claims that air on Fridays, but I bet more cobra offerings are for the newly unemployed, rather than the upwardly mobile.

It should also be noted, that this is just one aspect of cobra. Another large aspect deals with docs and hospitals dumping non-insured patients to other facilities, or diverting ambulances. This is a huge no-no, and one very painful financially for those who challenge it. Around the ER, cobra is simply referred to as the "anti-dumping" law. Some of this was modified soon after its adoption, as it was a little too stringent for many small hospitals and towns with limited specialists.

M&K's Retrievers
09-26-2010, 10:12 PM
Yeah, but those are exactly the people it was intended to protect from losing coverage, and not being able to find a new policy. Why should this be the insurance companies responsibility? They didn't cause the loss in employment. Why should they be responsible for the risk?

You're right about people moving to another job, that often will provide coverage, but lately, the middle class hasn't exactly been an upwardly mobile segment of the population. Again, I don't know the exact stats, except for the new unemployment claims that air on Fridays, but I bet more cobra offerings are for the newly unemployed, rather than the upwardly mobile.

It should also be noted, that this is just one aspect of cobra. Another large aspect deals with docs and hospitals dumping non-insured patients to other facilities, or diverting ambulances. This is a huge no-no, and one very painful financially for those who challenge it. Around the ER, cobra is simply referred to as the "anti-dumping" law. Some of this was modified soon after its adoption, as it was a little too stringent for many small hospitals and towns with limited specialists. You lost me here. What has Cobra to do with this?

my comments in bold

Gerry Clinchy
09-26-2010, 10:15 PM
Couldn't have said my case better. Insurance companies are competing on who can exclude the most high risk consumers, and collect money from the lowest risk consumers. Sounds pretty counter productive to me. Let alone unethical. Like I said several posts back. The Primary objective of Insurance Companies is to make profit.

Deppity, you keep skirting the point ... the point would be whether an insurance company should not be entitled to make a profit because their "business" happens to involve health care. By the same logic, a doctor or a hospital should not be entitled to make a profit. Nor a pharmaceutical company.

The whole point of insurance is that the insuror is betting that you will NOT get sick; and you're betting that you WILL. Truth is that for most of us, no matter how much we pay for health insurance over our lifetimes, a large # of us will take out a whole lot more than we put in.

One major disease or surgery & that profit they may have made on me over the past 25 years will go up in a puff of smoke. No matter how healthy we live, sooner or later, the end result is death. If you live to be 90, there will probably be a lot of $ spent on getting you there, most of it in the last 15 years of your life. So, even penalizing those who live less healthy lives doesn't necessarily mean they will use up more of that money than those leading a healthy life. It's the nature of the human body that it wears out, sooner ... or later.

Insurance companies base their decisions on actuarial tables. If you have enough people who are healthy for a long enough period of time, it will pay the bills for those who get sick ... and also leave some money to pay all the people who have to push all the paper around (just as the govt will be doing incrementally in trying to enforce the multitude of new regulations associated with Obamacare). Does it really matter whether it's a bureaucrat that makes a decision on who gets, or doesn't get care, v. an insurance company. In the end, the bureaucrat will also be under the same pressure to make the #s work. That's why Medicare is planning to reduce the amount of payments to service providers. That is why the UK now will deny treatment if it won't give at least "X" additional time before death.

Whether we like it or not, it all boils down to the money. If you want to eliminate the profit & let some govt entity take over all the research, etc. then that becomes socialism. Next you let them take over farms, and the energy production. Nobody who has tried that has been able to make it work.

M&K's Retrievers
09-26-2010, 10:27 PM
There is a large piece of all of this that has yet to be mentioned. Many large employers are actually self insured. Your insurance card may say the name of a well known insurance provider, but they are actually nothing more than an outsource for processing claims. The actual cost of the claims is paid by the employer. Anyone that actually has this insurance is directly dinged in the next years rates by a fellow employee with an extremely large claim. Or by an employee that runs to the doctor for a cold. Sometimes it is actually your fellow employee that is directly driving up your rates.

Good point but you going way over DS head. I'm just about to give up explaining anything to someone who refuses to listen.:(

dnf777
09-26-2010, 10:32 PM
Truth is that for most of us, no matter how much we pay for health insurance over our lifetimes, a large # of us will take out a whole lot more than we put in. .

I understand your point, but the above statement, and the billions in profit that insurance companies report, simply do not jive. Its like when you visit Vegas. Its ludicrous to look at the billions of dollars in opulence and casino construction, and then think you're gonna come out ahead at the end of your trip! Whether its United HC's corporate profits, or Vegas' house take, the consumer is funding the operation, and CANNOT come out ahead in the end, statistically speaking, averaged out over the population.

dnf777
09-26-2010, 10:37 PM
You lost me here. What has Cobra to do with this?


http://www.emtala.com/


A resource for current information about the Federal Emergency Medical Treatment and Labor Act,
also known as COBRA or the Patient Anti-Dumping Law. EMTALA requires most hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition.

M&K's Retrievers
09-26-2010, 10:47 PM
Couldn't have said my case better. Insurance companies are competing on who can exclude the most high risk consumers, and collect money from the lowest risk consumers. Sounds pretty counter productive to me. Let alone unethical. Like I said several posts back. The Primary objective of Insurance Companies is to make profit. How does this help the healthcare industry, the American Citizen, the Doctors, Nurses or even pharmaceutical companies?

Hey dumb Arse! Yes, the primary objective of insurance companies is to make a profit. DOH! What a concept. Do you think they opened their doors and said I wonder what the best way to lose money is? They have no responsibility to the health care industry, the American citizen, the doctors, nurses or pharmaceutical companies. They have a responsibility to their stockholders to make a profit just like any other business. Just because you want someone to take care of your every want and need for free, you need to look somewhere else. I for one am sick of your inability to comprehend a simple sentence or explanation.

Butt up a rope regards,

Gerry Clinchy
09-26-2010, 10:51 PM
I understand your point, but the above statement, and the billions in profit that insurance companies report, simply do not jive. Its like when you visit Vegas. Its ludicrous to look at the billions of dollars in opulence and casino construction, and then think you're gonna come out ahead at the end of your trip! Whether its United HC's corporate profits, or Vegas' house take, the consumer is funding the operation, and CANNOT come out ahead in the end, statistically speaking, averaged out over the population.

Simple solution to Vegas ... make a law that does not allow the casinos to make a profit :-)

Dave, think about it ... as a doctor you make a good living. Most of the very expensive homes in our area are owned by doctors and lawyers. Depitty seems to think that because you are in the health care industry, you should not make a profit ... or the amount of profit you are allowed to make should be limited (not sure how he would arrive at the limit you are allowed).

