My health insurance changes for the coming year:

[LWolf]

This week the bad news arrived. We were warned that costs were rising by 15-26%. Now we see the reality.

This is for employer-provided health care. We pay whatever the insurance costs over our negotiated cap.

First I got a letter explaining that there will now be "tiers" of copayments: the "value" tier is the lowest copay. Then comes the "additional cost" tier, which applies to endoscopies, spine surgery, knee or hip replacement, and arthroscopies; an additional $500 copay applies. MRIs, CT scans, and PET scans will now require an additional $100 copay. There are lower copays for office visits to primary care providers, higher for specialists.

Next I got a list of the plans available to me this year. I can choose between 4 plans, just like always. No fees were attached to this list. My current plan was not on the list.

Finally, I got an email from the district letting me know that I could look at rates on the district's HR pages.

I have to choose a new plan, since the current plan is no longer offered. So I looked at the plan that cost about the same as the one I've got now. Yes, I can have insurance without paying more.

That plan doubles my deductible, doubles my maximum out-of-pocket costs, and doubles my copay percentages. Which are already more than I can afford.

So I looked at the next cheapest plan. That one's premium is not 15-26% more. It is EIGHT TIMES what I'm paying for a premium now. And there is not one service provided that I'm not paying out more copays and deductibles in addition to that premium.

Finally, there is a section in the paperwork entitled "Health Care Reform." It informs me that "health care reform" passed in March requires 2 changes in our plans this year:

1. Extended coverage of dependents through age 25, of which I have none. I would have appreciated this when I did, though.

2. The lifetime maximum benefit has been removed. Not that this matters. If I didn't use my insurance because I couldn't afford the copays and deductibles this year, I'm not likely to use the insurance next year, either.

Since I can't find enough in the budget to pay EIGHT TIMES the cost of the premium for no care, I'll probably go with the plan that doubles the cost of everything except the premium. Since I can't afford the care regardless, I might as well not pay more for the insurance.

[Safetykitten]

1. You obviously are not aware of the HCR benefits.

A triumph in modern times. Revolutionary in it's incrementalism and forward thinking.

So don't worry about your increasing premiums and evaporating benefits.

2014 is on it's way to help.

[LWolf]

4. That's right. nt

[no limit]

77. The fact people will get help in 2014 is quite a leap to make too.

[Horse with no Name]

221. That's just the bone we were thrown to get us to "vote" in 2012.

We will be told by the democratic overlords that if we don't continue "the change" that was voted in--we will lose the promise of HCR in 2014.
Just one big fucking shell game.

[nightrain]

2. knr. so terrible. You can thank the President for what you got (have to take).

Disgusting corporate-protectionism.

[Bandit]

69. What do you think it would be like if nothing at all had been done like the GOP wished?

:shrug: Is this year any different than the last ten years?

[galileoreloaded]

73. Its pretty clear to me...............

that we gave them a conduit to gouge.

Monumental change offers monumental opportunity.

[INdemo]

114. This is a GOP kind of legislation

They balked just to oppose it,because they could.....When health insurance companies actually endorsed this bill in the end, then we should have known what we were in for.

[Lorien]

143. Um, yes, it is. It's worse.

Generally costlier premiums with fewer benefits are considered a bad thing.

[Knight Hawk]

193. Hope

There would still be some hope that something might get done.Who did you think was going to pay for the uninsured? The rich?

[woo me with science]

3. Gee thanks everyone for this piece of crap legislation. nt

[RufusTFirefly]

115. And the beauty of it is that it will elect Republicans, too!

When the American people finally recognize this POS legislation for what it is, they're likely to fix their blame not on blood-sucking corporations (no!!! can't ever do that!!!) but on the party that did the Illness Industry's bidding and pushed this bill through.

Of course, once the Republicans ride in on the wave of discontent, they'll use their leverage to make things even worse.

[woo me with science]

167. I fear that is a good point. nt

[Catherina]

5. You must not understand the rules of 3D chess.

I'm really sorry LWolf.

Our Human Resources Department is already warning us to expect substantial increases this year and that the 80/20 will be a thing of the past. I'm not looking forward to open enrollment this year.

I'll join you in working to change this.

[LWolf]

6. I surely don't get the 3D chess.

Thanks for your words of support.

[SammyWinstonJack]

9. Neither does obama apparently.

[laughingliberal]

93. Yes, I think the excise tax the President fought for took care of any lingering 80/20 plans. nt

[ejpoeta]

7. this is what we get with our corporate owned representatives.

this is why we need to figure out how to change the system so that corporations aren't friggin fixing the system to suit themselves. and who is going to get blamed? rightly or wrongly, the dems are. i swear they can take defeat from the jaws of victory better than anyone else. so busy trying not to upset any republicans, they friggin end up giving them what they want. sure there are positive things of the hcr law. but like the bill that was supposed to protect consumers from the financial industry, they give them a good long time to screw us before the laws change and then they don't really change them much.

[maryf]

8. When more realize how bad this is, more will start crying for the easy solution:

Expanded and Improved Medicare for all...HR 676 is still in the house...we could still demand it...

[LWolf]

14. I hope so. nt

[roxiejules]

72. How does my annual $7500 deductible sound?

All for only $350 month - while unemployed.

We need Medicare for all!

[SoCalDem]

10. Available, Eligible, affordable/ all wiggle-words that I predicted would bite us all in the ass.

and they have..and they always will..

If YOU are not the one setting the rates, you will never be able to "afford" coverage.

The ones who "provide" the "service" (aka insurance) will NEVER take less in profits, so when new rules come along, they just rework their formula so they continue to make obscene ever-increasing profits..

It's nothing personal.. they just don't care if you cannot afford their coverage..you pay it or you do without..that's their plan..

[LWolf]

16. Yes.

What's really tragic here is that I'm struggling because I can't afford care after paying only the amount that exceeds the cap negotiated in my contract. My employers are already paying them an obscene amount before they get to me.

[Knight Hawk]

194. NEVER

Never believe that anyone up there (anywhere) is watching out for you.They ARE watching you,but not out for you.All you have behind you is your shadow.

[NorthCarolina]

11. Welcome to "change you can believe in"!

It's so nice to finally have a progressive in the White House, instead of your typical run of the mill pro-corporate politician. :eyes:

[Catshrink]

12. Sounds about like ours.

The monthly premium for the plan I was on last year went from $40 to $400 so I opted for the lower tier since I'm not sick that much and, knock on wood, have no medications. It's a high deductible but, oh wow this is the really cool part, we have an HSA!!!!! I'm just so excited about this!

Just in case --> :sarcasm:

[LWolf]

21. HSAs are the cure for all our insurance ills, aren't they?

:grr:

[dflprincess]

24. My employer went to a high deductible with HSAs plan starting last January

(and don't forget, those HSAs are pretax dollars! Like that makes them magical.)

This kind of "coverage" is often called a "Consumer Driven Health Plan" (CDHP). There is growing evidence that these plans do save money the first year or two a company has them. After that they being to cost everyone more as the results of those "covered" by plan delaying routine treatment or checkups and not taking medications they way they should (to save money) start to catch up to them.

[eridani]

47. Consumer driven horseshit

Beause people are so great at making intelligent health care choices when unconscious.

[dflprincess]

152. Or calling around looking for the cheapest ambulance

when having chest pains.

Actually, the real costs come when people with chronic conditions, like diabetes, stop having tests like A1C done as often as they should or cut back on medications.

[QC]

13. How can you be so ungrateful!

I bet you really want Sarah Palin!

:sarcasm:

[LWolf]

15. Exactly.

Because she's such a champion of HR 676. :D

[rug]

17. Historic.

[spinbaby]

18. We're at the point where the middle class can't afford health care

I flinch whenever our company's health insurance renewal is up--the last three years have seen major increases.

[jtrockville]

19. Sounds to me like you overlooked something...

You're only considering health care, and your inability to pay for it anymore. You don't seem to realize how much your increased premiums/decreased benefits help health insurance companies stay healthy.

After all, isn't that the point of health care in the first place? So we can have healthy health insurance companies?

[LWolf]

22. Of course!

As long as they keep us paying premiums AND keep us from actually USING our insurance because of the copays and deductibles, they can keep raking in $$ for no services.

[Little Star]

20. I don't think die and die quickly is only a repug plan.

sigh

[Knight Hawk]

195. Sometimes its a twofer for them

If you are on SS and die quickly, they save on your medical bills AND your SS.

[Desertrose]

23. Shit, LWolf. I am really sorry to hear this.

I know how tight things are for you...damn. This sucks so bad.
:hug:

I'm still without insurance- self-employed. Can't really afford it no matter what the cost...if I want a roof over my head & food on the table. Hanging on for 4 more year still Medicare kicks in...like that'll really change that much.


My son had to get 20 stitches in his head last week...no insurance wither...gonna see what the state will do. He was going to pay it but so far - before the doctor bill & follow up visit its already over $1800.

When will people stop putting up with this insanity?

[LWolf]

25. Thanks for the good thoughts, friend.

:hug:

I hear you.

My son had a cardiac incident a couple of months ago; ended up rushed to the emergency room from work. I don't remember the name for the problem; it had to do with rapid heart beat.

The emergency room bill was $2600, but he had no insurance. He lost his insurance earlier this year when they cut his hours and he no longer worked enough hours to qualify for it.

Which means he didn't get any follow up care.

I'm guessing that people will put up with it for at least another 3.5 years, since the insurance "reform" is not fully on-board until then. They'll keep expecting something better to kick in.

[Desertrose]

26. Yeah, wonder how many will last that long?

So sorry about your son. I hope he's doing better.

Mine lost all his hours earlier this spring but is now back to 1 1/2 days. Better than nothing really....:)

Crazy world.

[G_j]

27. sometimes it would seem just putting the equivalent $ in a savings account

would be better preparation for an emergency.
:shrug:

[Lydia Leftcoast]

30. That's my "insurance plan" now

since I realized how much I had paid out in premiums over the years and received nothing in return besides paperwork explaining why the company wasn't paying.

I know that not everyone can do this, but perhaps we need to crash the system by dropping our insurance en masse. It may happen anyway as the rates rise.

[G_j]

32. as with L Wolf, many people can't afford to actually 'use' it anyway

It may work in a catastrophe (or it might not) but it is a royal scam, and we all know it.

[walldude]

106. I'm looking in to Major Medical

A friend told me I should get it. It has a huge deductible and is fairly cheap and only covers major hospital visits. You pay doctors visits out of pocket. Since I haven't had insurance for 10 years and haven't seen a doctor in 20 it sounded like a good option to me. Not that I have too many choices...



