If You Like Your Insurance Plan You Can Keep It...Not

[esmith]

Luckily I have never been in a situation that I did not have excellent health insurance, except when I was a child and a couple of years after I retired. However, I am not saying things will not change. I have no idea what is going to happen to Medicare nor to our military supplemental insurance, expecially the military program. It seems that the cost of health care continues to rise every year due to the advancement in medical procedures, the overall decline in the health of Americans and the ability of modern medican to detect and treat health issues. There is another issue, but I am not sure how much it adds to the cost and that is the test and refferals that your primary care doctor advises, I'm not smart enough to question my doctor. Another cost is the rising life expectance. However, on this I am questioning treatment to continue life vs the quality of life. I hope I neve have to make a decision on this.
I am between a rock and a hard place on providing health insurance for everyone. On one hand I am a fairly compansionate person but I am also realistic and not sure if the country can afford it along with every other program that the government wants or has to fund. It has been brought to my attention that over $40Billion in non-health insurance fraud cost the average American family between $400-$700 in increased premiums FRAUD and DOJ estimates that there is $60-$90Billion in fraud with Medicaid and an equal amount for Medicare FRAUD. Now with the ACA we are basically opening up a massive can of fraud worms that could exceed the cost of present non-health insurance, Medicare, and Medicaid fraud combined. Now add in the fraud in the welfare system. Maybe just maybe if we tackled these problems we might help pay for health care. My question is how much technical and manpower resources have been dedicated to this problem? So, what should be done? My answers is something but the answer is probably nothing.

 

[Mr Spinkles]

And that's why a universal system should be implemented: to simplify the process so people who aren't money-savvy can get help when needed.

So far, I've determined at least one major problem with ACA: it's way too complicated.

It is more complicated than a single-payer system. However, the Right makes it much, much more confusing for people to understand with all the misinformation about it.

Here's the ACA in a nutshell:

1. Large employers must offer group health insurance, or pay a tax.

2. Individuals must have health insurance, or pay a tax.
2.a. For those 15% of individuals who don't already have insurance (because it's not offered by their employer, or they can't afford it, or they aren't eligible for Medicaid/Medicare, etc.) HealthCare.gov will serve as a one-stop shop to more easily compare prices, and will offer subsidized insurance for those with low incomes.

3. Health insurers have to offer a minimum level of coverage (free preventive care, no lifetime maximums, no kicking off the kids until they are 26, etc.) States already had minimum levels of coverage before, now it's just standardized across all states.

4. Health insurers cannot refuse to cover people with pre-existing conditions.

For each of these points, there are various exceptions for people / businesses with special circumstances, but that is the ACA in a nutshell. It's really not much more complicated than the system we had before the ACA. Again the Right makes it incredibly confusing with all their nonsense and misinformation. That makes it harder for the average person to understand what the heck is going on.

 

[esmith]

It is more complicated than a single-payer system. However, the Right makes it much, much more confusing for people to understand with all the misinformation about it.

The big gorilla in the room is the cost to the taxpayer directly or the economic impact on the economy in terms of jobs. Now I know that those that support the ACA disagree with the latter but to be honest neither side knows what will happen. So, let's just wait and see what the overall impact of the law is before we rush to an unknown conclusion. Fair enough?

 

[Mr Spinkles]

The big gorilla in the room is the cost to the taxpayer directly or the economic impact on the economy in terms of jobs. Now I know that those that support the ACA disagree with the latter but to be honest neither side knows what will happen. So, let's just wait and see what the overall impact of the law is before we rush to an unknown conclusion. Fair enough?

Yes, you are right about that and that is fair.

 

[Riverwolf]

It is more complicated than a single-payer system. However, the Right makes it much, much more confusing for people to understand with all the misinformation about it.

Here's the ACA in a nutshell:

1. Large employers must offer group health insurance, or pay a tax.

2. Individuals must have health insurance, or pay a tax.
2.a. For those 15% of individuals who don't already have insurance (because it's not offered by their employer, or they can't afford it, or they aren't eligible for Medicaid/Medicare, etc.) HealthCare.gov will serve as a one-stop shop to more easily compare prices, and will offer subsidized insurance for those with low incomes.

3. Health insurers have to offer a minimum level of coverage (free preventive care, no lifetime maximums, no kicking off the kids until they are 26, etc.) States already had minimum levels of coverage before, now it's just standardized across all states.

4. Health insurers cannot refuse to cover people with pre-existing conditions.

For each of these points, there are various exceptions for people / businesses with special circumstances, but that is the ACA in a nutshell. It's really not much more complicated than the system we had before the ACA. Again the Right makes it incredibly confusing with all their nonsense and misinformation. That makes it harder for the average person to understand what the heck is going on.

Still too complicated for the sake of those of us who have to put our time and efforts into other things, and just want to go to the hospital if something happens, or occasionally get a check-up from a regular physician.

But none of those four points seem bad at all.