If you and the hospitals didn't make some profit on me and Depitty, they would not be able to provide those free emergency services to those who cannot pay & do not have any insurance.

In my mother's last years, she had a week's hospital stay (no surgery). She had developed an ulcer from an antibiotic she was given. The bill was over $11,000 (& that was several years ago). It would take about 3 wks like that to eat up most of what I've paid for health insurance in the last 15 years.

Many of the same insurance companies that provide health insurance also provide life insurance. When I was still in that business, the insurance company required that the whole group have life insurance (so usually the employer paid). That helped offset possible losses on the health insurance.

Also, insurors invest their excess funds, so profits in the years just prior to the recession might have been larger as a result of investments than they may have been since 2007.

I would not defend an insurance company that reneges on its promises of coverage ... but if they can provide a product that someone wants to buy, then is it any of my business that they manage their company well? Not any more than it is any of my business how much you earned last year, as long as the service you provided was honest & ethical. Should Bill Gates earn less since almost everyone today "needs" access to the Internet? It becomes a slippery slope.

M&K's Retrievers
09-26-2010, 10:59 PM
You lost me here. What has Cobra to do with this?


http://www.emtala.com/


A resource for current information about the Federal Emergency Medical Treatment and Labor Act,
also known as COBRA or the Patient Anti-Dumping Law. EMTALA requires most hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition.

Dave, the Federal law requires this not the insurance companies. Carriers don't benefit from this.

depittydawg
09-26-2010, 11:05 PM
Deppity, you keep skirting the point ... the point would be whether an insurance company should not be entitled to make a profit because their "business" happens to involve health care. By the same logic, a doctor or a hospital should not be entitled to make a profit. Nor a pharmaceutical company.

The whole point of insurance is that the insuror is betting that you will NOT get sick; and you're betting that you WILL. Truth is that for most of us, no matter how much we pay for health insurance over our lifetimes, a large # of us will take out a whole lot more than we put in.

One major disease or surgery & that profit they may have made on me over the past 25 years will go up in a puff of smoke. No matter how healthy we live, sooner or later, the end result is death. If you live to be 90, there will probably be a lot of $ spent on getting you there, most of it in the last 15 years of your life. So, even penalizing those who live less healthy lives doesn't necessarily mean they will use up more of that money than those leading a healthy life. It's the nature of the human body that it wears out, sooner ... or later.

Insurance companies base their decisions on actuarial tables. If you have enough people who are healthy for a long enough period of time, it will pay the bills for those who get sick ... and also leave some money to pay all the people who have to push all the paper around (just as the govt will be doing incrementally in trying to enforce the multitude of new regulations associated with Obamacare). Does it really matter whether it's a bureaucrat that makes a decision on who gets, or doesn't get care, v. an insurance company. In the end, the bureaucrat will also be under the same pressure to make the #s work. That's why Medicare is planning to reduce the amount of payments to service providers. That is why the UK now will deny treatment if it won't give at least "X" additional time before death.

Whether we like it or not, it all boils down to the money. If you want to eliminate the profit & let some govt entity take over all the research, etc. then that becomes socialism. Next you let them take over farms, and the energy production. Nobody who has tried that has been able to make it work.

This was addressed in a post yesterday Gerry. Is our Government run Military Socialism? Do our public Police Departments constitute Socialism? How about fire departments. Are they Socialism? Are Public schools socialism? How about our public roads? Public Lands? Publicly financed projects like Apollo? Was that socialism? Why is it accepted that these services can be administered by the government without hindering our free markets?

dnf777
09-26-2010, 11:13 PM
Dave, the Federal law requires this not the insurance companies. Carriers don't benefit from this.

Not arguing with you on that at all. You just asked what it had to do, and i gave a link. My point in passing, was that cobra is much more than just coverage for the newly unemployed.

M&K's Retrievers
09-26-2010, 11:16 PM
Not arguing with you on that at all. You just asked what it had to do, and i gave a link. My point in passing, was that cobra is much more than just coverage for the newly unemployed.

That's true but folks here are complaining bout Cobra like it's the carriers fault. Believe me, carriers would rather not have to deal with Cobra.

depittydawg
09-26-2010, 11:18 PM
Hey dumb Arse! Yes, the primary objective of insurance companies is to make a profit. DOH! What a concept. Do you think they opened their doors and said I wonder what the best way to lose money is? They have no responsibility to the health care industry, the American citizen, the doctors, nurses or pharmaceutical companies. They have a responsibility to their stockholders to make a profit just like any other business. Just because you want someone to take care of your every want and need for free, you need to look somewhere else. I for one am sick of your inability to comprehend a simple sentence or explanation.

Butt up a rope regards,

Very nice. That's two apologies you owe on this thread. Care to make it a trifecta?

Gerry Clinchy
09-26-2010, 11:34 PM
This was addressed in a post yesterday Gerry. Is our Government run Military Socialism? Do our public Police Departments constitute Socialism? How about fire departments. Are they Socialism? Are Public schools socialism? How about our public roads? Public Lands? Publicly financed projects like Apollo? Was that socialism? Why is it accepted that these services can be administered by the government without hindering our free markets?

The Constitution, I believe, always stated that the Federal govt should be responsible for a national military.

Actually, I'm not entirely sure that public schools were always the case in the US.

Fire Depts are still today often "volunteer" organizations in many parts of the country, including the area where I live; as are ambulance services.

It seems very logical that law enforcement is a responsibility of government; like the courts. Enforcing the law is definitely a govt function.

I believe there is a provision for "toll roads" in the Constitution. The space program was, as far as I can see, part of a military preparedness. Indeed, today, satellites are part of military defense and communications.

Except for the national nature of the military, most of your other citations are matters of local govts, not Federal. In fact, there are some who believe that the Federal govt should get out of some of the very functions you mention.

I don't think your citations make your point.

M&K's Retrievers
09-26-2010, 11:36 PM
Very nice. That's two apologies you owe on this thread. Care to make it a trifecta?

For what? I can't help it if you can't comprehend 2+2. I've laid it out for you but you can't even understand what's said. I've given you the benefit of many years experience in the employee benefit business and all you can do is offer your unsupported and incorrect opinions. Never go to a gun fight with a knife.

Nice chatting with you regards,

depittydawg
09-26-2010, 11:49 PM
The Constitution, I believe, always stated that the Federal govt should be responsible for a national military.

Actually, I'm not entirely sure that public schools were always the case in the US.

Fire Depts are still today often "volunteer" organizations in many parts of the country, including the area where I live; as are ambulance services.