LWolf, man sorry to hear about this, I have been struggling with the insurance issue for years now, I feel ya.

[BlueCheese]

34. They've thought of that.

Hence the individual mandate.

[Lydia Leftcoast]

35. But aha! The fine costs much less than the insurance

I see an out.

[JonLP24]

76. They've been talking about raising the mandate

so that it would cost as much as getting health insurance. I don't know what the status is but I first heard of them talking about that months, months, and months ago so I wouldn't be surprised if they closed that up quickly, that out.

[Lydia Leftcoast]

99. So you pay a fine of hundreds of dollars a month and don't get any care?

Why not just have a robust public option then.

I swear, both parties have gone MAD. If they actually do that, I will seriously looking into moving to one of the countries that welcomes older American retirees and semi-retirees. I can do what I do anywhere that has good Internet.

[G_j]

118. if you know of any

countries that welcome older American retirees and semi-retirees, please let me know.
:-)

[Lydia Leftcoast]

176. Mexico, Costa Rica, Thailand, to name three of the biggies

And there are others.

[G_j]

201. thanks

I hope I didn't come across as sarcastic, I just haven't looked into it.
I know that having little to no $$ doesn't help. All those places sound promising.

[Knight Hawk]

196. ok

Mexico

[laughingliberal]

101. Maybe that's the 'fix' so many told us would be forthcoming in incremental world. nt

[napi21]

210. When the mandate kicks in, your Ins coverage can't cost you ore than

I believe it's a % of your annual income Sorry I don't remember what the % was, but although it wasn't cheap it was I think doable in most cases. I think there's a supplement paid to you for the diff. in what you are charged & the max %.

[customerserviceguy]

50. That's what HSAs are

And I'm not really sure why people here don't like them. If I could have gone on high-deductable insurance back when I was in my 20's and 30's, and let the amounts I didn't have to use accumulate at interest, tax-free, then I'd have plenty by the time I hit my late 40's and beyond, and high deductables wouldn't be a problem. Also, we could have evolved a system where my physician would possibly cut me a deal, because she wouldn't have to fill out yards of paperwork to get paid by my HSA, I just fork over a Visa/Mastercard that taps the account.

But, we've taken the path that we've taken, and now the healthcare system is going to have to deal with all of us baby boomers who kept it afloat while we were in our healthy earning years.

[Arkansas Granny]

65. My understanding is that you have to have a HDHP (high deductible health plan)

before you can make contributions to a HSA. So you are still paying insurance premiums, plus contributions to the HSA. You still have to pay the high deductible and other out of pocket expenses, but you are just paying it in advance to a savings account. So, if your premiums are already so high that they are unaffordable, putting money into your HSA is going to make things even harder.

Maybe I'm looking at this all wrong, but it doesn't sound any more affordable, it's just another way of paying the same amounts.

http://www.irs.gov/publications/p969/ar02.html#en_US_publink1000204045

[customerserviceguy]

182. You do have to have a high deductable plan

But the idea is predicated on the theory that during your young, healthy years, you'll take out far less than you save up. The catastrophic insurance is there only for stuff that gets beyond your ability to afford it. It makes health insurance like fire insurance, we hope that we never have to use it.

The thing I've seen about HSA policies is that they are way too expensive for what I call "do nothing" policies. In most years, younger, healthier people are going to generate nothing in the way of expenses to a health insurance company, other than the expense of sending them pieces of paper and processing their premiums. In the rest of the insurance world, these cost savings are reflected in premium differentials, the $1000 deductable collision/comp parts of my auto policy are going to cost me way less than your $100 deductable policy, on the same car in the same neighborhood. My auto policy issuing company knows they're not even going to hear from me about a claim, unless I rack up even a bit more than a grand in claims, and they charge less accordingly.

If high-deductable HSA policies reflected this differential, they'd be affordable, but they don't.

[Bluenorthwest]

74. The HSA works for you, everyone in my life who has tried it

finds it to be a poor fit. I assume that you work for a single employer, not yourself, not multiple employers, and that your Insurance is a very high deductible plan.
Here is what I had in my 20's. Insurance, no deductible, no co-pay. I paid no premiums. This was, of course, much better than a 'hsa' and allowed me to have simple savings accounts stuffed with cash I was not sending to Blue Cross.
If you are going to pine for a better past, pine for quality.

[laughingliberal]

102. +1 nt

[PatSeg]

168. I remember those days

When my son was born, insurance paid everything except for $12.00 (that was for phone use). Premiums were paid 100% by my employer.

[customerserviceguy]

185. Except for a lucky dwindling few

that ship has sailed. And it's not coming back to these shores.

[PatSeg]

212. That is true

Before medicine and pharmaceuticals became big, big business, people didn't seem to get all that sick that often. Diseases like diabetes and asthma were extremely rare. Hospitals were places where people were born or had their tonsils taken out. Any kind of surgery was a really big deal and generated a lot of attention and concern. I know much of it is because of environmental issues, but drug companies pushing medicine on television 24/7 has convinced many people that they are "at risk for _______" and need to ask their doctor about___________. I would make jokes with my doctor about it and he'd chuckle and nod his head knowingly.

Whatever is wrong with you (or whatever you perceive is wrong with you), there is a pill for it. Or an expensive test that could save your life. They sell fear and people are buying it, until they can't afford it anyway and that usually happens when they really need medical attention.

[SheilaT]

214. You're touching on something very important.

Modern medicine has made even the tiniest deviation from some artificial standard something to be treated, especially with drugs.

Your blood pressure is higher than 110/80? Take this med.

Your blood sugar is over 105? Take this med.

And so on. Those ads on TV you referenced are absolutely despicable. I don't own a TV, and every so often when I'm at someone's house and their TV is on, I'm truly astonished at all the ads pushing medication for some obscure condition or another.

[PatSeg]

217. Sometimes I hear the ads in the background

when I'm on the computer and they sound like some spoof on SNL. It is hard to believe that they are real or that people are buying into it. I told my doctor I think I have "Restless Leg Syndrome" and then busted out laughing. Big Pharma comes up with drugs and then they create diseases to fit the drugs. What really annoys me is they air ads that sound like public service announcements, when they are really designed to serve their profits, not the patient. Then that is followed by a long, frightening list of possible side effects. The commercial ends with happy, smiling people who evidently didn't suffer any of those "side effects".

[SheilaT]

225. I am

62 years old. I don't take any prescription medications. I see doctors as infrequently as possible. I am the healthiest person I know. Coincidence?

What's also noteworthy is that last fall I tripped and fell on my concrete driveway at home and sustained a non displaced hairline fracture of the ulna, just below the elbow. Right arm, and I'm right handed. At the ER my arm got put in a splint and sling. Took the splint off a week later and just was very cautious about using the right arm. I was back at work (mostly typing on a computer and signing my name all day) two weeks later. The first day back my arm ached at the end of my shift. I then had two days off, and my arm did not hurt at all after that.

Can you guess that the ER doctor told me the x-rays showed absolutely no signs of bone thinning or osteoporosis. Lucky me.

[PatSeg]

226. I am a few years older than you

Until the last few years, the only medication that I usually had in the house was aspirin. I went over 25 years without any medical treatment except for a fall at work and a broken toe. I am enormously grateful for the doctors who saved my life recently, but on the flip side, another doctor almost killed me by over medicating me a couple years back (ended up with blood clots). He was young and cocky and spent more time ordering additional medication than he did examining me or asking me questions. There are drugs that I know saved my life, but it was as difficult recuperating from the drugs as the disease. Fortunately my regular doctor is very moderate with medication and respects my views.

You are very lucky indeed, though obviously your lifestyle has a lot to do with it. Many drugs contribute to bone loss, so not taking any unnecessary medications undoubtedly has served you well.

[feslen]

216. yep

you hit the nail right on the head...I say just forget paying health "insurance" and go with the flow, but then again, I'm in the minority.

the only ensurance we're giving is more money for the insurance! :(

[PatSeg]

218. I've been there a number of times

but then I got hit with some serious health issues. I was insured, but ended paying thousands of dollars in out-of-pocket expenses, enough to eventually drive me into bankruptcy. Turned out I was better off "indigent" than "insured" (long story). What a screwed up system we have.

[customerserviceguy]

184. I've never had an HSA

But if such a thing had been available when I started my working years in my twenties, I would have easily seen that it was a pretty good deal for me.

I, too, have had cheap insurance policies in the past, paid for almost entirely by employers. But what if I could have picked a high-deductable policy, with even half of the company's savings going to an HSA that would accumulate tax-free until withdrawn to pay for health expenses? I'd still be in pretty good shape, since I only visit a doctor a few times a year.

[JJW]

28. Doing very well under Obama

the corporations that is.

[radhika]

29. But at least the Corporate Overlords are happy!

Isn't that what America's about these days?

[suffragette]

31. I'm so sorry you are faced with this

Profit over care and conscience and the health of the insurance industry valued over citizens' health.

It's a sad and sorry state of affairs, and it's getting worse rather than better.

[bertman]

33. This is just THE FIRST YEAR.

REC. nt

[Jackpine Radical]

36. I'm always so sad to hear these stories.

I must say that I didn't really expect better of our corporate-friendly government. Health care is about 18% of GDP, which means that you're bucking a whole hell of a lot of money when you try to make changes they don't want. Everywhere you see people being wrung by the corporations for every bit of juice in them, the greed of the rich more obvious every day. They have no need to even hide it any more. There was a time when we had liberal and progressive politicians who would fight for us, but no more. We are on our own, and the sooner we realize it, the better.

[scentopine]

37. Don't worry, the centrists will fix it later. They're all over it - right? Hello?

[CoffeeCat]

38. I can barely stand it...

After electing "change we could believe in" and a President who promised healthcare for all and major
changes in the system--we now have a system that is MUCH WORSE than we had under Bush.

For the love of Pete, we had this Congressional song and dance about healthcare passing and it being "so hard"
to pass it...and oh, isn't this a complex problem???!!

Now, it is more expensive and we have fewer benefits.

I'd love to puke out a lung right now, but I'm guessing that would bankrupt me.

How does Obama expect to get re-elected when every citizen in the U.S is going to be paying MORE for less
benefits????

Republicans will run against this silly, stupid plan--and it won't be difficult to find pissed off Americans
who are paying more now under Obamacare.

