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Thread: Individual Mandate Delayed

  1. #21
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    Quote Originally Posted by Migillicutty View Post
    Right because insurance companies don't have to collateralize expected losses based on the the risk profile of the policy holder base, current investment returns, actuarial studies based on their long term CBR, or renegotiate their re-insurance treaties, and refile their forms with the department of insurance in their state for approval. They can just pull old policies from their servers and offer exact same terms and rating.
    If the policy was good at one time, and then the rule changes back to where that policy is now acceptable again, reinstate it. Why would you have to resubmit it to the state. It was approved before, so reinstate it. Give the same rates you were giving and call it good. Cost of doing business. You win some and you lose some.

    Just like in the food or auto industry or any other industry for that matter, products get recalled, you fix the problem and carry on. The business takes a hit, but you have to do what is the right thing. Take your medicine and go on about your business. Most recalls are caught by the company, but sometimes the Govt finds something and forces the company to recall things. It is what it is. Don't have to like it, just have to do it.
    Last edited by shinyhead; 03-13-2014 at 05:43 PM. Reason: adding

  2. #22
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by shinyhead View Post
    If the policy was good at one time, and then the rule changes back to where that policy is now acceptable again, reinstate it. Why would you have to resubmit it to the state. It was approved before, so reinstate it. Give the same rates you were giving and call it good. Cost of doing business. You win some and you lose some.

    Just like in the food or auto industry or any other industry for that matter, products get recalled, you fix the problem and carry on. The business takes a hit, but you have to do what is the right thing. Take your medicine and go on about your business. Most recalls are caught by the company, but sometimes the Govt finds something and forces the company to recall things. It is what it is. Don't have to like it, just have to do it.


    Man! Why didn't I think of that?

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  3. #23
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    Quote Originally Posted by M&K's Retrievers View Post
    Man! Why didn't I think of that?

    I coulda had a V8 regards
    Does the insurance industry have a problem with doing the right thing or following the rules? People here have said that you can fire your doctor and go to another doctor. There's the rub, there are certain doctors or hospitals, that the insurance company tells you that you have to use. So where is the free market?

  4. #24
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    Quote Originally Posted by paul young View Post
    Then I guess that there's nothing to worry about, in that case. The legislative branch will be overwhelmingly Republican with the Teas cracking the whip and the ACA will be deflated like a 2 week old balloon with a slow leak. It's only 7 1/2 months to November and Nirvana......-Paul
    Here is when progressives of the Republican Party step up to the plate and form a gang of 6, 8 or 10. They are going to be the knight in shinning armor, with 3, 4 or 5 democrats, and fix the Obamacare. Then we will have a real fiasco. This is my believe unless both McConnell and Bohner are gone.

  5. #25
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by shinyhead View Post
    Does the insurance industry have a problem with doing the right thing or following the rules? People here have said that you can fire your doctor and go to another doctor. There's the rub, there are certain doctors or hospitals, that the insurance company tells you that you have to use. So where is the free market?
    The industry does not have a problem following the rules. The problem is the rules keep changing don't they?

    If those companies could snap their fingers and have all that business back that they worked hard for, I'm sure they would. How would they do it? Send all their old customers a bill for back premium and say "we were just BSing you". Or how's this, start billing every old policy starting 4/1/14 and see who pays. What about medical expenses incurred since the termination? What about those who got other more expensive coverage? Are they going to get their money back so they can return to their old policy? These questions are off the top of my head since I haven't given it any thought because it ain't gonna happen.

    I guess you didn't bother to search...
    M&K's HR UH Tucker of Texoma JH
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  6. #26
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    Quote Originally Posted by M&K's Retrievers View Post
    The industry does not have a problem following the rules. The problem is the rules keep changing don't they?

    If those companies could snap their fingers and have all that business back that they worked hard for, I'm sure they would. How would they do it? Send all their old customers a bill for back premium and say "we were just BSing you". Or how's this, start billing every old policy starting 4/1/14 and see who pays. What about medical expenses incurred since the termination? What about those who got other more expensive coverage? Are they going to get their money back so they can return to their old policy? These questions are off the top of my head since I haven't given it any thought because it ain't gonna happen.

    I guess you didn't bother to search...
    This is what happens when people start "fixing" something they never understood from the get go. I really feel sorry for people in the insurance business right now. Where's that magic wand when we need it. Our government seems to think we all have one it seems. What a massive boondoggle ( sp. ?). M&K "ignore the ignorant" ( my husband's saying ). No one knows the ins and outs till they have ran a business for a long time. It's like a child rearing book by an expert who has never raised a child. No clue.
    charly

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  7. #27
    Senior Member Migillicutty's Avatar
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    Quote Originally Posted by shinyhead View Post
    If the policy was good at one time, and then the rule changes back to where that policy is now acceptable again, reinstate it. Why would you have to resubmit it to the state. It was approved before, so reinstate it. Give the same rates you were giving and call it good. Cost of doing business. You win some and you lose some.

    Just like in the food or auto industry or any other industry for that matter, products get recalled, you fix the problem and carry on. The business takes a hit, but you have to do what is the right thing. Take your medicine and go on about your business. Most recalls are caught by the company, but sometimes the Govt finds something and forces the company to recall things. It is what it is. Don't have to like it, just have to do it.
    You made a fallacious leap with that analogy. You can't compare the quantifiable hard cost of a recall caused by a product malfunction that the company was responsible for with the very complex cost of collateralizing loss picks in insurance. However, to play it out, it would be like the government forcing a car manufacturer to make their auto frames out of plastic and then when they all break forcing them to recall every car and replace them with the steel frames they previously made them discard. See it isn't just the "cost of doing business". It's the cost of government sticking its nose in business.