 

[DallasApple]

I will note the operative word in your presentation...

..."seems"...

It seems that aliens from another world are now in control of all media outlets including Drudge Report, NewsMax, and Fox... reports of seemingly factual facts soon to follow...seemingly...really soon...maybe...or it would seem so...

LOL!! Thats good!

It seems Obama is the anti Christ!

 

[Reverend Rick]

What I see is basically we are expecting young folks to foot the bill for folks with pre-exising conditions.

I futher believe the taxes collected for not having insurance will not keep pace with the money government will spend helping folks pay for insurance.

The young folks cannot afford this nor can the government so we borrow even more money?

 

[Reverend Rick]

Another issue I have is people who support the ACA said everyone would get check ups and that would lower costs over all.

Most of the policies I have heard about have a 4,000 deductable which would mean these "check ups" would be paid for out of pocket which means folks will not go to the doctor unless they are really sick.

 

[dust1n]

Another issue I have is people who support the ACA said everyone would get check ups and that would lower costs over all.

Most of the policies I have heard about have a 4,000 deductable which would mean these "check ups" would be paid for out of pocket which means folks will not go to the doctor unless they are really sick.

Usually yearly doctor visits are part of a separate section of a plan, where there is a usually a small co-pay. I think deductibles are generally what apply to emergency and primary care. I could be wrong here, but at least on my health plan, which is terrible on I have through a temp agency at the moment, I'm allotted a check-up per year at the co-pay of fifty dollars.

 

[dust1n]

In addition, Obama's statement was literally 99.9% true, according to the facts given in the article. I'd call that closer to "true" than "false".

Thanks, I didn't even see your post at first. Wow, so all those cancellation notices we're really just the same sort of notices everyone receives every year when they have to re-enroll in the program, and are allowed to make changes. It even auto-adjusts to the new standards if one doesn't reply. Now that convenience is everything, but hasn't this been relatively convenient for almost everyone, other than they might have to pay a little more.

 

[dust1n]

Sounds like we replaced GW Bush with GW Bush.
I expect he'll win again in 2016.
Oh, well...at least we aren't at war in Iran or Syria.
(Look'n at the bright side of the current Dubya.)

In some regards yea. It doesn't really seem to me like rhetorical approaches have actually really changed at all since Teddy. What matters is policy and whether or not it achieves its intended affects.

 

[Mr Spinkles]

Thanks, I didn't even see your post at first. Wow, so all those cancellation notices we're really just the same sort of notices everyone receives every year when they have to re-enroll in the program, and are allowed to make changes. It even auto-adjusts to the new standards if one doesn't reply. Now that convenience is everything, but hasn't this been relatively convenient for almost everyone, other than they might have to pay a little more.

In addition, by calling it a "cancellation" instead of a standard "re-enrollment" notice as people typically receive every year, it's possible the insurance companies are just trying to encourage the sick (costly) customers to look elsewhere. They can't force those customers off the plan but they can scare/confuse them into finding a new insurer. This wouldn't be surprising since the ACA is requiring them to expand benefits. How do you maintain profitability while expanding benefits? Tell the sick ones the plan is "cancelled" and hope they find a better deal at HealthCare.gov so they leave your plan on their own. The OP article discusses this possibility although the insurance PR people deny it.

 

[Mr Spinkles]

Another issue I have is people who support the ACA said everyone would get check ups and that would lower costs over all.

Most of the policies I have heard about have a 4,000 deductable which would mean these "check ups" would be paid for out of pocket which means folks will not go to the doctor unless they are really sick.

No. The deductible is irrelevant in this case. Preventive care is free under the ACA, period. Get thee edumacated:

Under the ACA, private health plans – other than those that were in existence prior to March 23, 2010 and have “grandfathered” status – must provide coverage for a range of preventive services and may not charge any copayments, deductibles, or co-insurance to patients receiving these services.

Source: Preventive Services Covered by Private Health Plans under the Affordable Care Act | The Henry J. Kaiser Family Foundation

 

[Mr Spinkles]

What I see is basically we are expecting young folks to foot the bill for folks with pre-exising conditions.

Sooner or later, they end up being essentially the same folks. Young folks are future folks with pre-existing conditions. My parents spoon-fed me when I was a child and I expect to spoon-feed the next generation .... it's a sensible arrangement that benefits everybody.

The young folks cannot afford this nor can the government so we borrow even more money?

What we know, for certain, is that we could not afford our health care system BEFORE the ACA took effect. We were spending 18% of GDP, the most of any wealthy nation, and it was rising fast. One of the top reasons for foreclosure was medical bankruptcy. And we were the only wealthy nation where people (15%, or 30 million) go without health insurance. Not very pretty.

The most salient fact about health insurance, if you look at WHO data, is (1) the U.S. has the lowest % of its population covered by insurance by far, (2) the U.S. spends the most on health care by far. Conversely, every other wealthy nation is capable of (1) insuring all their citizens, (2) spending less than the U.S. These facts demonstrate, beyond any reasonable doubt, that yes, WE CAN afford to cover all our citizens. We know it can be done because MANY OTHER wealthy countries have done it.