Do Obama and the Democrats realize that by doing this they have killed real healthcare reform for a generation?
You can damn well bet the Republicans will be crowing, "We told you so!! This is what happens when the government
runs healthcare! You pay more!! You get less!"

Real reform won't happen in our lifetimes, because Obama's plan will be the biggest argument against ANY government
healthcare reform.

YAY! Way to go! :sarcasm:

[technotwit]

39. health care

I'm dreading at work what increase we see this year. Last year Kaiser wnt up about 10% for our small non-profit. With the economy having an impact on donations, electricity and other insurance going up, I don't know where I'll come up with this year's increase in our budget.

Well , Obama promised us Hope, and we got it this year

[BzaDem]

52. The bigger problem is that there are some people that believe the new system will somehow be worse

than the old system.

It is very difficult to get certain people to realize the truth. For example, I could cite all the reasons to you why you are completely and utterly wrong in every way.

But would you read the facts and realize that? No. The more facts that could be provided to you that challenge your opinion, the more you come up with more and more far-fetched explanations on how your opinion is right.

[zipplewrath]

55. It isn't addressing the majority problem

HCR endeavored to reduce the cost of health insurance costs to the federal government in general, and Medicare and Medicaid specifically. It succeeded. It also made some regulatory changes in the insurance industry which will affect small portions of the insured. It will force alot of people to actually get federally subsidized insurance, who previously weren't obtaining it for various reasons, again a single digit percentage change in the population.

However, in the end, it ignored the singular problem that the vast majority of the population was/is facing. It literally did virtually nothing for them. Health CARE costs are rising faster than inflation. They have been for a few decades now. Premiums are going up PREDOMINATELY because of this fact. Yes, the health insurance companies often exaserbated this problem with all the stupid crap that the bill attempted to address, like pre-existing conditions, canceling policies once you did get sick, life time limits, and all that crap. It made great headlines. But the vast majority of people in this country have been struggling with just one thing, the cost of premiums, and the cost of the underlying cost has been getting more expensive every year. And HCR did little to nothing to "help" that population.

My company supplied healthcare is good. But it also is very expensive, to me, and to the company. I've watched it change over the years as they have tried to "manage" the cost. They are self insured. What that means is that they pay the actual costs of our health care every year. Yes, they "hire" an insurance company to mangage the system, collect the costs, set up the networks, etc. But they negotiate that management cost. They aren't dumb enough to over pay for such services. The reasons our cost have risen so much are because the cost of health CARE is so high.

The outrage over the loss of the public option is so high is because it was the ONLY mechanism in the bill that would address the MAJORITY concern of rising health CARE costs. The public option didn't keep the health INSURANCE companies honest, it was going to start to create a "payer" with enough clout to actually affect health CARE costs. Without that feature, the costs were/are going to continue to rise at unsustainable rates. The exchanges wont', and were designed not to, be big enough to have the kind of cost controlling clout that is need to actually address health CARE costs.

The federal government got their costs down over what they otherwise would have been. HCR created new revenue streams in both the personal mandate fine, and the employer tax for those that don't supply health insurance to their employees. The cadillac tax adds to that stream as well. These things help the feds bottom line. But it does virtually nothing for the vast majority of us that are watching costs of both care and insurance continue to rise to unaffordable levels. Yes, 90+% of us will not be insured, as oppose to the 88% that were before. But the rest of us will still have insurance that is hard to afford, and no guaranteed access to CARE. People with insurance will get coverage of preventative care at 100%, I already have that feature. My annual out of pocket already reaches into $1500+ dollars. And that doesn't include the pharmaceuticels. Preventative care is nice for those who aren't sick. But it doesn't do much for those who actually do get sick, which of course are the people who have been struggling with health CARE costs all along.

[BzaDem]

56. You should be complaining to Ben Nelson and Joe Lieberman.

The public option would have passed were it not for them (not withstanding the "Obama killed the public option in a back room deal" conspiracy theorists).

At all of the recent Democratic National Conventions, the rallying cry has been "we have 47 million people uninsured, and that is unconscionable." Not "the cost of healthcare is rising at three times the rate of inflation."

Yes, cost is a big problem for even more people, and the increase in the cost of medical care in this country is not sustainable. The bill had more cost controls than you acknowledge. But to the extent that it didn't have more cost controls, that is primarily due to a few Senators. (Or, if only the robust public option would be satisfactory to you, it was due to around 20-30 house members out of 250+). Not Obama, and not 90% of the Democratic party. We were left with a single choice. Do we insure 31 million of the 47 million uninsured, with some modest cost controls that might work well or might not, or do we do nothing? Our party chose the former.

If you don't like the choice, you should be directing your criticism at the cause of that choice, not everyone else who wanted a better choice.

[zipplewrath]

57. As well

I should complain about them "as well". The sad reality is that Obama never called Lieberman over the year that he worked on the bill. Not once. He did fly to Kucinich's district, and called him out specifically. But he never even picked up the phone to call Lieberman.

He also excluded the single payer folks from the outset, giving up a "bargaining chip" before he ever started. And really, he was communicating as early as July that the public option was up for grabs. One can hardly call that "fighting for it". He even tried to claim that he "never campaigned on" the public option.

The extent that it had no cost controls is directly traceable to the fact that the cost controlling feature from the outset was going to be the public option. Had half the people realized that it was going to be dumped in July, they'd started from a different point entirely. Drug price negotiation would have been a more prominent feature (something Obama negotiated away practically the first day). Expanded Medicare availability would have been a more prominent feature, instead it was first floated in about July/August as folks began to understand that the public option was going away. And in the end, we didn't even get "health insurance for all, as there will still be 25 million uninsured.

[BzaDem]

58. Lieberman would have been happy to single-handedly kill the bill or even become a Republican

if he didn't get every demand. Ben Nelson's opposition was really not relevant. Obama tried to claim that he "never campaigned on" the public option after he knew it was dead.

On top of that, the only public option that would have had a significant impact on cost was the robust public option using Medicare + 5 rates. That couldn't even get out of the house. There were fewer than 200 votes for that (which, while still a significant number, was not enough for passage).

[zipplewrath]

61. Public option

The public option, robust or otherwise, would have established the structure for ultimately a single payer. As costs rose, and more and more private insurance became unaffordable, the public option was the "creeping" structure that would have "fixed" the various local and regional problems that would have come along. Once large enough, even before it was "single payer" it could have begun to control and dictate prices. What we have now is an impediment to such a progression.

[BzaDem]

64. Not really. The non-robust option would create no incentive for providers to agree to below market

prices.

The only incentive for providers to accept dictated prices would be if it were tied to all of Medicare's patients. In that case, the government could demand lower prices up until the point where it would be more profitable to not take any Medicare/PO patients than it would be to take Medicare/PO patients at set prices.

If the PO isn't tied to Medicare, the public option would start out at 0 people, which is no negotiating leverage over larger private companies. The best a non-robust public option would have done would have been to limit the profit of insurance companies below what the MLR already limits it. It would have done nothing to move towards a system where the government could set prices for actual medical care. Providers would literally laugh in the face of the director of the non-robust public option if that director tried to demand prices below prevailing market rates.

[zipplewrath]

68. The structure to grow

On day one, a weak public option has little or no capacity to influence prices. The strength of the public option will come later, because it provides a structure for congress to expand in small increments to handle regional problems with insurance prices. You could have a "mandate" that literally forces everyone because you won't "subsidize" people buying private insurance, you'll merely "sell" them a policy at the price they can "afford". Yes, at first there would probably be some private subsidy for the folks needing the least help. Right now those needing the most just get nothing, they are exempt from the mandate. But with a public option, those people ultimately are just charged what they can "afford" and it initially doesn't take away anything from the private insurers.

As the program grows, it becomes easier to include more people because it's function and existence become more familiar. When a "crisis" rolls around of some sort, the structure is there to expand. Ultimately it can become a force, potentially just regionally at first, to influence prices. There will be an inflection point where they become such a force that the insurance companies truly wouldn't be able to "compete" other than the fact that the government many actually affect prices to everyone, including private insurance companies.

[BzaDem]

78. "But with a public option, those people ultimately are just charged what they can "afford""

You are now talking about a taxpayer-subsidized public option, which is even more than the robust public option that couldn't get 200 votes in the house.

ALL public options under consideration by ANY committee were self-sustaining public options. Any such self-financed public option could NOT just charge people what they could "afford," because such a public option would have to cover the cost of ALL medical care through premiums (and find willing providers at whatever price of medical care they ask for). If what people could afford was less than the total cost of medical care, the insurance company would have to charge more than people could afford.

The non-robust public option would not be able to influence prices any more than any private insurer. The ONLY difference between the non-robust public option and a private insurer is that the non-robust public option would not have a profit motive at the insurance-level. That's it. Nothing more. It would have been insiginficant. It wouldn't have saved the government much money, let alone its customers.

To the extent that such an option could "grow" into something that actually mattered, well, so can the current system. We are one law away from adding an additional option on every exchange.

[zipplewrath]

90. Not the same at all

To the extent that such an option could "grow" into something that actually mattered, well, so can the current system. We are one law away from adding an additional option on every exchange.

The current system was designed to prevent a public option from coming into being at all. It will have to be created out of thin air. It would be quicker just to create "medicare part E". The whole point is to create a structure that is running at some level, and waiting to be expanded. This current bill, originally laid out by the GOP to obstruct universal health care that Hillary was working on, has no mechanism in it for providing direct health insurance from the government to individuals. It was never intended to, and in fact was designed to avoid it. THAT'S why the public option was so important, it created the structure within the government to achieve what we all know will ultimately be needed. Instead we got a system that places the insurance companies between us and the government, with them acting as the "mandated" conduit into the health care system. And as more and more plans become "cadillac" because of rising health CARE costs, it will establish the insurance companies as the arbiters of what health care we need, and what is "luxury" coverage.

[BzaDem]

95. "it will establish the insurance companies as the arbiters of what health care we need"

"and what is "luxury" coverage."

No, actually, the government (through the law and associated regulations) does that. It dictates what is an acceptable insurance plan and what is not. What an insurance plan must cover and what it doesn't have to cover. What is "luxury" coverage, and what isn't.

Switzerland and the Netherlands provide world-class care to 99.5% of their populations without any public insurance at all. They mandate insurance through private companies and subsidize them. (GASP!) They adopt a system similar to what we have, except they have price controls and heavier regulations.