    What you also don't seem to grasp and it is at the very crux of this issue is while the delay in the individual mandate delays individuals being penalized for not getting insurance, it does not preclude the insurers from complying with the rules of ACA. So it is actually worse for insurers. The only way ACA even comes close to making sense is if all the young healthy people get insurance to offset the high risk individuals who already have high healthcare costs. Those people will sign up, but the young people won't, even with the individual mandate. Why would a healthy young male pay ACA premiums for healthcare with they can just pay a very small penalty starting in 2017 and if they get sick and need care they can just go buy the insurance? They won't. So you see the insurance companies are burdened with people signing up that have astronomical health care costs. They have to pay for that. That money has to come from somewhere. The government produces nothing. This is the real world and to get that money to stay solvent they must raise the cost of their goods and services. It isn't about them not wanting to do the right thing. It is about them having to have more money left over than they put out. Something that is also regulated heavily. If they are not collatarlized well enough they go into government mandated receivership and are sold off.
    Last edited by Migillicutty; 03-13-2014 at 11:48 PM.

  8. #28
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    Quote Originally Posted by Migillicutty View Post
    You made a fallacious leap with that analogy. You can't compare the quantifiable hard cost of a recall caused by a product malfunction that the company was responsible for with the very complex cost of collateralizing loss picks in insurance. However, to play it out, it would be like the government forcing a car manufacturer to make their auto frames out of plastic and then when they all break forcing them to recall every car and replace them with the steel frames they previously made them discard. See it isn't just the "cost of doing business". It's the cost of government sticking its nose in business.

    What you also don't seem to grasp and it is at the very crux of this issue is while the delay in the individual mandate delays individuals being penalized for not getting insurance, it does not preclude the insurers from complying with the rules of ACA. So it is actually worse for insurers. The only way ACA even comes close to making sense is if all the young healthy people get insurance to offset the high risk individuals who already have high healthcare costs. Those people will sign up, but the young people won't, even with the individual mandate. Why would a healthy young male pay ACA premiums for healthcare with they can just pay a very small penalty starting in 2017 and if they get sick and need care they can just go buy the insurance? They won't. So you see the insurance companies are burdened with people signing up that have astronomical health care costs. They have to pay for that. That money has to come from somewhere. The government produces nothing. This is the real world and to get that money to stay solvent they must raise the cost of their goods and services. It isn't about them not wanting to do the right thing. It is about them having to have more money left over than they put out. Something that is also regulated heavily. If they are not collatarlized well enough they go into government mandated receivership and are sold off.
    A loss is a loss. It still sounds to me like the insurors, want to cut people loose when they have medical issues, and make them uninsurable so they go bankrupt. Then they start getting govt assistance and everybody wants to call them leeches. Since we are all so concerned with personal responsibility, why don't we just get rid of the insurance industry altogether and let people pay for themselves. Then the hospitals will go bankrupt because they charge exorbitant amounts for care, and the average person can't afford to go into the hospital. Let's truly practice "Darwinism". Survival of the fittest. Then everybody would be happy I guess. Except of course, the people that make their living giving people false sense of security because they have sold "insurance" to the people that are expecting to have some of their expenses covered by the insuror. Which then it will almost take an "Act of God" to get the insuror to pay the claim.

  9. #29
    Senior Member GaryJ's Avatar
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    I think too much time has passed and too many things have changed to put the genie back in the bottle. Can something be done to make it better - I am sure it can since like most things there is always room for improvement.

    I too wish the the law never saw the light of day but now that it is here and for such a long period of time the best thing to do is change it - not repeal it.

    I am not convinced that either party has the fortitude to really tackle the issues or make changes. IMHO the politicians, while they have party affiliation, are more about being self serving than public serving.

    I will continue to do what I have been doing for years and that is vote against the incumbents.
    What if all we have today is what we gave thanks for yesterday?

  10. #30
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    I too wish the the law never saw the light of day but now that it is here and for such a long period of time the best thing to do is change it - not repeal it.
    Maybe they planned it that way? Remember, single-payer has been & remains the ultimate goal.

    Just read an interesting piece on the tax for not being covered.

    First off, it's not just $95 ... it's 1% of AGI ... which could be more substantial than $95. If children are involved, there is an additional assessment for each child not insured.

    We've been told that the IRS cannot seize assets WRT to this tax ... however, IRS can place a lien on assets (almost as bad if you want to sell your house) They CAN also assess penalties for the unpaid tax, and then they CAN seize assets based on the penalties owed. Nobody has been telling us what the IRS penalty for non-payment of this tax is ... so far. Nobody has talked much about the IRS capability to even assess a penalty or what they can do to collect the penalty. Based on past history, do we doubt that the IRS will pursue those remedies?

    A loss is a loss. It still sounds to me like the insurors, want to cut people loose when they have medical issues, and make them uninsurable so they go bankrupt.
    Do we think the govt will not also do that? Some have successfully sued insurance companies for such malfeasance. Part of the law will allow govt to deny treatment, and there will be no recourse at all. The UK is trending back to private care, with the blessing and encouragement of the govt, because its state system is in trouble. Canada's may survive longer since Canada's economy will be stronger due to its energy wealth.
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