It seems very logical that law enforcement is a responsibility of government; like the courts. Enforcing the law is definitely a govt function.

I believe there is a provision for "toll roads" in the Constitution. The space program was, as far as I can see, part of a military preparedness. Indeed, today, satellites are part of military defense and communications.

Except for the national nature of the military, most of your other citations are matters of local govts, not Federal. In fact, there are some who believe that the Federal govt should get out of some of the very functions you mention.

I don't think your citations make your point.

My point is that some services or even industries can be most effectively managed in the public arena. This does not constitute a socialist economic system. It is simply a matter of choosing what is best for the Community at large.
IMHO, there is enough evidence throughout the world, that an effectively run Public Health Insurance system, working either alongside a heavily regulated Private system, or even in many cases, excluding a private system, delivers better outcomes at a lower cost than strictly Privately operated systems.

In this country, any industry, that creates a monopoly and extracts from the general public an unwarranted cost of it's services is illegal. That precedent has been set and restated many times in the past. Bringing industries that run amok, and out of control is a Responsibility of the Government. And is necessary for the capitalist system to exist.

depittydawg
09-26-2010, 11:51 PM
For what? I can't help it if you can't comprehend 2+2. I've laid it out for you but you can't even understand what's said. I've given you the benefit of many years experience in the employee benefit business and all you can do is offer your unsupported and incorrect opinions. Never go to a gun fight with a knife.

Nice chatting with you regards,

First you confuse agreement with understanding. Then you resort to name calling. Very impressive. Perhaps you should put me back on ignore before you get in trouble.

M&K's Retrievers
09-27-2010, 12:12 AM
[QUOTE=depittydawg;681766 Perhaps you should put me back on ignore before you get in trouble.[/QUOTE]

Oh, you have never been off. Other posters send your socialist ramblings to me.

road kill
09-27-2010, 07:18 AM
You already called DNF a liar and by that standard also, you lose. No one ever called you a "LAR". Also, you called yourself a straight shooter. How does being called simply a "shooter" become an exercise in name calling. Finally, the only one bobbing (or maybe boobing or bobbling) and weaving has been you. A man told you something that he observed personally and you called him a liar without presenting any basis whatsoever for your statement.

From a substantive perspective, the facts of the situation described are actually irrelevant. Similar things happen all the time, which was the point of the article that was referenced. You then attacked DNF for violating medical ethics by citing (not "siting" as you wrote) the specific circumstances of the story. When it was pointed out that you were incorrect (what a surprise) and that medical ethics were not at issue as long as the patient was not identified, you basically said that DNF was a liar because he could not prove the event happened as described and implied that the woman was not protected by confidentiality laws since she was no one's patient (another error on your part).

All that looks like a lot of bobbing and weaving but also walks you into having called a man a liar with no proof whatsoever. By your own definition that makes you a liar since you can't prove your assertion. More importantly, it suggests that you lack basic lack of personal ethics.

With all your bobbing and weaving, you may fly like a butterfly, but you certainly don't sting like a bee -- more like an overripe banana.:rolleyes:

The REAL Yardley!!

If that's not a personal attack, there has never been one.
I guess because I made a couple spelling errors your political veiws must be more meaningful!!

HAHAHAHAHAHAHA!!!!!:D:D:D

Nice try big fella.....


BTW--Show me where I used the word "liar," like you have towards me, I will apologize.
Standing by............this ought to be worth at least 6 paragraphs of pompous verbosity!!


Gosh, I'll never forget that classic moment when Yardley called another poster a "blow hard!!":p


RK

YardleyLabs
09-27-2010, 08:18 AM
The REAL Yardley!!

If that's not a personal attack, there has never been one.
I guess because I made a couple spelling errors your political veiws must be more meaningful!!

HAHAHAHAHAHAHA!!!!!:D:D:D

Nice try big fella.....


BTW--Show me where I used the word "liar," like you have towards me, I will apologize.
Standing by............


RK
Show me where I said you used the word.

I stated that you effectively called him a liar. My basis for that was your repeated assertions that he made his story up to support his position (Isn't that lying?). For example:

"Yeah, well this "5th Grader" just exposed you again. You have a female patient with undiagnosed breast cancer who passed and you can mention that, but no facts to support it, because even though she was noones patient the Dr. Patient confidentiality exists. You should get your fabrications straight, they are a little mixed up.You fabricated ... a situation, not thinking anyone would question it, to use as a liberal propaganda tool"
"My challenge is that you claim you know someone and just saw her as a patient. Baloney, you can not support that personal claim."
"I would like some proof of that. It doesn't pass the smell test."
"You made up a scenario to support your mistaken idea... I being one of the few people that actually read your bleeding heart liberal crap called you on it."
"Prudence would have dictated no discussion of this fictitious character. But he is in it too deep to get out now."
"You sited a SPECIFIC case. I state you made it up."
"The "Old RK" and the one you don't like now have 1 thing in common. STRAIGHT SHOOTERS, I am afraid you don't know what that is."
"The difference is, she didn't make her story up, you did!!"At no point did you use the word "liar", but you called DNF out for lying eight times and an apology would be appropriate unless you are able to back up your charge.

The distinction between my questioning your personal ethics and your accusations that DNF is a liar is simple: I have stated the factual basis for my statements while yours remain baseless accusations. Stating that your arguments carry the weight of an overripe banana can hardly be called a personal attack.

In one of your many posts you said:

"You see, you two guys have a specific style. You bob & weave and trick those less able to respond into losing their way and name calling."

I guess that is your excuse. You feel DNF and I "tricked" you into calling DNF a liar so you would look like a fool. Unfortunately, I think you did this one all by yourself.

road kill
09-27-2010, 08:21 AM
Show me where I said you used the word.

I stated that you effectively called him a liar. My basis for that was your repeated assertions that he made his story up to support his position (Isn't that lying?). For example:

"Yeah, well this "5th Grader" just exposed you again. You have a female patient with undiagnosed breast cancer who passed and you can mention that, but no facts to support it, because even though she was noones patient the Dr. Patient confidentiality exists. You should get your fabrications straight, they are a little mixed up.You fabricated ... a situation, not thinking anyone would question it, to use as a liberal propaganda tool"
"My challenge is that you claim you know someone and just saw her as a patient. Baloney, you can not support that personal claim."
"I would like some proof of that. It doesn't pass the smell test."
"You made up a scenario to support your mistaken idea... I being one of the few people that actually read your bleeding heart liberal crap called you on it."
"Prudence would have dictated no discussion of this fictitious character. But he is in it too deep to get out now."
"You sited a SPECIFIC case. I state you made it up."
"The "Old RK" and the one you don't like now have 1 thing in common. STRAIGHT SHOOTERS, I am afraid you don't know what that is."
"The difference is, she didn't make her story up, you did!!"At no point did you use the word "liar", but you called DNF out for lying eight times and an apology would be appropriate unless you are able to back up your charge.