Now, whether the free-market 2.0 system we are implementing through the ACA achieves that, or not, is another question. I wanted single-payer, or an actual (semi-) government takeover of health care, rather than an imaginary one.

Finally, yes the government can afford the ACA. In fact, the ACA LOWERS the federal deficit. I repeat: LOWERS. DECREASES. REDUCES. The bill John Boehner introduced to repeal the ACA would have INCREASED the federal budget deficit. Source: http://www.cbo.gov/publication/43471

 

[dust1n]

In addition, by calling it a "cancellation" instead of a standard "re-enrollment" notice as people typically receive every year, it's possible the insurance companies are just trying to encourage the sick (costly) customers to look elsewhere. They can't force those customers off the plan but they can scare/confuse them into finding a new insurer. This wouldn't be surprising since the ACA is requiring them to expand benefits. How do you maintain profitability while expanding benefits? Tell the sick ones the plan is "cancelled" and hope they find a better deal at HealthCare.gov so they leave your plan on their own. The OP article discusses this possibility although the insurance PR people deny it.

Good point.

My estimation is that eventually, we will have to commit to a single-payer system. I'm hoping all this debacle is a stepping stone to the only thing that will really drive down costs for everyone. Besides that, seeing how I'm constantly barraged with indifference in concern with my ability to access healthcare, I find myself rather indifferent when those same people are likely to ones to end up paying more.

Perhaps cost will start to shrink once hospitals actually start receiving a much higher rate of insured patients, which will mean costs will be less, and there is no justifiable way to keep prices the same, even though the costs of many things in hospitals are hardly justifiable.

 

[dust1n]

Sixty-two percent of all American bankruptcies are due to unpaid medical bills; 78% of these were insured at the time.[10]

Unraveling the Crisis in American Healthcare | Physicians for a National Health Program


It does seem to me that as long as the profit motive remains an integral part of the system, that the healthcare system will never really work.

 

[esmith]

Sixty-two percent of all American bankruptcies are due to unpaid medical bills; 78% of these were insured at the time.[10]

Unraveling the Crisis in American Healthcare | Physicians for a National Health Program


It does seem to me that as long as the profit motive remains an integral part of the system, that the healthcare system will never really work.

And to counter

http://www.physiciansfoundation.org/uploads/default/Physicians_Foundation_2012_Biennial_Survey.pdf

 

[DallasApple]

What I see is basically we are expecting young folks to foot the bill for folks with pre-exising conditions.

I futher believe the taxes collected for not having insurance will not keep pace with the money government will spend helping folks pay for insurance.

The young folks cannot afford this nor can the government so we borrow even more money?

Excuse me ? Im 45 . "young folk" can get catostrophic insurance (basic) for about $40 a month..if they are too poor they are exempt from that.Prove you are too poor with your tax returns and you don't have to pay at all ..its free..

ME ..with NO pre existings and my husband who does have type 2 my 17 yo and my 24 yo still under our care? On our income we can get insurance at a discount based on our income..Its not free..its AFFORDABLE.

And so what if young kids pay for it ..probably a 4 yo old sewed the shirt you are wearing..Look at the label in your shirt...or your Nike's on your feet..Trust me..unless you have a taylor little children and I mean LITTLE children are being paid slave labor for you to buy cheap clothes.

 

[Dirty Penguin]

From the source:

"Like other insurers, the Blue Shield letters let customers know they have to make a decision by Dec. 31 or they will automatically be enrolled in a recommended plan."

Whooptey-doo. Insurers regularly change their policies, typically every year, and require people to find a new insurer or automatically be enrolled in the new plan. That was happening long before the ACA.

The article says this is happening to hundreds of thousands of people ... in other words, 0.1% of Americans ... and as the article says "By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost". Obama did not lie, the ACA doesn't make you change your insurer it just requires your insurer to offer a certain minimum level of coverage.

This....:yes:

 

[esmith]

Quote:

Originally Posted by Mr Spinkles
From the source:

"Like other insurers, the Blue Shield letters let customers know they have to make a decision by Dec. 31 or they will automatically be enrolled in a recommended plan."

Whooptey-doo. Insurers regularly change their policies, typically every year, and require people to find a new insurer or automatically be enrolled in the new plan. That was happening long before the ACA.

The article says this is happening to hundreds of thousands of people ... in other words, 0.1% of Americans ... and as the article says "By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost". Obama did not lie, the ACA doesn't make you change your insurer it just requires your insurer to offer a certain minimum level of coverage.

This....:yes:

So, the following are, according to both of you, false? Can neither of you hear or read?
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President Obama says If you like your Doctor You can Keep Your Doctor - YouTube
Arrival of Obamacare forcing insurers to drop customers with low coverage - CBS News