We ALREADY pay for the uninsured through taxes and higher insurance premiums -

[JohnWxy]

The high rates for the uninsurable that some have cited would have to be paid by us whether we had the new Health Care law or not.

The Federal, state and local governments (i.e. us taxpayers) compensate hospitals for caring for people who can't pay their bills. It's called uncompensated care and without us covering these costs, hospitals would go out of business. If you have insurance your premiums are higher because of uncompensated care provided by hospitals (about 8.7% higher)(see The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending? - Kaiser Family Foundation

An example of someone who could not afford the premiums for a policy the Health Care reform act makes available to those who could not get any coverage because of pre-existing conditions is cited here:

Pre-existing health condition insurance premium too expensive for many

The case cited at link above is a good example of why we needed Health Care reform....

If we had had a system that had everyone insured, getting periodic checkups at a doctor's office, he might very well have been advised to take steps to address his developing heart disease earlier on and have prevented his condition from getting that bad.

BTW, there must have been some extraordinary care done in that hospital because ordinarily having a stent put in is nowhere near a $100,000 deal. It's not even considered surgery (its done by catheterization)

Coronary Angioplasty: "Cost of procedure performed in the US: $34,847."

I know someone who had one stent put in for $22,000 (surgeon, anaesthesioligist, one day/night hospital stay).
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"Holladay has been uninsured since 2001. When his marriage ended, so did his health insurance through his wife's employer. He said he was doing okay without insurance, despite an enlarged prostate and some herniated discs in his back.

But in 2009, he suffered a heart attack and had a stent implanted to clear the blockage. Northside Hospital wrote off his nearly $100,000 bill as charity care, but Holladay said he knows he needs insurance."
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By the way, if the cost is legitimate, all taxpayers as well as anyone who has insurance picked up the tab for the unfortunate person. It's called Uncompensated Care and local, state and the Federal Government - you and I, cover these costs for hospitals so they can stay in business. Insurance policy holders cover the costs because they do lead to hospitals billing at higher rates. Thus, the insurance companies pay for it, and that means the policy holders pay for it.

The cost of paying for the care of the uninsured increases Private Company Group Insurance policy premiums about 8.7%

We can pay for it the hard way, or we can insure people and have many illnesses caught early when they can be dealt with much more effectively, and also MUCH CHEAPER.

[xchrom]

1. Medicare for all will bring rates DOWN.

I know there are folk who think they can dispute that.

[JohnWxy]

2. Since we know people are not immortal, and will get sick, especially without medical care ..it makes

more sense to have everybody insured and getting medical care from an early age on. This way the person cited in the other post might have never got so bad off that he needed a stent.

IF you are talking about a single payer system.. you are right.. it would be cheaper than keeping profit making insurers in the loop and not gaining by having one large pool. It would be a lot simpler too!

But, could we have gotten that through with the lobbyists (Republicans) in Congress? My feeling is probably not. But, obvously, this is open to debate. (I wish somebody had tried to get a Public Option, at least. I think that might have been achievable.)

[xchrom]

3. We don't get things through because we never

Fight about the real facts.

We fight about everything else -- which in

Itself is a kind of lie.

[Skittles]

5. do you not understand?

LOTS AND LOTS OF "INSURED" people CANNOT AFFORD to get HEALTH CARE - they CANNOT AFFORD the CO-PAYS and DEDUCTIBLES

[Amonester]

4. So let's get it straight: by not covering everybody, the overall bill

gets a awful lot higher for both taxpayers AND the insured

BECAUSE BY NOT COVERING EVERYBODY, AN AWFUL LOT OF COSTLY, BUT PREVENTABLE ILLNESSES cannot and R not pre-empted, but added to the overall COST.

But, hey, at least the wealthiest 1% can keep their tons of highly-profitable shares so that must be OK. :sarcasm:

:banghead: :wow: :grr:

[JohnWxy]

6. YOU'VE got it perfectly backward. Without the healthcare reform we would be paying for the growing

number of uninsured anyway, through taxes, federal, state, local and in your insurance premiums IF you could still afford insurance or IF your employer could still afford it. In a few years at the rate the premiums were going up we would be seeing 30% of the population uninsured and going to hospital emergency rooms for care which would be paid for through taxes (as above).

THe example mentioned of the guy who could get insurance at high rates - without Health CAre reform he wouldn't even have it available to him. He would have to go into the emergency room ... when he had an emergency .. like a heart attack. Which means he would be risking death before he could get care.

Health care reform also means that young people up to 26 yrs old will now be able to remain covered under their parents family coverage. -- not possible before. People in between jobs would not lose their coverage. So, while it's possible to think up worst case scenarios that doesn't make them representative of the whole picture (unless you want to delude yourself and others).