The distinction between my questioning your personal ethics and your accusations that DNF is a liar is simple: I have stated the factual basis for my statements while yours remain baseless accusations. Stating that your arguments carry the weight of an overripe banana can hardly be called a personal attack.

In one of your many posts you said:

"You see, you two guys have a specific style. You bob & weave and trick those less able to respond into losing their way and name calling."

I guess that is your excuse. You feel DNF and I "tricked" you into calling DNF a liar so you would look like a fool. Unfortunately, I think you did this one all by yourself.

So.....

#1--I never called him a "LIAR" like YOU said I did, you admit it (so YOU are wrong).
#2--Prove I am wrong with a link to the specifics he used, I will respond accordingly.


RK

david gibson
09-27-2010, 08:41 AM
And I just saw a lady in her 50s come in with advanced breast cancer, that in a country such as our, NEVER should happen. She didn't have insurance, and didn't want to run up bills, so never went to the doctor. She never got a chance to have a heart attack at 71. She died of a treatable disease, for lack of basic health care.


since when does a proctologist treat breast cancer?

sounds like an obama campaign speech yarn to me. you learn well!

YardleyLabs
09-27-2010, 08:59 AM
So.....

#1--I never called him a "LIAR" like YOU said I did, you admit it (so YOU are wrong).
#2--Prove I am wrong with a link to the specifics he used, I will respond accordingly.


RK
You are proof of the saying attributed to Mark Twain, "Never argue with a fool; onlookers may not be able to tell the difference."

If I say that you regularly fabricate the things you post and that you make stories up to fit your propaganda, I am calling you a liar whether I use the term or not.

You argue that DNF is a liar because he cannot possibly prove the truth of his story (with an Internet link of all things), and that by extension his story must be false. Of course, for yourself, the standard is different -- "Prove I am wrong with a link to the specifics..." This is the type of non-sequitur used by television caricatures of bad lawyers.

I am left with only two conclusions: either you are stupid and foolish, or you are simply unethical and willing to engage in personal attacks without basis. While I tend to believe the latter, the former is certainly plausible.

With that, I leave you to Mark Twain. When DNF described your arguments as those of a 5th grader, he was being generous.

dnf777
09-27-2010, 09:07 AM
since when does a proctologist treat breast cancer?

sounds like an obama campaign speech yarn to me. you learn well!



To answer your question, I am trained in colon and rectal surgery, and am also board certified in general surgery. Most surgical specialists are boarded in general, and if you live in a small town, you help out however you can. Like RK, you're showing your ignorance in a field you know NOTHING about. Kind of like me arguing with you about hammering rocks with a hammer.

As for RKs drunken rants that make no sense except to bare his ignorance of the medical field.....when did anyone say "no one's patient"? Besides being innaccurate, its irrelevant to the point of confidentiality in anynymous discussions. Oh, i"m sorry, this is just too ridiculous to discuss. its like arguing with a drunk. Besides, he's on the ignore list, and wouldn't even see this childish nonsense had it not been pasted in a reply.

david gibson
09-27-2010, 09:13 AM
To answer your question, I am trained in colon and rectal surgery, and am also board certified in general surgery. Most surgical specialists are boarded in general, and if you live in a small town, you help out however you can. Like RK, you're showing your ignorance in a field you know NOTHING about. Kind of like me arguing with you about hammering rocks with a hammer.

As for RKs drunken rants that make no sense except to bare his ignorance of the medical field.....when did anyone say "no one's patient"? Besides being innaccurate, its irrelevant to the point of confidentiality in anynymous discussions. Oh, i"m sorry, this is just too ridiculous to discuss. its like arguing with a drunk. Besides, he's on the ignore list, and wouldn't even see this childish nonsense had it not been pasted in a reply.

i merely asked you a question! all you had to do was answer with the small town aspect, and it at least appears plausible. just knowing you i know what lengths you would go to make a point.

ignore list? thats pretty immature dave. you will see most all of his posts in reply's one way or another, so why bother? wasnt it just a week or two ago you were crowing about how even though you may dissagree you still like people in general and value different viewpoints?

did he wish you happy fathers day or something?

road kill
09-27-2010, 09:49 AM
You are proof of the saying attributed to Mark Twain, "Never argue with a fool; onlookers may not be able to tell the difference."

If I say that you regularly fabricate the things you post and that you make stories up to fit your propaganda, I am calling you a liar whether I use the term or not.

You argue that DNF is a liar because he cannot possibly prove the truth of his story (with an Internet link of all things), and that by extension his story must be false. Of course, for yourself, the standard is different -- "Prove I am wrong with a link to the specifics..." This is the type of non-sequitur used by television caricatures of bad lawyers.

I am left with only two conclusions: either you are stupid and foolish, or you are simply unethical and willing to engage in personal attacks without basis. While I tend to believe the latter, the former is certainly plausible.

With that, I leave you to Mark Twain. When DNF described your arguments as those of a 5th grader, he was being generous.

Very nice "Big Yardley," very nice!

You should be real proud of that one!
Very well thought out and fact based!

RK

road kill
09-27-2010, 10:27 AM
That "ignore list," that's like "Double-Secret Probation," isn't it?

Serious business!!



RK

Gerry Clinchy
09-27-2010, 10:31 AM
My point is that some services or even industries can be most effectively managed in the public arena. This does not constitute a socialist economic system. It is simply a matter of choosing what is best for the Community at large.


IMHO, there is enough evidence throughout the world, that an effectively run Public Health Insurance system, working either alongside a heavily regulated Private system, or even in many cases, excluding a private system, delivers better outcomes at a lower cost than strictly Privately operated systems.


I disagree with your conclusion in view of the newest developments in health care in the UK. It has taken a long time, but eventually they are running out of OPM ... other people's money.

Because the program is "universal" they were able to keep the "cash flow" going for a long period of time. In business one knows that "cash flow" can only substitute for actual "income" for a period of time. In the end, lack of sufficient income will cause the "cash flow" solution to implode.


In this country, any industry, that creates a monopoly and extracts from the general public an unwarranted cost of it's services is illegal.

At this point, there are multiple health insurors to choose from, so I'm not sure where you get the "monopoly" theory. Additionally, the law, I believe, that a monopoly is only illegal when price-fixing is involved ... doesn't matter whether the cost is unwarranted or not.