Well guess what. We are one law away from price controls and heavier regulations, with no "set-up" required. The important and essential structure is community rating, a mandate, and subsidies. Without that, a public option (or alternatively, price controls on private options) would never work. Those three legs of the stool were BY FAR the most important structural changes necessary, and we got them all. I do not know of a SINGLE healthcare economist that disagrees with this. Once we have those, price controls and/or a public option are easy to add.

[zipplewrath]

107. That's one heck of an exception

"They adopt a system similar to what we have, except they have price controls and heavier regulations."

Your "exception" is the whole point. There are no price control mechanisms. There are pricing regulations on the INSURANCE premiums, but not on health CARE costs. The insurance companies are positioned to negoatiate the health care, and how it will be provided, in 50 different states, with the federal governments primary influence being upper limits on what it must cost, but not how that is met. The stated purpose of the cadillac tax (as oppose to the other purpose which is a revenue stream) is to discourage insurance companies from providing more generous health care plans, by taxing the employer who provides them. As health CARE cost rise, the primary methodology for the insurance companies to accomplish that is by limiting what care you have access to.

[BzaDem]

112. Except health insurance companies won't be able to limit categories of care

because the law doesn't let them do that below a certain point. An employer plan cannot be below the standards for a sufficient plan on the individual market.

Insurance companies will either negotiate better rates or go out of business. One insurance company doing this on their own will not lower rates (the providers will just laugh in their faces), but ALL insurance companies being forced to (by the cadillac tax, or eventually by insurance price controls) will start the process. If necessary, provider price control laws can be passed directly (as they exist in every other country). This does not require a new public option to be set up.

"That's one heck of an exception"

I never said it wasn't. I simply said that we can fix the exception easily with a new law, with little to no setup time. We built the structure to make such a change easy. The lack of a public option doesn't change this fact here, just as it doesn't change this fact in Switzerland.

[zipplewrath]

122. Easily

"we can fix the exception easily with a new law"

Yeah, I keep hearing about how easy these fixes are. It was going to be easy to fix the senate bill once it came out of committee. Then it was going to be easy to fix it when it came out of the senate. Then it was going to be easy to fix it once it got signed into law.

One small problem with that. Obama has no interest in the changes you seek, and worked to block them the whole time. He wants the market to fix the problem.

[BzaDem]

124. "Obama has no interest in the changes you seek, and worked to block them the whole time."

Do you belong to the LIHOP or MIHOP camp too?

Seriously. This shit should be moved to the 9/11 forum.

[zipplewrath]

129. Ah, character assassination

Completely out of material huh?

The reforms you suggested were all proposed during the process, and the White House expressed a preference AGAINST those features. They were supposedly afraid of the "taking over your heathcare" charge and just wanted to regulate the insurance industry.

[Jax]

165. Yes you nailed them, and they are out of material

that is how it always ends, out of info then character assassination.

Thanks for your great efforts zipplewrath!

[BzaDem]

183. More like I thoroughly debunked the poster, which made them resort to tinfoil conspiracy theories.

Once they did that, I realized that their opposition to HCR wasn't fact-based, and that they were not interested in facts or in having a serious conversation about them.

[truedelphi]

158. You know, back in the day, Nixon felt that

The price rate increases on everything from cars to insurance were too extreme. So he had Congress pass a law or else he issued an Executive Order, (sorry but I don't remember which) that stipulated that prices had to be rolled back (Summer of 1973)

I know that this could never currently happen. After all, everyone in Office (for the most part) is so whored out to the Big Corporations that they would sooner eat ground glass than infringe on the "rights" of the Big Companies to take every penny the few working people out there still possess.

[TheKentuckian]

179. The real deal to start on the path would be a national exchange accessible at least eventually to

all.

You add in expanding Medicare at both ends looking too meet in the middle and in a short few decades, maybe just two you have a functional single payer.

The public option would be good step too IF it wasn't allowed to just be a dumping ground for the people the private companies don't want to cover. Which is where they were herding this thing.

The thing was going to fail because of being so out of balance in the pools. By putting up firewalls on the option so that it wouldn't even allow all of the few people in the exchange, we had already lost the entire battle.

National exchanges, killing the anti-trust exemption, and broad access should have been the hills to die on.

Of course we were probably toast on any kind of cost control and beneficial containment the very moment it was decided that folks with coverage through work were in fairly good shape. Next thing we knew affordability was no longer a focus at all other than for the mostly deeply impoverished who make less than a full time job at the ridiculous and not even close to living, minimum wage.

No worries though, in 2014 it might get less bad less quickly if the rainbow don't dim and the unicorn don't get lost.

At best we expanded coverage at the cost of every loose nickle from every working class and poor person and as much as they could extract from the treasury to pay the blood ransom to the insurance companies to please let more people at least have the illusion of coverage to shut down the bitching and news stories.

[BzaDem]

192. I think we would have had a national exchange (or a federally-regulated one)

had Scott Brown not won the election. The House's bill had one, and Obama endorsed it early in the informal conference (before it became clear that Brown might win and derail any hope of changing any non-budgetary component of the Senate bill).

We also would have had a Medicare buy in had Lieberman not gone back on his word. Even Ben Nelson initially supported that.

I also think that when you say the "illusion of coverage" that you are not giving enough weight to the mandated benefits and actuarial values insurance plans must have in 2014 (and the medical loss ratio, which caps profits and other administrative expenses at 15% of premium dollars). While it is far from perfect, it is much better than throwing people into some wild west unregulated market. Insurance companies are now basically utilities.

[TheKentuckian]

220. They are not even within eye shot of being a utility and no honest person would make such a claim

This is no Scandinavian system like you and Kent Conrad want to pretend.

It would take decades to get to such a place and a very different perspective on regulation than had ever existed in this country.

We are on a path to nowhere good for the broad populace in the health care arena. Absolutely no ground work had really been laid to change the existing system. We failed to control pricing, our cost controls are either phony or at the expense of the customer, we maintained the employer based system, we continue to allow virtual monopolies and a cartel, we left for profit companies as the primary gate keepers, the overwhelmed states left with primary responsibly for regulation, and on and on.

A scheme was passed that appears to increase access but I believe it will reduce actual care by self selection and desperation. The cost sharing model allowed to be put in place and finally actually demanded via the benefits tax will put so much weight on already drowning consumers that insurance will effectively all become high deductible catastrophic garbage with a wellness program.

We are absolutely not on a path to quality affordable health care for all Americans.

[GOTV]

80. The P.O. might have been the compromise if S.P. had been the starting point

I blame those that short shortsightedly worked with republicans on their priorities before working on our behalf.

There should be no cheering for Democrats or Obama when they start with the bare minimum and negotiate down from there. That's just incompetence disguised as bipartisanship.

[BzaDem]

82. Obama campaigned against single payer. If they started with single payer, they would have been

laughed out of the room and no bill would have been passed.

Your theory of negotiating is really a sight to behold. That would be like a salary negotiation where one demands 100 times their current salary and compromises down to 50 times their salary. People with unreasonable demands (such as a demand for a bill that would not even get 10 votes in the Senate) are not taken seriously in any future negotiations, let alone the current one.

[zipplewrath]

108. They should have let it be scored

You know why they didn't? Take a guess. Yeah, it would have beat EVERY other plan, hands down.

And more importantly, it would have demonstrated where the real cost controls were. From there, they can bend over backwards trying to figure out how to achieve them. The public option would have been the closest they could have come.

[BzaDem]

116. They did let it be scored, and then they didn't release the score when it came back.

Because they didn't like the score.

"Here are the facts: There has been no debate in Congress over HR676. There has not been a single mark-up of the bill. Single payer was "taken off the table" for the entire year by the White House and by congressional leaders. There has been no reasonable period of time to gather support in the Congress for single payer. Many members accepted a "robust public option" as the alternative to single payer and now that has disappeared. The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?"

http://kucinich.us/index.php?option=com_content&task=view&id=2837&Itemid=1

[zipplewrath]

109. They should have let it be scored

You know why they didn't? Take a guess. Yeah, it would have beat EVERY other plan, hands down.

And more importantly, it would have demonstrated where the real cost controls were. From there, they can bend over backwards trying to figure out how to achieve them. The public option would have been the closest they could have come.

[GOTV]

117. And that was another error - in a string of them,

S.P. is not like a salary boost of 100X. S.P. is like a salary boost up to the level of other's salary. S.P. is widely adopted and successful. It is not some fairytale fantasy.

"no bill would have been passed."

My crystal ball says otherwise.


"People with unreasonable demands are not taken seriously in any future negotiations"

The GOP never took the negotiations seriously. They were going to turn down any offer. And those kinds of concerns are appropriate when buying a house, the buyer can go elsewhere, but not when making legislation. The GOP and the blue dogs can not go off and make laws with some other body.

It's ridiculous to start negotiations at the minimum and the HCR we ended up with is proof of that.

[BzaDem]

121. "It is not some fairytale fantasy."

In this country and at this time, it is absolutely a fairytale fantasy. It is nothing other than a fairytale fantasy. There aren't even 10 people in the Senate that would support Single Payer. The only reason the House has over 100 (out of the 218 necessary) is because there are tons of members in 2-1 or similar Democratic districts due to the way districts are drawn.

Your fatal assumption is that single payer (at this time in this country) is not a fairytale fantasy. All of your other mistakes and wrong assumptions flow from this incorrect assumption. In general, when 80-90% of people respond "YES" to questions of the form "Are you satisfied with the insurance you have now," it will CONTINUE to be an absolute fairytale fantasy. It will only cease to be such a fairytale fantasy when that percentage drops significantly.

[GOTV]

213. It is not and it will happen here as well.

It's OK that there are not the votes to achieve this today. Still, it's where the negotiations should have started. You start above where you would like to end up. They started with a public option so either they lied and never wanted the P.O. or they are incompetent and started at their minimum and negotiated down.

The public option and medicare for all were both popular. Starting from either one would have allowed a fairly rapid slide toward S.P. You don't need to wait until majorities dislike their own insurance. Just provide something better and cheaper. Market forces can make S.P. a reality.

[Lost4words]

59. fools gold ,... nt

[LWolf]

81. Projecting. nt

[laughingliberal]

104. I believe the system will be worse for some.

A lower middle class couple in their 50's who make $58,280 a year will be mandated to buy insurance so long as the premium does not exceed 24% of their income. They would be obligated to pay up to $1165 per month for a premium and would not qualify for a subsidy. This premium will be for a 'bronze level' plan which would leave them big out of pocket expenses if they get sick. If they can't afford the insurance, they'll be fined. If their premium is 25% of their income, they'll be excused but they still won't have insurance.