THe fact is with a larger pool of insured the rates will go down -- relative to what they would have been with smaller pools without Health Care reform. The fact also is,without health care reform, many millions more would be losing their coverage in the next several years as the premiums even for people without pre-existing conditions - would become unaffordable either to the individuals in group plans or to the employers.

As the number of uninsured grew dramatically the cost of uncompensated care would explode and this would be covered by local, state and federal governments meaning higher costs to the Government and higher taxes. This would also impact private insurance premiums driving them up.. leading to more people/employers unable to afford insurance.. and thus more uninsured.

Having people insured and getting actual medical care - in timely fashion - makes more sense than paying for people to wait until they need to go to the emergency room for treatment of an advanced medical condition.

[Hello_Kitty]

7. Then why are premiums projected to keep increasing even after the mandate goes in effect?

They should drop at least some percentage immediately since all these previously uninsured people are now covered. Right?

[Turbineguy]

9. Right now insurers can still

charge through the nose because people like me are scared we'll still somehow lose coverage.

[JohnWxy]

11. No. the large increase in numbers covered won't really impact until 2014

You can't expect insurance companies to make changes fast enough to take on milions more people in like 6 months to a year after passage.


from article linked to below:
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2014

Employers will be required to provide coverage to employees, people will be required to obtain coverage.

-- Provides subsidies for families earning up to 400 percent of the poverty level -- or, under current guidelines, about $88,000 a year -- to purchase health insurance.

NOTE: before this could be done you have to, among other things, have insurance exchanges set up for people not getting group coverage through employer.


HEre's an article on phase-in of various features of the program:

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/23/AR2010032301714.html
(here are the features which will be phased in right away:__JW)

Within a year

-- Provides a $250 rebate to Medicare prescription drug plan beneficiaries whose initial benefits run out.

90 days after enactment

-- Provides immediate access to high-risk pools for people who have no insurance because of preexisting conditions.

Six months after enactment


-- Bars insurers from denying people coverage when they get sick.

-- Bars insurers from denying coverage to children who have preexisting conditions.

-- Bars insurers from imposing lifetime caps on coverage.

-- Requires insurers to allow young people to stay on their parents' policies until age 26.

(more in the article at link)

[JohnWxy]

13. NOte also, that nobody said Health Care reform would stop premiums from going up. Just that the

premiums would not go up as much as they would have - without the large buying pools created by Health car reform bill. (along with other features of the Health Care Reform bill aimed at changing the way service providers bill and get paid by insurance companies - i.e. pay for results instead of quantity of tests or procedures performed).

NOTE that the 'individual' mandate (needed to achieve large buying pools) is an idea first proposed by Republicans. Obama took it from a Republican health care reform proposal made during the Clinton administration.

http://arkansasnews.com/2010/03/21/a-brief-history-of-the-individual-mandate-in-hcr/">A Brief History of the Individual Mandate in #hcr: "The Republican Party put the idea on the table in a counter-proposal to President Bill Clinton’s health care reform proposal in 1993. GOP Senator Lincoln Chaffee along with 19 other Republicans supported the idea.."

To expect Health Insurance premiums to immediately start going down or immediately significantly slow their rate of increase, is of course not realistic. It will take time (like more than 6 months to a year or two.) to have an impact on an industry.

NOTE, the insurance industry practice of every insurer using their own billing procedures with their own codes etc creates a huge amount of costs. Doctors, and their staff spend a large amount of their time filling out forms, calling insurers to find out why they didn't pay for a charge ("Oh, you changed the code for a flu shot! Nice to know. Okay, we'll change and re-submit the form!") Billing procedures/nomenclature need to be standardized. THis would save a huge amount of time and expense just from reducing administrative workload.

There is another aspect to HCR (i.e. deciding everyone should be able to get insurance and stopping denial of coverage by insurers). The insurance companies spend a considerable amount of money to pay for people to comb through medical histories to find a "pre-existing" condition, so they can deny coverage. If they cannot deny coverage there is a hell of a lot of administrative costs for insurers that will go away. The result is more of your premiums will go to professional medical services instead paying for someone to find ways to deny coverage.

[Amonester]

10. You're talking about the Health INSURANCE reform.

How about the people who will be mandated to pay for health INSURANCE, but will STILL not be able to afford any actual medical CARE?

Will they STILL need to go the emergency room, or will the DEDUCTIBLES/CO-PAY portions of their medical bills (you know, the costs they cannot afford?) be reimbursed by some kind of 'magic' subsidy?? (Tax credits? If so, what kind of such tax-credits, in case they don't earn enough in a fiscal year in order to pay any taxes to begin with?).

Thanks.

[JohnWxy]

12. the people who have pre-existing conditions who could not even get coverage before

can apply for subsidies from the Federal government to help them pay for the coverage that wasn't available to them before reform:

Interim health insurance subsidies start for people with pre-existing conditions

residents with pre-existing medical conditions who have not been able to buy insurance for at least six months can now apply for federally-subsidized insurance -- until the money runs out.