Each member of an industry (even if there are only a few of them) can set its own price. As long as they don't talk to each other to "conspire" on a price, they can charge whatever they want. Ever notice how the price at gas stations is always within a couple of cents of each other. If Gulf looks down the street & sees Hess's price, and unilaterally decides to charge about the same (a penny up or down), that's just fine. If Gulf and Hess talk about what a "good" price should be, they are breaking the law.

Gas stations are probably a bad example, as you probably figure they should be compelled to limit their profits as well. Obviously, BP wouldn't have had billions to repair its negligence if it had not made some big profits along the way. Who would have paid those billions? You and me, in taxes for the govt to do the repair. So, in a way, the consumer pays for it all one way or another. The question is only which way can we get more bang for our buck.

Only in rare cases does a govt "create" new wealth ... the space program created some new technologies from which private industry could create consumer products & services. Building infrastructure of roads and bridges provide temporary jobs ... the long-term benefits come from private industry using the infrastructure to transport goods & services they create. Without innovation to create ever newer useful products & services are the roads worth anything.

Suppose the govt had spent all $787 billion in funding private industry to build solar voltaic panel production? China did that ... by giving tax breaks and land to such producers. China is now the largest producer of solar voltaic cells purchased by the rest of the world. It may help their own energy situatioin as well.

The World Bank says that China played unfairly. They are supposed to only be allowed to subsidize industries for products meant for domestic consumption (so that they are not competing unfairly in the world markets). Okay ... we could have built those voltaic panels for domestic consumption! We'd save a lot on oil, create a lot of jobs for many years, and ultimately, perhaps, make solar voltaic energy truly viable? Once govt subsidies were removed, then the US might be the one competing in the world market.


That precedent has been set and restated many times in the past. Bringing industries that run amok, and out of control is a Responsibility of the Government. And is necessary for the capitalist system to exist.

The govt is mandated to protect free/fair commerce ... not "control" industry. You might say that the auto industry is a monopoly as well. Only a few major players. Infrastructure investment is huge, so only a few survived over the long haul. Same for other "heavy" industry.

Monopoly had nothing to do with GM's mess ... poor planning and management did. Was it the govt's responsibility to bail out GM? Really doesn't matter whether GM seems to be surviving for the moment; the future of the company is still uncertain. Ford took its own path & didn't need govt bailout. Kudos to Ford!

For a long while after the Great Depression American consumers retained their habits of saving and being frugal. In more recent times that "wore off"; people forgot about being frugal in favor of instant gratification with credit cards. Now Americans are reverting to saving and frugality again.

Our govt has never learned that lesson ... they stole from SS surplus for the general fund (leaving IOUs); they spent budget surplus with new entitlements. Now, when govts (UK, for example) want to cut back, there is an uproar from those who have grown used to the free lunch.

Govt control is not a substitute for individual responsibility. When GM products did not fill consumer expectations, the consumers voted for other brands.

YardleyLabs
09-27-2010, 10:41 AM
The govt is mandated to protect free/fair commerce ... not "control" industry. You might say that the auto industry is a monopoly as well. Only a few major players. Infrastructure investment is huge, so only a few survived over the long haul. Same for other "heavy" industry.

Monopoly had nothing to do with GM's mess ... poor planning and management did. Was it the govt's responsibility to bail out GM? Really doesn't matter whether GM seems to be surviving for the moment; the future of the company is still uncertain. Ford took its own path & didn't need govt bailout. Kudos to Ford!

For a long while after the Great Depression American consumers retained their habits of saving and being frugal. In more recent times that "wore off"; people forgot about being frugal in favor of instant gratification with credit cards. Now Americans are reverting to saving and frugality again.

Our govt has never learned that lesson ... they stole from SS surplus for the general fund (leaving IOUs); they spent budget surplus with new entitlements. Now, when govts (UK, for example) want to cut back, there is an uproar from those who have grown used to the free lunch.

Govt control is not a substitute for individual responsibility. When GM products did not fill consumer expectations, the consumers voted for other brands.
Gerry,
Just to address one specific point. In the UK, health care expenditures (public and private) represent one-half as much of GDP as they do in the US (8% vs 16%+). The shortage of funds is the product of political decisions not to spend more. I would hope we get more by spending twice as much. However, based on health outcomes, there is little evidence that we do. In both countries, the money being spent is other people's money. In the US, 90% of health care spending comes from the government or corporations, while only 10% comes from patients. How different is that from the UK?

Buzz
09-27-2010, 10:54 AM
I disagree with your conclusion in view of the newest developments in health care in the UK. It has taken a long time, but eventually they are running out of OPM ... other people's money.

Because the program is "universal" they were able to keep the "cash flow" going for a long period of time. In business one knows that "cash flow" can only substitute for actual "income" for a period of time. In the end, lack of sufficient income will cause the "cash flow" solution to implode.

How do you reconcile that with this chart showing how much gets spent per capita? Looks to me like here in the good old USA we're spending about twice as much of OPM.

http://www.kff.org/insurance/snapshot/images/figure-1.gif

M&K's Retrievers
09-27-2010, 11:01 AM
..... you're showing your ignorance in a field you know NOTHING about. ......

Kinda like DS talking about health care.:rolleyes:

david gibson
09-27-2010, 12:06 PM
Kinda like DS talking about health care.:rolleyes:

or anything at all for that matter

luvmylabs23139
09-27-2010, 12:23 PM
Kinda like DS talking about health care.:rolleyes:

I felt like I was banging my head against a brick wall yesterday. We were supplying him with facts but he wouldn't accept them.:rolleyes:

M&K's Retrievers
09-27-2010, 12:34 PM
I felt like I was banging my head against a brick wall yesterday. We were supplying him with facts but he wouldn't accept them.:rolleyes:

Know what you mean. Some folks don't want to listen or learn.

Gerry Clinchy
09-27-2010, 01:01 PM
Buzz, I'd really like to see stats like this explained.

I don't think we can assume that the outcomes are better in countries that spend less. As with infant mortality, the discrepancy with US figures is that US figures consider death of infants up to 12 mos of age ... which is not done in many of the other countries that are included in those stats. The method of "reporting" can influence what stats like this look like.

Also interesting how much is spent in Luxembourg (pretty small country), Switzerland and Norway ... yet Finland and Norway are considerably lower.

I won't refute the figures of how much is spent on health care in the US v. UK ... but, again, we need to look deeper than the numerical stats. For example, dialysis is very expensive. In the UK, dialysis is precluded in many cases of elderly patients due to the govt mandate. If US Medicare does not limit dialysis, that would be one way to send the health care bill up quickly. I don't know the conditions under which dialysis is dispensed with Medicare. Organ transplants might be another big $ expense. Does the US do more of that than some of the countries who spend less per capita?