But, as the President told us, "Insurance companies deserve to make a profit.'

[BzaDem]

126. That is utterly false. No one who has to pay more than 8% for premiums has a mandate. Not 25%. n/t

[laughingliberal]

134. A very common falsehood, here. The 8% limit on premiums is for employer based programs & NOT those..

who have to purchase their plans privately but I notice a lot of the defenders try to obscure the facts with this. People who find their part of their employer based premium is more than 8% will be allowed to turn down the plan and shop in the exchanges.

For those having to purchase their plans privately and over 400% FPL (those who won't qualify for a subsidy) they will only be granted a waiver for not obtaining health insurance (thereby avoiding a fine) if the premium is 25% of their income.

But keep on spinning. I'll just pick up some extra Dramamine.

[BzaDem]

137. You are, again, completely wrong. The 8% limit is for exemption from the mandate AND allowing

employees into exchanges.

Here is the actual text of the bill:

"``(e) Exemptions.--No penalty shall be imposed under subsection (a)
with respect to--


‘(1) INDIVIDUALS WHO CANNOT AFFORD COVERAGE-

‘(A) IN GENERAL- Any applicable individual for any month if the applicable individual’s required contribution (determined on an annual basis) for coverage for the month exceeds 8 percent of such individual’s household income for the taxable year described in section 1412(b)(1)(B) of the Patient Protection and Affordable Care Act. For purposes of applying this subparagraph, the taxpayer’s household income shall be increased by any exclusion from gross income for any portion of the required contribution made through a salary reduction arrangement."

I'd LOVE to see you try to spin that one away. Perhaps you think "no penalty shall be imposed" to mean "a penalty shall be imposed?" Or perhaps to you 8 = 25. I'm looking forward to hearing about how the very text of the law could possiby be a "common falsehood." Please enlighten me.

[laughingliberal]

163. I am not wrong and you are either seriously misinformed or deliberately misleading.

"Required contribution" refers to the amount an employee is required to pay for employer sponsored medical insurance. It applies only to employer sponsored plans and the employee's required contribution.

I did, unintentionally, misstate the upper limit an individual in the private market would have to pay. It is 17% of AGI. If 8% was the limit any individual would have to pay, it does not jive with the fact that those at the upper end of the spectrum who qualify for a subsidy (just below 400% of FPL) will be paying up to 10% of AGI with the subsidy paying the balance.

Funny, you didn't include the section number from which your quote was pulled. Is that because people could then go read it for themselves and find that section applies to those with employer sponsored plans? I'm certain you drew your 'very text of the law' from a section addressing employer sponsored plans and the employee's 'required contribution' and that it is not relevant to those in the private market.

Individuals who do not qualify for a subsidy and who will be purchasing their insurance in the private market will receive a waiver only if their premium exceeds 17% of their AGI.

[BzaDem]

181. WOW! When you are in a deep, deep hole, you should really put down the shovel. Seriously.

The section is 5000e. Yup. The individual mandate section. It has nothing to do with the employer mandate or anything else. Look it up. The title of the section is "Requirement to maintain essential minimum coverage." Subsection a (the subsection that the penalty refers to) reads "An applicable individual shall for each month beginning after 2013 ensure that the individual, and any dependent of the individual who is an applicable individual, is covered under minimum essential coverage for such month."

In case you don't believe the legislative text actually became the law, here is Jon Walker of Firedoglake (who hates HCR and the mandate due to the lack of a public option) explaining the hardship exemption is in fact at 8 percent (on the morning the Senate bill was finalized):

http://fdlaction.firedoglake.com/2009/12/18/hardship-wavier-and-restrictions-on-immigrants-buying-insurance-undercut-arguments-for-an-individual-mandate/

This is the point where if you were being intellectually honest, you would back off and apologize. The fact that you aren't shows that opposition to HCR here is primarily driven by misinformation about the bill.

[laughingliberal]

204. Here's what I find in that section:

(e) Exemptions- No penalty shall be imposed under subsection (a) with respect to--

`(1) INDIVIDUALS WHO CANNOT AFFORD COVERAGE-
`(A) IN GENERAL- Any applicable individual for any month if the applicable individual's required contribution (determined on an annual basis) for coverage for the month exceeds 8 percent of such individual's household income for the taxable year described in section 1412(b)(1)(B) of the Patient Protection and Affordable Care Act. For purposes of applying this subparagraph, the taxpayer's household income shall be increased by any exclusion from gross income for any portion of the required contribution made through a salary reduction arrangement.
`
(B) REQUIRED CONTRIBUTION- For purposes of this paragraph, the term `required contribution' means--
`(i) in the case of an individual eligible to purchase minimum essential coverage consisting of coverage through an eligible-employer-sponsored plan, the portion of the annual premium which would be paid by the individual (without regard to whether paid through salary reduction or otherwise) for self-only coverage

That does look to me as if 'required contribution' is defined just as I said it was-as the portion of an employer sponsored health care plan an individual is required to pay for the coverage.

Regardless, the whole thing of the waiver does, yes, exempt some people whose premiums are very high from a fine if their premium exceeds some percentage of their income. The bottom line there is it will apply to most over 50 and they may not be assessed a fine for not obtaining insurance but they will still be left with no health care. This will, I believe, comprise the bulk of still uninsured Americans.

My delay in responding was due to a 1 hour commute from the shop, a stop to pick up materials for a job we start tomorrow, a dog and a husband who needed feeding upon our arrival at home.

[BzaDem]

207. In your quote, you included B1, but not B2, which proves my point completely.

Here's the full quote:

`(B) REQUIRED CONTRIBUTION- For purposes of this paragraph, the term `required contribution' means--
`(i) in the case of an individual eligible to purchase minimum essential coverage consisting of coverage through an eligible-employer-sponsored plan, the portion of the annual premium which would be paid by the individual (without regard to whether paid through salary reduction or otherwise) for self-only coverage, or
`(ii) in the case of an individual eligible only to purchase minimum essential coverage described in subsection (f)(1)(C), the annual premium for the lowest cost bronze plan available in the individual market through the Exchange in the State in the rating area in which the individual resides (without regard to whether the individual purchased a qualified health plan through the Exchange), reduced by the amount of the credit allowable under section 36B for the taxable year (determined as if the individual was covered by a qualified health plan offered through the Exchange for the entire taxable year).

This is quite obvious. The required contribution is the employee's contribution if they qualify for employer insurance, OR the annual premium for the lowest cost bronze plan if they do NOT qualify for employer insurance.

In other words, you just clipped out the part that said that if someone didn't qualify for employer insurance and the lowest cost individual market bronze plan is more than 8% of their income, the mandate does not apply to them. Or, if they do qualify for employer insurance, if the cost to them is more than 8% of their income, the mandate does not apply to them.

To put it another way, if one's premium would be more than 8% of their income, the mandate does not apply to them. It is not 17% or 25%. It is 8%, always and everywhere. It is exactly what I have been saying for this entire thread. It is not a "common falsehood."

[laughingliberal]

208. You may be right about that and it may be something which changed because I know,

at one point, it was 17% for those in the individual market and I do apologize for missing that. I know, at one point, the Senate bill was on track to allow a multiplier of 5 for age and it was reduced to 3. So, thank the stars for small favors.

This does not change the fact that those who are priced out will still be without insurance. Our last premium (before we had to drop it and take our chances) was $1200 per month which constituted 25% of our income at that time (back when we still had some income).

Most of the uninsured are uninsured because they can't afford the insurance. It's good they won't be fined for this but they still won't have insurance. My hypothetical couple in their 50's with income of $58,280 per year and a premium of $1200 per month (and I know some this age whose premiums are as much as $2000) won't qualify for a subsidy. They won't be fined if they don't get insurance but they won't have insurance. If they opt to buy insurance at that premium, I can't think it won't be a hardship if they are still paying for housing.

[BzaDem]

209. Yes, some right above 400 FPL will not benefit much under the law. I'm just saying that they won't

be hurt.

The point is that before this law passed, those poor without employer insurance went uninsured unless they were so poor they could qualify for Medicaid. This only helped people at the poverty line or lower (depending on the state).

Under the new law, EVERYONE up to 400% of the poverty level is GUARANTEED to not pay more than 2%-9.5% of their income for health insurance plan (with mandated benefits and actuarial value). This includes people with pre-existing conditions, who would otherwise often have to pay multiple times their income to afford insurance (which is of course impossible).

In other words, we moved the threshold to guaranteed affordable health insurance from 50-100% of FPL (depending on the state) to 400% of the FPL, AND we got rid of pre-existing conditions. This helps 31 million people, which is around 2/3 of the legal uninsured population.

Does it help everyone? No. People above 400% of the poverty level won't get help (other than the pre-existing condition discrimination ban, and the 3x age rating instead of 10x-20x before). But is the fact that people over 400% won't be helped as much a reason not to help everyone UP TO 400%?

[laughingliberal]

211. The problem with that is it includes a really large group of people,...

most of whom are over 50 and in real need of health care. We are the ones the insurance companies didn't want, to begin with., and the bill has set it up so they won't have to worry much about having to take us. Insurance companies can price us out and many people this age have, after working all their lives, just made it to the 400% of FPL level so the government avoids having to spend anything on us, too. Mission Accomplished? Insurance companies are rid of us and the government won't have to worry about us until we reach 65 which will be increasingly unlikely if we get no health care for our 50's and early 60's.

I guess it could be worse. They could be pricing us out AND not giving us a waiver so we could be fined, too.

[Lorien]

141. The President should ask "Why do insurance companies deserve to exist at all"?

Do people in Nations with universal health care spend 25% of their income for that tax? If so, they are still ahead of us because they aren't saddled with all of the out of pocket expenses. And before anyone sheds a tear for the people who work for our insurance corp. middle men; OUR jobs are being lost to Countries who HAVE universal single payer care. RIGHT NOW. One of my main clients was bringing jobs back for their American workers...but then recently built a second studio in Vancouver and cut it's American workforce in half, sending the rest of the jobs to it's Canadian studio. Are they paying the Canadian workers less? NO. The Canadians get the same pay, but the company saves 20-30% in operating costs because they don't have to pay for health insurance for their Canadian workers. Skilled English speaking workers with universal health care. Hard to blame the company when they didn't make the health insurance rules.

[inna]

197. massive fail

[truedelphi]

40. Thank you President Obama. Thank you Rahm Emanuel. thank you

Big Health Insurers and Big Pharma.

Thank you Thank you Thank you.