As part of its health care reform effort, the Obama administration has allotted $5 billion nationwide to help pay for coverage for such individuals over the next four years, until more permanent "high risk pools" begin operation in 2014.

"It is a significant difference," says Joan Galletta of Jacksonville, a board member of the Florida Association of Health Underwriters. "Some people denied insurance in the independent market will be able to get insurance through this program."

The sign-up period for the Pre-Existing Condition Insurance Plan began July 1. Eligible persons can go on
http://www.healthcare.gov to apply, or they can consult a local health insurance agent. Coverage can begin as early as Aug. 1 depending on when a person applies.

[Amonester]

15. Thank you for this important info, but it did not answer my equally important

question about what will happen to people with a pre-existing condition who will (then) be able to get INSURANCE through this program, BUT... who DON'T HAVE the money to pay the DEDUCTIBLE/CO-PAY portion of their treatment??

Will they still be able to go in through the Hospitals ER? (Since they will be insured, BUT CANNOT pay for the COST of the deductible or co-pay PORTIONS of their bill.)

IOW, will the emergency rooms REFUSE to treat them, again BECAUSE THEY DON'T HAVE any, or ENOUGH MONEY?!? If so, where will they go with their so-called INSURANCE COVERAGE that don't cover those fees (if that $5 billion doesn't ALSO cover for them)?

Is it possible to know THE ANSWER to that very PRECISE question? If so, thanks in advance for posting it.

If not, where can it be found? And why is it so hard to find? :shrug:

Thanks.

[JohnWxy]

16. There will be subsidies ...

There is a government site which I cannot now find (I did once before, but that doesn't help much) that explained this in complete detail. This explanation from Kaiser Family Foundation is pretty good.


http://www.kaiserhealthnews.org/Stories/2010/March/22/consumers-guide-health-reform.aspx
Q: I want health insurance, but I can't afford it. What do I do?

A: Depending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded sharply beginning in 2014. Low-income adults, including those without children, will be eligible, as long as their incomes didn't exceed 133 percent of the federal poverty level, or $14,404 for individuals and $29,326 for a family of four, according to current poverty guidelines.


Q: What if I make too much for Medicaid but still can't afford coverage?

A: You might be eligible for government subsidies to help you pay for private insurance that would be sold in the new state-based insurance marketplaces, called exchanges, slated to begin operation in 2014.

Premium subsidies will be available for individuals and families with incomes between 133 percent and 400 percent of the poverty level, or $14,404 to $43,320 for individuals and $29,326 to $88,200 for a family of four.

The subsidies will be on a sliding scale. For example, a family of four earning 150 percent of the poverty level, or $33,075 a year, will have to pay 4 percent of its income, or $1,323, on premiums. A family with income of 400 percent of the poverty level will have to pay 9.5 percent, or $8,379.

In addition, if your income is below 400 percent of the poverty level, your out-of-pocket health expenses will be limited.
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[JohnWxy]

17. Okay, here is the government site on the Affordable Healthcare Act. You realize beyond this, I will

have to bill you for anymore questions answered. Good Luck.:-)


http://www.healthcare.gov/foryou/conditions/affordable/index.html

[Turbineguy]

8. This seems to be the hardest thing to explain to wingnuts.

Reagan convinced them there's a pot of magic money out there that pays for shit they don't want to pay for.

[ejpoeta]

14. exactly. look at it this way.

you have a job. you pay into your insurance diligently for twenty years. then you get sick or you lose your job. now this insurance you have paid into for twenty years is gone. the insurance company gets to keep that money. and you end up on medicaid if you are lucky or medicare and even though you have paid into that for profit insurance, they don't have to pay a dime.

we already pay for the uninsured. i figure we pay for healthcare three times.... we pay our premiums. then we pay for medicare/medicaid social programs. then we pay inflated costs at the doctor/hospital that they have raised to pay the bills of the people who don't have insurance and can't pay the bill.

here's another thing. you pay into for profit insurance for you whole life while you don't need to use it. even when you retire you may be healthy, but chances are you will need to use your insurance more. so you have paid into the private insurance for x amount of years and then end up in medicare. the idea of insurance is to pool money and the sick use it when they need it. but we have lots of pools. and when someone in the for profit pools gets sick they usually end up getting kicked out of the pool they were in and end up in medicaid or as i stated medicare. so mostly sick people are in medicaid or medicare programs then of course those programs will be hard to keep up with. the pool only works if you have healhty and sick in the same pool. but the insurance companies have got it so they get all the profits and the sick end up on public plans. could you imagine going to get lunch and you pay for it ahead of time and then when you get to the table they tell you you have to pay for your dinner again. who would stand for that!!! yet they do with their health. how is that.