When corporations pay for health care insurance it is very much part of the employee's compensation. Direct compensation could (probably would) be higher if the employee did not get that "benefit". I think, Yardley, you already mentioned that in your business you had to consider the cost of the benefit as part of the cost of having an employee.

In the end, whether the individual pays through lesser compensation from their employer or through union dues or through taxes to the govt ... it always comes from the employee's pocket.

You can easily say the same is true for business taxes. Who pays? In the end it is always the consumer who pays in the form of higher prices. But it always sounds better to say that businesses are being taxed, not individuals.

luvmylabs23139
09-27-2010, 01:33 PM
When corporations pay for health care insurance it is very much part of the employee's compensation. Direct compensation could (probably would) be higher if the employee did not get that "benefit". I think, Yardley, you already mentioned that in your business you had to consider the cost of the benefit as part of the cost of having an employee.



I can give a perfect example of this. I worked for company X. My husband previously worked for company Y. Oddly enough, his last day at company Y was on a Friday and my first day with company X was the following Monday.
This is relevant because it reflects identical timing.
The companies were direct competators. Both were privately held foreign owned. Both had headquarters in Europe, both with socialised medicine.

Company X had 100% employer paid family medical. Company Y did not.
Company X's overall benefit package was much better than company Y's.
Every now and then rumblings would start at company X about the guys at company Y having a higher hourly rate. Of course, the rumblers failed to aknowledge the benefit difference.
We had employees say they were going to go work for Y if they didn't get more money. Go ahead, interview and ask about their benfit package. Needless to say we never lost an employee to Y. We did get employees from X though.
X eventually went out of business in the US.

road kill
09-27-2010, 01:44 PM
I felt like I was banging my head against a brick wall yesterday. We were supplying him with facts but he wouldn't accept them.:rolleyes:

None so blind as those who refuse to see!!!:cool:


RK

dnf777
09-27-2010, 01:45 PM
i merely asked you a question! all you had to do was answer with the small town aspect, and it at least appears plausible. just knowing you i know what lengths you would go to make a point.

ignore list? thats pretty immature dave. you will see most all of his posts in reply's one way or another, so why bother? wasnt it just a week or two ago you were crowing about how even though you may dissagree you still like people in general and value different viewpoints?

did he wish you happy fathers day or something?

DG,
I prefer to discuss issues with those I disagree with. Its the only way to learn anything. If all we did was self-congratulate, we'd stagnate. And I apologize for being a little "jumpy". In fairness, you did ask, but I thought I detected a little sarcasm.....my bad.

As for RK, until he stops these bizarre posts out of nowhere, and accusing me of lying and trying to box me into a corner like this thread exemplifies, there is really no meaningful discussion going on. Until then, I have no use wasting my time reading that crap. He was wrong, called out on it several times, given citations and explanations, and he persisted on his inane argument. Just like arguing with a drunk. The recent aggressiveness, change in personality, and numerous typos (a change for him) make me wonder if he's not having issues? So I'll give him the benefit of the doubt, and am more than willing to un-ignore when he can converse maturely, and stop with the out of place and false accusations. Nothing personal, just don't have the inclination to sort through the chaff.

dnf777
09-27-2010, 01:46 PM
Kinda like DS talking about health care.:rolleyes:

Who is DS? (I really don't know)

YardleyLabs
09-27-2010, 01:48 PM
...

When corporations pay for health care insurance it is very much part of the employee's compensation. Direct compensation could (probably would) be higher if the employee did not get that "benefit". I think, Yardley, you already mentioned that in your business you had to consider the cost of the benefit as part of the cost of having an employee.

In the end, whether the individual pays through lesser compensation from their employer or through union dues or through taxes to the govt ... it always comes from the employee's pocket.

...
Health care costs are definitely a cost of labor, but are not generally given full value by employees. My "experiment" in that regard came from offering to include the full cost of our subsidy for health care in employee paychecks, giving them the ability to decide whether or not to buy coverage. Virtually every single employee took the cash and decided not to buy health insurance. Some had coverage through spouses. Most simply decided to go without when faced with paying the true cost of the benefit. Our recruitment improved immediately because we were paying more than our competitors. Over time, we came out ahead because we avoided premium increases that had averaged from 20-40% per year.

In the US, the percentage of employees receiving health coverage through their employers has been declining slowly over time, and the percentage of health care costs (premiums and out of pockets) being paid by employees has been going up. The fact that employers have been paying the bulk of the cost has shielded the cost from the beneficiaries. Instead, employees have focused on what is covered or not covered instead of how much the benefits cost. That creates bad decisions from an economic perspective.

The payment of benefit costs by employers has also contributed to the export of jobs from the US to countries where such subsidies are not the norm. It simply adds to the relative cost of American labor.

road kill
09-27-2010, 01:49 PM
DG,
I prefer to discuss issues with those I disagree with. Its the only way to learn anything. If all we did was self-congratulate, we'd stagnate. And I apologize for being a little "jumpy". In fairness, you did ask, but I thought I detected a little sarcasm.....my bad.

As for RK, until he stops these bizarre posts out of nowhere, and accusing me of lying and trying to box me into a corner like this thread exemplifies, there is really no meaningful discussion going on. Until then, I have no use wasting my time reading that crap. He was wrong, called out on it several times, given citations and explanations, and he persisted on his inane argument. Just like arguing with a drunk. The recent aggressiveness, change in personality, and numerous typos (a change for him) make me wonder if he's not having issues? So I'll give him the benefit of the doubt, and am more than willing to un-ignore when he can converse maturely, and stop with the out of place and false accusations. Nothing personal, just don't have the inclination to sort through the chaff.

If you disagree with the fine DR., he will decide you are a drunk.

Another concocted anecdote to support a false assertion, a strength it appears.

That "Victim Card," is that page 3 or 4???;-)


RK

luvmylabs23139
09-27-2010, 01:58 PM
Who is DS? (I really don't know)

Ya know I didn't even notice that he typed DS. I was under the assumption he was refering to Depittydawg and I read it as DD. I made my comment in reference to DD.

dnf777
09-27-2010, 02:02 PM
Ya know I didn't even notice that he typed DS. I was under the assumption he was refering to Depittydawg and I read it as DD. I made my comment in reference to DD.