Life in this nation is just so peachy keen. Fifty nine billion bucks passed recently to fund war,
while the average wage earner is gauged and gauged again for things like Health insurance.

[Bluebear]

41. You said it.

[LWolf]

83. I try not to think about how much higher my salary would be

if my employer weren't paying out so much for my premiums, even before I do.

They are paying 1/3 the amount of my net take-home pay before I pay the REST of the premium.

[truedelphi]

157. Often people do not understand that fact

A friend of mine didn't get his usual annual raise one year.

he finally brought the matter up with his boss, wanting to know if he had done something wrong that the company his not getting a raise was to show him his job performance was inadequate.

The boss said, "Yep, you've done something wrong, through little fault of your own. you went and turned fifty. And we can either pay the increase in your health insurance, and forget about your raise (which is actually less than the increase.) Or we can lay you off, or you can die."

This man had a wry sense of humor - the exchange wasn't as vicious sounding as it is in type. The man was smiling sympathetically when he said all this.

[shireen]

153. +1

[Bluebear]

42. THANK GOD IT PASSED!!!1

Ecch.

[harmonicon]

43. at least it isn't a horrible socialist system

For instance, here in the UK, this is what I had to go through this week:
I called the clinic I go to on Friday and asked to see a GP asap (non-emergency though) and was given an appointment for monday morning (today). I went to the appointment, was written a prescription (for which I'll pay about £7 - the cost of all prescriptions) and booked another appointment in two weeks. All totaled, it took about 30 minutes, and no money ever changed hands.

Can you imagine the horror if a system like that was "forced" upon everyone in the US?

[Hannah Bell]

44. nhs is going to be taking cuts of 20%.

[harmonicon]

45. and your point is what?

Never elect a conservative? The torries got a wopping 30% of the vote, and they'll be out of power in 5 years at the latest. The first ever David Cameron campaign sign I saw was his smug face with a text saying something like "I'll never cut your NHS".

[Hannah Bell]

46. my point is nhs is going to take cuts of 20%.

[harmonicon]

49. and tomorrow is tuesday

Just saying things isn't having a discussion.

[Hannah Bell]

51. what's your problem?

[harmonicon]

160. my problem is simple:

you're not having a discussion, but simply making short statements in the form of a discussion, making no attempt at dialogue. Do you want to say something about this 20% cut? Do you want to discuss something about why/how it came about or what effect it might have on those receiving healthcare in the UK? If not, I don't see the point of your posts.

[iamforobama]

54. RIGHT ON!!

The EU is so far ahead of the US. Maybe some day, maybe some day, maybe some day..We will set-up a socialist democracy with free education, universal health care, and affordable housing for everyone.

[harmonicon]

161. the UK is far from all of those things

But they have health care down better than anywhere else I know of. Talking to the doctor this morning, she said she thinks she'd rather be in the US; "the grass is always greener", she said. I just didn't have the time to explain the horrors of the healthcare system to her and that just being in that consultation was one of the main reasons I prefer living in the UK.

[LWolf]

84. I can imagine it.

I imagine an immediate improvement on the quality of life and the economic condition for all.

:(

[harmonicon]

162. I'm sorry for your situation

It really is crap. I moved here three years ago and have only had to go to a doctor four times in that period. However, if I were back in the US - even when I did have insurance - I honestly don't know if I would have gone once for any of these things. I simply couldn't have afforded to. The last time I saw a doctor in the US - at my parents' behest - I was sent to some consultation by the GP that cost $80. $80 for some expert to spend five minutes with me and tell me that nothing was wrong and that my GP was worried for no reason. How that is not considered criminal is beyond me.

[truedelphi]

219. Oh migawd. I thought you were going to tell me

You had to wait three weeks to see a doctor. And then you waited for two hours even though you had the appointment.

And then you were given the prescription, but it was not available at the HMO's pharmacy (We keep only some drugs here, the rest are at our other "campuses.")

And then you were told no one on the staff really knew the directions off the building that had the prescription meds, but every one did agree it was a three hour drive away in heavy traffic.

And for that, you were paying only $ 957 a month for you and your spouse.

And so life in A-mer-cur continues. While we become more and more like roadside curs.

[harmonicon]

224. haha...

The closest pharmacy is in the grocery store about 5 minutes walk from the health centre, which itself is maybe a 10 minute walk from my house. The health centre does cover an area of three miles, so some people have to go further, but not much further.

[truedelphi]

227. Such "planning" smacks of socialism...

I am sure that that is how our "Planners" consider such.

When I lived in Norway back some thirty odd years ago, one of the first things that stuck me was how there was an excellent child care center - built on the road into the campus parking lot.

To me, that was simply astounding.

[Fumesucker]

48. Clearly you were wishing for a rainbow pooping unicorn..

Sensible pragmatic centrists know that there are no such things as rainbow pooping unicorns and those who wish for them really pine for president Palin in their secret heart of hearts.

[BzaDem]

53. The funny thing is that Obama actually specifically campaigned against Single Payer as too extreme.

If your rainbow pooping unicorn analogy is relevant to anyone, it is certainly relevant to people who thought Obama would have dissolved Congress and enacted a system that he CAMPAIGNED AGAINST.

[Fumesucker]

200. He also campaigned against the individual private mandate..

And yet signed a bill with an individual private mandate as a centerpiece.

Funny how that worked out, eh?

[LWolf]

85. Of course. Because anything

that improves the quality of life for us "little people" can be equated to ponies, puppies, or unicorns that poop rainbows.

Don't you love being told by people supposedly on your "side" that we are wrong to expect any politician to work for average citizens?

[Lost4words]

60. this thread has attracted its own oil slick, I'm there with you LWolf,

and with no job to boot, the bright siders will tell you how wrong we all are. patoowie

[burnsei sensei]

62. AHIP have looked after themselves well

this year.

Quote:
So I looked at the next cheapest plan. That one's premium is not 15-26% more. It is EIGHT TIMES what I'm paying for a premium now.
end quote.

It's the wave of the future.
How's that for-profit health care working out for you?
Had enough?

[laughingliberal]

97. I'd had enough of for profit health care long ago. The President, Senate, & House? Not so much.

Paying more and getting less is 'uniquely American!'

[MannyGoldstein]

63. The president promised change!

And you got change.

It's not our fault if you want listening during the campaign.

[KoKo]

66. Our insurance has increased, too. Less options more Co-Pay....

Thank you for posting in detail. :kick:

[sinkingfeeling]

67. I also got a letter from my employer-provided insurance company last week. No

changes to the premium, no increases in deductible, no increased co-pays, only that it had been extended to cover dependents through age 25 and the lifetime maximum had been removed.

We have seen increased premiums for 3 out-of-the last 5 years.

[LWolf]

86. We've seen increases in the last few years, too.

Much smaller increases, but still increases. 1-3% per year.

[bvar22]

70. If we put the Democrats in charge, they'll stop this Corporate Extortion!!!!

.
.
.
.
.
.
.
My Bad.

[laughingliberal]

110. Does seem something of a cruel joke played on us now, does it not? nt

[annabanana]

71. MY Health Insurance changes for the coming year:

My 23 year old, allergic, asthmatic son with severe excema will finally be able to see his doctor again, having been kicked off the family plan when he graduated college. He will be able to stop cutting his medicine in half, and suffering through bouts of wheezing to conserve albuterol. I will be able to get him a couple of new epi-pens in case he accidently eats a peanut. I will not have to worry myself sick every time he gets in a car.

For this alone, I am grateful for the change.

[LWolf]

92. I am really glad your son has a couple more years of coverage.

As I indicated, if my sons were still young enough, I would appreciate that.

They aren't, though. They are 30 and 32. Neither of them has health insurance.


The older son lost his when he was laid-off. Since there were no jobs to be had, he went back to school to finish his degree. Last December, he took an infected spot on his knee to the campus health center. They misdiagnosed it as a spider bite. I spent xmas eve with him in the emergency room. It was MRSA. The family pooled our resources to pay the exorbitant costs for that diagnosis and the multiple anti-biotics it took to knock it down. "Pooled our resources" means that a few of us have extra hundreds of dollars of credit card debt, since none of us have that kind of cash stashed away.


The younger son had a cardiac incident at work in March. He, too, has no insurance. He's got a job, but they cut his hours back to below the threshold for insurance. Again, family stepped in to take on debt, which he is trying to pay back a little at a time even though the cut hours has him scrambling to pay rent. What's worse is that he's had no follow-up care, since he's still trying to pay for the emergency room visit.

Our children are our children no matter how old, or self-sufficient, they get. My sons have been self-sufficient for a long time. But when they need me, I'm there, whether they are on my insurance, or not. And they are there for me.

It's good that we can cover our kids for a few more years. Better would be knowing that they will get the care they need at any time, regardless of age, without bankrupting themselves or their families.

[revolution breeze]

75. You must have the same coverage as I do

I am still bouncing the numbers around. I have chronic health conditions and see my rheumatologist, orthopedist, opthalmologist and general practitioner at least once every three months so lower co-pay and deductible are probably the worth the higher premium. Or I can quit seeing my doctors and let my disease progress and hopefully get disability in a year or two *sarcasm*.

[crim son]

79. I feel your frustration.

I'm sure it feels very much like you aren't insured at all, except for the ridiculous monthly premiums. I have the choice of being uninsured or borrowing money (until a miracle occurs and I can somehow pay it back) to pay for catastrophic coverage. My choice? I'm uninsured for the first time in my life. It's a horrible feeling.

[LWolf]

87. I feel yours.

While my situation is bad, I at least have catastrophic coverage if something major goes wrong. Some chronic conditions go untreated, getting slowly worse and affecting quality of life, but I can still function, and if a major disease or an accident runs up bills that exceed my mortgage, I'll get treatment and some of that will be covered.

I've always thought that every person in the nation deserved equal access to high quality, affordable health care. I still do. I want national, socialized health plan that doesn't have gatekeepers deciding how much, and what, kind of health care a person can get based on their ability to pay.

I'd hoped to see that in my lifetime. I'm not confident of that any more.

[SheilaT]

88. Hos in the world are they justifying

raising the premiums 800%???

For a long time now the insurance companies have used every excuse possible to raise premiums, co-pays, and deductibles, while cutting actual coverage.

I work at a local hospital. They are a self-covered health care program, although it's administered by United Health Care. Whatever your base pay is, they put in 3% of that which you can use any way you want to pay for medical insurance, and it's a kind of complicated tier system, based on how much you make, but they guarantee that the 3% will at least cover your own health care premium. And it does. And for 2011, the third year in a row, our premiums are not going up nor is the coverage changing.

If this corporation can do it (my hospital is part of a larger corporation which has I'm not sure how many hospitals and clinics, at least thirty) why can't others? Why can't every single small business or individual be given the opportunity to join a much larger pools, so that health costs are spread out in a reasonable way? Several have already posted in this thread about chronic, on-going medical challenges they or a family member face. I'm one of those amazing and fortunate people who simply is never sick, don't take any regular medications, and try (not always successfully) not to behave smugly about this. I DON'T think in terms of "why should I pay for your health care?", but "Why shouldn't we all help each other out?"

[LWolf]

130. It's not technically 800%.

They are offering 4 different plans, so I can't say that the plan I'm paying for this year will cost a certain percent more next year. My current plan isn't on the table.

The 4 new plans do offer one that won't raise my premium. It will just double everything else I pay.

The next cheapest plan, which retains the same deductibles and copays I can't afford now, adds the new "tiers" with some extra copays, and costs 8 times what I'm paying now.

The other 2 plans cost significantly more than the 8-times the cost plan.

[SheilaT]

174. The mind boggles.

I'm still feeling confused, as I'm sure you are also. What comes through loud and clear is that no matter what you choose, you'll be paying a lot more.

And again, I ask (and I know that you don't actually have the answer) how on earth are they justifying the increases?

It's not as though the insurance companies are losing money or have had to cut salaries at the corporate level.

[LWolf]

187. They apparently don't feel the need to justify the increases.

And you are right; no matter how you spin the numbers, I'll be paying significantly more.

[orbitalman]

89. LWolf... my experience very nearly parallels yours...

With no annual raises in sight (the economy, you know), premiums have raised the last 2 years 23% and 19%. That means we have taken that much of a CUT in pay from employer based insurance. It also means by extrapolation that we will be "paying" to work in a few years. Where does it stop??

EVERYTHING about healthcare insurance is higher. Those who solely blame the healthcare industry is partly bullshit because: Insurance companies negotiate a lower rate than what is actually charged anyway.

My insurance company, HUMANA, is ONLY profit-driven. We pay exorbitant rates while the insurance company pays LITTLE. They ARE a SCAM. Everyone here on DU needs to CALL THEIR'S OUT. :mad: We all must. Then compile a list for a fight.

The ONLY solution I see and have seen is "single-payer." We cannot settle for less. Even tho Obama has, I will not. His "change" has done me NO GOOD WHATSOEVER but continues to harm me. Thanks Obama :sarcasm:

[LWolf]

96. Single Payer.

And/or a great SOCIALIST national health plan.

I hope people are noticing that, while I posted about my personal situation, I am not alone.

I hear you about pay cuts. I can add: since my job is dependent on state revenues (I'm a teacher,) I've not only taken pay-cuts in the form of increased premiums, I've taken significant multiple salary cuts and pay cuts on top of that.

First they cut the salary, then they cut the # of days worked. That's two hits at once. It happened in August of '09 and again last June. I get my first paycheck for the new school year in October. With the salary cuts, days cut, and the increased premiums, I'm not sure if I'm going to be able to make mortgage payments.

I'm thankful that I've still got a job; that I wasn't one of the 50 or so RIF'd last year.

[grahamhgreen]

91. It's 3D chess - you pay more now, but in the future you pay less! nt

:sarcasm:

[iamthebandfanman]

94. blasphemer!

how dare you show how half assed this 'reform' is!!!


dont you know theres been no reform since FDR !? GAWD!

;)

[LWolf]

98. That's me, lol.

I've been called worse by some on DU. ;)

Remember when we were outraged at the Bush administration's Orwellian labeling of legislation and programming?

Look what we've done with the terms "reform" and "change." :(

[mzmolly]

100. Where do you support the 15-26% increase in your argument? We just had costs go down.

Co-pays went from $30 to $10 and office visits for preventive care is now $0 vs. $30. Our insurance changed annually and increased for years PRIOR to this legislation.

[laughingliberal]

113. Well, good for you. Which is really what it's all about, huh? I guess you've missed the stories...

about the massive premium increases people are seeing now.

[mzmolly]

119. I guess you missed the stories about the massive increases

prior to reform, huh? I guess you (and Faux Newz) also missed the stories about people whose children were previously denied coverage and who now have care?

From the http://www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf">CBO:

The legislation would have much smaller effects on premiums for employment-based coverage, which would account for about five-sixths of the total health insurance market. In the small group market, which is defined in this analysis as consisting of employers with 50 or fewer workers, CBO and JCT estimate that the change in the average premium per person resulting from the legislation could range from an increase of 1 percent to a reduction of 2 percent ... Employment-Based Coverage 6 In the large group market, which is defined here as consisting of employers with more than 50 workers, the legislation would yield an average premium per person that is zero to 3 percent lower ...(relative to current law).

You people are looking for evidence to support your tireless advocating against health care reform. Trouble is, you, like the OP and republics, can't support your case.

[laughingliberal]

131. We don't have to look far for evidence that premium prices are rising at the same or faster rate for

many. Nothing was done to control the cost of premiums and the pie in the sky speculation about the costs coming down after implementation are underwhelming. Almost 4 more years for them to jack up rates before it might slow down?

But, hey! YOUR costs came down and that's what counts! Everyone with a different experience needs to STFU!

"You people." Typical.

[mzmolly]

132. My point is, if it were true that reform increased premiums, it wouldn't be limited to a few.

Ever consider the fact that some insurance companies may want to help overturn reform by raising costs?

Speaking of being self centered, if we did have to pay a bit more so that kids with cancer could get health care coverage, I'd gladly do so!

[laughingliberal]

164. It's not limited to a few. I don't know anyone, personally, whose premiums have not gone up...

by a susbtantial amount. Self centered, my butt. My husband is a cancer survivor and I have 2 chronic illnesses and we are completely uninsured and hoping for the best as our premiums were over 25% of our income. Under the HCR bill, we would qualify for Medicaid so this is not about me. It's about a bad bill that will further enslave the working and middle classes (of which I was once a member) to an immoral, criminal industry that will continue to gouge the last pennies they can out of people's pockets while providing the least care they can get away with.

As for children with cancer, I spent the 1st 4 years of my work as an RN working at St. Jude Children's Reseach Hospital so you can save the sanctimoniousness. They never charged patients' families for care and they still don't.

[mzmolly]

166. Saint Jude's obviously does not treat every child cancer patient in the US.

Since when is it sanctimonious to consider families who are dealing with child cancer and other childhood diseases? :wtf: My family was personally impacted when we witnessed a four year old ravaged by the disease. So spare ME your attempt at shaming others who bring up valid concerns in this debate.

"Under the HCR bill, we would qualify for Medicaid so this is not about me." Of course not. :eyes: You've been helped by this legislation as many have.

As for your anecdotal stories about premiums which support your previous anti-health care reform position, I'll take them with a grain of salt. I am glad that you qualify for Medicaid however.

[laughingliberal]

173. The sanctimonious nature of your statement was about those you assume, selfishly, don't want to pay.

..more so children with cancer can get care. Perhaps it would have been nice if our elected leaders had cared more about children with cancer than they did about finding a 'uniquely American' system to preserve the industry's need for ever increasing profits and could have found a way for health care to be affordable for all.

The point about our qualifying for Medicaid is in answer to your assumption that everyone opposed to this bill has a selfish motive. Some of us can look beyond our own little part of the world and see far reaching effects of legislation beyond the direct impact on us, personally. Sure, if my husband survives until 2014 without a return of his cancer and I live that long we will, likely, qualify for Medicaid. Of course it is damned near impossible in our area, as in many others, to find a doctor who takes Medicaid patients but that is beside the point. Just because I'm not hurt, personally, by the legislation does not mean it is good for the general welfare of the people. It enshrines the worst parts of our system without any mitigating factors like a PO.

And, btw, your statement that your costs went down is, also, anecdotal with no more validity than mine that everyone I know who is purchasing insurance in the private market has seen a substantial increase. I believe headlines across the country have shown that these increases are happening in a lot of places to a lot of people. I've not seen any reporting on widespread premium reductions by the industry. Of course, you've already stated your premiums didn't go up so I assume you're not going to be paying more so children with cancer can get care.

[mzmolly]

175. You might have a point had I actually said what you're claiming I did.

Also, your suggestion that democratic lawmakers don't care about children with cancer is shameful. The system we enacted is not uniquely American, it's based upon the http://scienceblogs.com/denialism/2009/05/what_is_healthcare_like_Neth.php">Dutch model, even if lawmakers don't openly admit it for political reasons.

"Some of us can look beyond our own little part of the world and see far reaching effects of legislation beyond the direct impact on us, personally."

... which is why I mentioned the fact that children with cancer etc. are now covered and I'd gladly pay more for that advantage.

"And, btw, your statement that your costs went down is, also, anecdotal with no more validity than mine that everyone I know who is purchasing insurance in the private market has seen a substantial increase."

My point isn't merely anecdotal. >>> "Health Insurance Reform to Help 30 Million Women"

"The Commonwealth Fund has issued a report in which it claims that over the next 10 years, 30 million women in the United States will benefit from the changes in health insurance laws, making insurance more affordable. Health reform reportedly will both stabilize and reverse the disadvantages regarding health insurance that women have faced over the decades."

http://www.emaxhealth.com/1275/health-insurance-reform-help-30-million-women

"How Will the PPACA Impact Individual and Small Group Premiums in the Short and Long Term?"

"Those policies that did not include lifetime or annual limits prior to reform should not see higher premiums because of these provisions. For plans with lifetime maximums of $2 million or higher, removing the limits entirely will tend to increase premiums by less than 1% (with the small group impact being smaller than non-group). And according to America’s Health Insurance Plans, the vast majority of individual market plans have limits of $5 million and above, making it highly unlikely that this change will cause a noticeable impact on non-group premiums. Because small group plans tend to be more comprehensive than non-group plans, a measurable impact in that sector of the market is even less likely, according to Ms. Blumberg.

Federal agencies estimate that the provisions related to annual and lifetime limits will increase group premiums by about 1/2 of 1% and will increase non-group premiums by less than 1%. While premiums could increase modestly in such a way, out-of-pocket costs for those using care will fall as a result, potentially leading to substantial savings for those with serious health care needs, according to Ms. Blumberg."