"D" is right next to "S"! Not again! :D

luvmylabs23139
09-27-2010, 02:17 PM
"D" is right next to "S"! Not again! :D

Nothing to do with the typing. Both of us and a few others spent a good amount of time providing Depitty with facts yesterday on this thread and DD just didn't seem to grasp many of the facts. Or maybe DD just didn't like the legal answers?:rolleyes:

M&K's Retrievers
09-27-2010, 02:32 PM
"D" is right next to "S"! Not again! :D

No, not a mistake.

menmon
09-27-2010, 03:26 PM
I am sorry you pay so much. I am fairly certain that you make a good bit more money than I do as well, so the ratio of cost to income may not be that much different.

Will your rates go up or down as a result of this healthcare legislation?

I don't think healthcare is progressive like taxes. If you are paying that little, your employer is paying most of it

ducknwork
09-27-2010, 03:31 PM
I don't think healthcare is progressive like taxes. If you are paying that little, your employer is paying most of it

I understand that it doesn't change per what you make. The reason I mentioned that is because someone seemed to be complaining about the cost of their insurance and basically telling me to shut it, because mine was such a good deal that I shouldn't complain. The bottom line to what I said is that $120 a month increase is a lot more important to some people than it is to others. I also stated that I forgot to mention that the company pays 50%.

depittydawg
09-27-2010, 09:15 PM
DG,
I prefer to discuss issues with those I disagree with. Its the only way to learn anything. If all we did was self-congratulate, we'd stagnate. And I apologize for being a little "jumpy". In fairness, you did ask, but I thought I detected a little sarcasm.....my bad.

As for RK, until he stops these bizarre posts out of nowhere, and accusing me of lying and trying to box me into a corner like this thread exemplifies, there is really no meaningful discussion going on. Until then, I have no use wasting my time reading that crap. He was wrong, called out on it several times, given citations and explanations, and he persisted on his inane argument. Just like arguing with a drunk. The recent aggressiveness, change in personality, and numerous typos (a change for him) make me wonder if he's not having issues? So I'll give him the benefit of the doubt, and am more than willing to un-ignore when he can converse maturely, and stop with the out of place and false accusations. Nothing personal, just don't have the inclination to sort through the chaff.

Unfortunately most of the righties around here are drunk. Drunk on the mis-information and lies they absorb like sponges. When you do pin them down, and show their arguments to be folly, they circle their wagons and go into their group think attack mode.

I have to admit, I often wondered how this radical right demographic (I can't use the word conservative, because there is nothing conservative in the traditional sense in these people), As I said, I often wondered how the right wing fanatics got so screwed up. And was curious as to what kind of people make up this dysfunctional group of Americans. Well, after a year on this site. I now understand. I guess its just time to accept the fact that many American's are just to ignorant to know how ignorant they are.... This site takes the prize... Never seen so much ignorance in my life.

Gerry Clinchy
09-27-2010, 09:26 PM
Unfortunately most of the righties around here are drunk. Drunk on the mis-information and lies they absorb like sponges. When you do pin them down, and show their arguments to be folly, they circle their wagons and go into their group think attack mode.

I have to admit, I often wondered how this radical right demographic (I can't use the word conservative, because there is nothing conservative in the traditional sense in these people), As I said, I often wondered how the right wing fanatics got so screwed up. And was curious as to what kind of people make up this dysfunctional group of Americans. Well, after a year on this site. I now understand. I guess its just time to accept the fact that many American's are just to ignorant to know how ignorant they are.... This site takes the prize... Never seen so much ignorance in my life.

A gross and unfair generalization.

M&K's Retrievers
09-27-2010, 09:52 PM
Unfortunately most of the righties around here are drunk. Drunk on the mis-information and lies they absorb like sponges. When you do pin them down, and show their arguments to be folly, they circle their wagons and go into their group think attack mode.

I have to admit, I often wondered how this radical right demographic (I can't use the word conservative, because there is nothing conservative in the traditional sense in these people), As I said, I often wondered how the right wing fanatics got so screwed up. And was curious as to what kind of people make up this dysfunctional group of Americans. Well, after a year on this site. I now understand. I guess its just time to accept the fact that many American's are just to ignorant to know how ignorant they are.... This site takes the prize... Never seen so much ignorance in my life.

You are insulting my professionalism and expertise acquired through over 30 years as an employee benefit agent and consultant. I'm offering facts not opinions on this subject. I'm finished wasting my time trying to enlighten you since you apparently cannot comprehend a simple sentence. I offered my advice to you for your nephew via PM but you had rather bitch, moan and complain about how poorly the world has treated you. Quite frankly, at 62, I don't need your whining and insults.

Stick a fork in you regards

david gibson
09-27-2010, 09:52 PM
I have to admit, I often wondered how this radical leftist demographic (I can't use the word liberal, because there is nothing liberal in the traditional sense in these people), As I said, I often wondered how the left wing fanatics got so screwed up. And was curious as to what kind of people make up this dysfunctional group of Americans. Well, after a year and a half on this site and with this president. I now understand. I guess its just time to accept the fact that many American's are just too ignorant to know how ignorant they are.... These obama lefty followers take the prize... Never seen so much ignorance in my life.

there, fixed. ever heard of a mirror dippity? or some things called pots and kettles? you may want to study up a bit on those things before your next post... ;-)

i even fixed your grammar errors. no thanks necessary.... ;-)

Buzz
09-27-2010, 09:54 PM
"When the going gets weird, the weird turn pro."

Hunter S. Thompson

david gibson
09-27-2010, 09:58 PM
A gross and unfair generalization.

isnt that typical of these types? they and only they know whats best for all of us and they feel they have the right to cram it down our throats.

such unparalleled arrogance. when the majority of americans back them on something, its a mandate, majority rules! but now that the shine is worn off of obamas chrome and the people are turning against him - even many of his own aides abandoning him - well, then those people in the majority are just ignorant. we arent as enlightened as they are. they are the chosen ones.

:barf:

Buzz
09-27-2010, 10:08 PM
Actually I'm extremely happy to see those who are jumping ship or getting shown the door make their exit.

ducknwork
09-27-2010, 10:08 PM
isnt that typical of these types? they and only they know whats best for all of us and they feel they have the right to cram it down our throats.

such unparalleled arrogance. when the majority of americans back them on something, its a mandate, majority rules! but now that the shine is worn off of obamas chrome and the people are turning against him - even many of his own aides abandoning him - well, then those people in the majority are just ignorant. we arent as enlightened as they are. they are the chosen ones.

:barf:

Hey, look at the bright side. At least we have their pity.

M&K's Retrievers
09-27-2010, 11:11 PM
Actually I'm extremely happy to see those who are jumping ship or getting shown the door make their exit.

You going somewhere?

depittydawg
09-28-2010, 12:02 AM
You are insulting my professionalism and expertise acquired through over 30 years as an employee benefit agent and consultant. I'm offering facts not opinions on this subject. I'm finished wasting my time trying to enlighten you since you apparently cannot comprehend a simple sentence. I offered my advice to you for your nephew via PM but you had rather bitch, moan and complain about how poorly the world has treated you. Quite frankly, at 62, I don't need your whining and insults.

Stick a fork in you regards

Hey MK:

Kiss my codpiece thou churlish addlepated lout.

luvmylabs23139
09-28-2010, 12:10 AM
Hey MK:

Kiss my codpiece thou churlish addlepated lout.
DD,
You were presented with facts yesterday not fired off personal opinions. While you may not like the facts or the laws that those facts are based on, the facts are the facts and the laws are the laws. Stop shooting the messengers. It make you look like a fool.

M&K's Retrievers
09-28-2010, 12:12 AM
Hey MK:

Kiss my codpiece thou churlish addlepated lout.

That's Mr. M&K to you, kiddo.:cool:

Grow up regards

JDogger
09-28-2010, 12:18 AM
Hey MK:

Kiss my codpiece thou churlish addlepated lout.

Pretty soon we'll all be banished to 'read only' status. Then we won't even be able to quote one another and we'll all be 'ignored'. :rolleyes:

In a perfect world regards, JD

2tall
09-28-2010, 01:14 AM
"When the going gets weird, the weird turn pro."

Hunter S. Thompson

Can I get an AMEN on that brother??? I think a lot of folks could learn quite a bit from Mr. Thompson's work.:-)

We have an awful lot of pro noise maker, line quoting, didactic, types here. I admit, I am an anarchistic, ex conservative, politic hating new age hippie. None of you will ever get what you want from the existing political system. Enjoy the crap the CEO's feed you and continue to feed them caviar.

JDogger
09-28-2010, 02:11 AM
"Buy the ticket, take the ride." -HST. ;-)

JD

dnf777
09-28-2010, 06:01 AM
Can I get an AMEN on that brother??? I think a lot of folks could learn quite a bit from Mr. Thompson's work.:-)

We have an awful lot of pro noise maker, line quoting, didactic, types here. I admit, I am an anarchistic, ex conservative, politic hating new age hippie. None of you will ever get what you want from the existing political system. Enjoy the crap the CEO's feed you and continue to feed them caviar.

And I'll give an AMEN to THAT, 2tall! Well said.

M&K's Retrievers
10-01-2010, 01:40 PM
I'm afraid you aint seen nothing yet. Those of us dumb enough to still be in the business are just now starting to get emails from our carriers laying the groundwork for major rate increases in the offing due to Obamacare mandates. They can't do this crap for free. My guess is after the first of the year we will see companies withdrawing from the health care industry by either canceling their business or selling it to other companies. In either case the result will be less carriers competing for your business. The remaining companies-mainly The Blues and United Health Care- will hang around awhile hoping for a shot at administering the only game left in town - the government health plan. Me and thousands like me will be out of business not to mention thousands of support people from insurance companies, agencies, state insurance departments, etc who will be jobless. Don't forget the loss of state income in the form of premium taxes. And Dave, you will be a salaried government employee working long hours and being underpaid for your services.

Someone said earlier "Does Obamacare?" No. He doesn't but we had better care or an outcome similar to the one described above will ensue.

Pretty picture regards,

Per the Des Monies Register today (I couldn't get the link to work), Principal Financial Group will be exiting the health insurance business in Iowa and 30 other states over the next 18 months. UnitedHealth will offer coverage to existing policyholders. 1500 employees will lose their job, 150 of them immediately This does not include the effect on agents who will more than likely be excluded from the UnitedHealth offers (maybe not but probably).

In 1941 Principal Financial under the name of Bankers Life wrote one of the first group contracts in the industry. Oddly, they become one of the first major companies to exit the business after the passage of Obamacare. The first but surely not the last.

road kill
10-01-2010, 04:20 PM
Can I get an AMEN on that brother??? I think a lot of folks could learn quite a bit from Mr. Thompson's work.:-)

We have an awful lot of pro noise maker, line quoting, didactic, types here. I admit, I am an anarchistic, ex conservative, politic hating new age hippie. None of you will ever get what you want from the existing political system. Enjoy the crap the CEO's feed you and continue to feed them caviar.

Where is Mr. Thompson now and how did he get there??


A real American hero!!



RK

Gerry Clinchy
10-01-2010, 04:45 PM
Can I get an AMEN on that brother??? I think a lot of folks could learn quite a bit from Mr. Thompson's work.:-)

We have an awful lot of pro noise maker, line quoting, didactic, types here. I admit, I am an anarchistic, ex conservative, politic hating new age hippie. None of you will ever get what you want from the existing political system. Enjoy the crap the CEO's feed you and continue to feed them caviar.

Love the blog ... have a hard time believing your self-portrait ... but surely you and Carol are "free spirits" :-)

Buzz
10-01-2010, 05:11 PM
Per the Des Monies Register today (I couldn't get the link to work), Principal Financial Group will be exiting the health insurance business in Iowa and 30 other states over the next 18 months. UnitedHealth will offer coverage to existing policyholders. 1500 employees will lose their job, 150 of them immediately This does not include the effect on agents who will more than likely be excluded from the UnitedHealth offers (maybe not but probably).

In 1941 Principal Financial under the name of Bankers Life wrote one of the first group contracts in the industry. Oddly, they become one of the first major companies to exit the business after the passage of Obamacare. The first but surely not the last.


Just came across this little nugget.


Susan Voss, Iowa's insurance commissioner, told Politico Thursday that "there's no correlation between health reform and Principal."

"They have been slowly decreasing the medical percentage of their revenue base for 10 years now, from something like 30 percent down to 3 percent," Voss said. "We knew a decade ago they were focusing on a different market. … This is a strict business decision

From now on, whenever anyone sneezes, it'll be Obama's fault.

T. Mac
10-01-2010, 06:14 PM
Just came across this little nugget.



Quote:
Susan Voss, Iowa's insurance commissioner, told Politico Thursday that "there's no correlation between health reform and Principal."

"They have been slowly decreasing the medical percentage of their revenue base for 10 years now, from something like 30 percent down to 3 percent," Voss said. "We knew a decade ago they were focusing on a different market. … This is a strict business decision

From now on, whenever anyone sneezes, it'll be Obama's fault.

But if the health insurance industry is so profitable, as many on this list tend to believe, why would a company that had 30% of the market choose to abandon that market?

M&K's Retrievers
10-01-2010, 11:39 PM
Just came across this little nugget.

What would you expect them to say

From now on, whenever anyone sneezes, it'll be Obama's fault.

Gee, kinda sounds like what you do to Bush.