Lastly here is a report concluded in May by TCFAP: http://www.americanprogress.org/issues/2010/05/health_spending.html

"The Impact of Health Reform on Health System Spending"

"This updated analysis projects the effect of national reform on total national health expenditures and the insurance premiums that American families would likely pay. We estimate that, on net, the combination of provisions in the new law will reduce health care spending by $590 billion over 2010–2019 and lower premiums by nearly $2,000 per family. Moreover, the annual growth rate in national health expenditures could be slowed from 6.3 percent to 5.7 percent."

[laughingliberal]

178. I think we covered the talking points about the "Dutch Model" during the debate.

Yes, there are a couple of other countries whose systems are based on private insurers. Here's where theirs is different and far superior to what we passed:

Insurers are tightly regulated for quality, provision of basic services, and to prevent discrimination, as they are required to accept everyone in their coverage area at a flat rate, no matter what their health status. To prevent loss of profitability from chronically-ill patients, they have a risk equalization system so that rather than losing profits from recruiting sicker patients, insurance companies are compensated for providing service to those patients who need it most.

Nothing like that was passed in HR 3590. A flat rate? In our dreams. Our lovely vultures are allowed to charge 300% more for older patients (who are, as a rule, the sickest). Guess we should be grateful. Baucus wanted to allow them to charge us 5 times as much.

We put nothing like the strict regulations in ours that other countries whose system is based on private insurance have.

I highly doubt we are going to see anything like the following outcomes here:

Their citizens are the least likely to think their system needs major reforms, they have one of the best access rates with most patients being able to see a physician within the same day, have short wait times for elective surgery, the shortest ER wait times, they are most likely report they are getting the drugs they need, the best treatment technology, and high-quality safe care. They are the least likely to avoid medical care, or to fail to fill a prescription due to concerns over cost. And more objective measures such as mortality due to health care amenable causes shows the Dutch perform better than most other countries in outcomes.

http://scienceblogs.com/denialism/2009/05/what_is_healthcare_like_Neth.php


If you think we'll see anything like that, then I'm not the one who believes in rainbow excreting unicorns.

As for your bold blue talking points, it is all conjecture at this point and is all projected to be the case after the bill goes into effect. So, the savings they are estimating we will see are all after 2014 by which times some hefty increases will have gone through for a whole lot of folks like the OP who is already being priced out of the market. The savings, should they materialize at all, will be savings over what people will be paying by 2014.



As for what you said being sanctimonious, Here it is:

"Speaking of being self centered, if we did have to pay a bit more so that kids with cancer could get health care coverage, I'd gladly do so!"

Brave words for someone whose costs 'went down.' And a slam at people who are upset because they are struggling to pay their premiums. It looks to me as if you called those who are worried about their rising premiums selfish because they don't want to pay more so children with cancer can get care. But, no matter, it's there for all to read. Others can decide for themselves what you intent was.

[mzmolly]

180. Those weren't MY talking points, those were quotes from analysis that you said does not exist.

I quoted various experts to prove that the points I made, were not merely anecdotal. You, on the other hand haven't proven your claims of mass headlines (from impartial sources) bolstering your cynical position.

Regarding the flat rate, we're moving in that direction which is why younger self insured people may see an increase in premiums and older people, a decrease. Unlike yourself, I think this bill is a beginning, not the end.

"But, no matter, it's there for all to read. Others can decide for themselves what you intent was."

And others can decide for themselves what YOUR intent has been throughout this entire health care debate.

Lastly, I'll take a moment to remind you what I replied to initially with my comment about my gladly paying more so that children would get HC coverage. "But, hey! YOUR costs came down and that's what counts! Everyone with a different experience needs to STFU!" :eyes:

As I pointed out in the analysis above, I'm not alone in seeing a reduction in overall cost. And, my ultimate support of this bill has never been about me.

[laughingliberal]

189. Please show me where I said analysis did not exist.

I did say it is all conjecture at this point and they are talking about savings they estimate we will see after the bill takes effect in 2014 meaning they are talking about savings over the 2014 rates which will be higher than today's already for many unaffordable rates.

Here's a few headlines to get you started. I think most of us here have seen some these. I know Keith and Rachel have covered it.

http://www.allvoices.com/contributed-news/6379367-health-insurers-raise-premiums-by-double-digits-by-awash-in-cash

http://www.washingtonpost.com/wp-dyn/content/article/2010/07/25/AR2010072503295.html?wpisrc=nl_cuzhead

http://www.reuters.com/article/idUSTRE65K54620100621

http://www.marketwatch.com/story/health-care-shocker-policy-premium-goes-up-69-2010-02-19

http://www.usatoday.com/news/health/2004-03-16-healthcost_x.htm

http://wonkroom.thinkprogress.org/2010/03/23/cigna-premiums-reform/


We are not moving towards a flat rate when the bill allows a 300% increase in a premium rates for age. No doubt the premiums for the young will go up. And the premiums for those over 50 will be 3 times the increased rate the young will pay.

Yes, I read here all the time, during the debate, about how this was the beginning. Problem is all I still see is the defenders touting the wondrous wonder of the historic bill and not admitting to the problems it has and banding together with fellow Democrats to start organizing some action to get some improvements made to the bill. Woolsley introduced a bill to create a public option in the House a couple of weeks ago. Where are the massive calls for everyone to bombard their reps to get behind this? What about Reid's promise to Sanders to get a bill creating a PO to the floor under reconciliation in this Congress? Anyone on here posting calls for pushing Reid to make good on it.

Yeah, I hope they improve a lot about the bill. But, so far, all I see is people telling me how I'm wrong about the problems with the bill. How am I to expect these 'proud incrementalists' to help us get it improved when all I see is more defense of it.

Here's your statement, again, about people who are worried about not being able to pay their premiums:

"Speaking of being self centered, if we did have to pay a bit more so that kids with cancer could get health care coverage, I'd gladly do so!"

I see no other way to interpret that except that those who are strapped already and can't meet the increases they are being hit with are selfish and want children with cancer to go without care whereas you (who say your costs have gone down) are unselfish and willing to pay more so children with cancer can live. Noble. But, then again, your rates didn't go up. So, easy for you to say. No?

My intent is the same it has been since the Republicans allowed the for profit industries to take over our hospital system when I was a new nurse (which, in case you don't know, was the first domino to fall in this disaster we call a health care system). It is to see the American people join the other first class citizens of the world who have access to health care without fear of losing everything to get it. My intent is to see us move towards a system that recognizes people's lives are more important than shareholder dividends and executive compensation paid by a murderous, criminal cartel. Diabolical, huh?

[mzmolly]

190. The headlines you note do not support your suggestion that reform is the

reason for any increase in premiums. In fact, every article you posted, supports the rational for reform.

From your first link -

"As an example Blue Cross Blue Shield of Arizona holds 7 times the minimum amount but raised it rates 14 to 19 per cent for policy holders in 2007 and another 13 to 15 per cent in 2008."

Your second link appears to reiterate the problem noted in the first, and suggests reform as a solution -

"Though neither states nor the federal government have veto power over premiums, they will be charged with creating a process to annually review "unreasonable" rate increases. "

The third link you posted, shares the same basic info as the first link and actually points out the benefits of reform as a corrective measure by closing with the following comment -

"In the vast majority of states, the nongroup market is subject to substantially less regulation than group insurance," the Kaiser report said. "Much will change under the new health reform law."

The fourth link is from February of 2009, and again it points to the need for reform, not a problem with it -

"This once again underscores the need for Congress to pass comprehensive health-care reform so that Americans have access to affordable health care and are protected from abusive insurance-company practices," ~ Henry Waxman stated

Your fifth link is from 2004 - which again demonstrates a NEED for reform.

The last link is from March of 2009 and also notes the fact that reform is a corrective measure.

"The Senate health care bill tries to address this problem by requiring insurers to spend a certain percentage of premiums on health care benefits (it establishes medical loss ratio targets) and stipulating that the Secretary of Health and Human Services, in consultation with the states, must develop a plan to look for “unreasonable increases.” Insurers are required to submit “a justification for an unreasonable premium increase” to the state insurance commission authority, who then makes the appropriate recommendations “to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.”

...

Lawmakers will have to tweak the legislation over time, but insulating voters from steep premium hikes in the interim period is both good policy and good politics."

At this point you've supported the case FOR reform, not against it. In fact, you've made my case in favor, stronger.

It is clear that you're passionate in your advocacy for a single payer system. But, this does not mean you should ignore the good that current health care reform accomplishes, IMO.

Regarding my statement about child cancer, again it was in reply to your "you've got yours and you don't care about others" bologna. I was simply demonstrating to you that I would pay more if it meant covering others, as this reform does. I need not apologize for my comment, or my sentiments in this regard. I also need not apologize for supporting the very reform meant to address the previous problems with rate increases (problematic prior to reform) which your six articles articulate, beyond a doubt.

That said, I respect the desire for a single payer system on your part. I simply don't believe it will happen overnight, if ever. Nor do I believe it's superior to the system adopted in the Netherlands, given what I've learned about that particular system in recent months. I believe that we've taken a step in the right direction, regardless of the avenue. Progress is just that ... progress.

Peace

[laughingliberal]

199. I did not say reform is the cause of rising premiums.

I said it has failed to stem the tide as of yet. Rising health care costs and lack of access for many are the reasons reform was needed.I think we all agree on that. The current bill has done little, if anything, IMO to slow the stratospheric rise in premium costs at least in the next almost 4 years. The analysis you posted shows they believe it will slow premium costs once implemented. Meanwhile, the insurance cartels are continuing to raise rates and GOK what they will be by the time the bill goes into effect.

I'm aware of the MLR that the bill set. I'm also aware it was set at the level the industry lobbied for and the industry has reassured their shareholders that they can easily get around this by reclassifying many of their operating expenses as medical expenses. I also know the state of CA has a law mandating a Medical Loss Ratio. They have found it very difficult and, in many cases, impossible to enforce. I am glad it is in the bill but I don't hold out much hope for it being the strong cost control measure that is needed. I'm willing and hoping to be proven wrong but this is an industry I have had dealings with for most of my adult life and I have no reason to suspect they will play by the rules without serious regulations in place and strong enforcement mechanisms like the Dutch system has. The point of my links is that premium rates are still rising at the same, and in some cases, faster rates than they were before the bill passed. It remains to be seen if this will slow significantly after 2014 but, by then, many who are not yet priced out of the market will be.

I apologize if I misinterpreted your statement about children with cancer. I'm sure there are many who would be willing to pay more to provide care for those children if they could. Many are stretched beyond their limits and unable even to provide for their own health care needs. The OP is one who is likely to lose access. His premium for less coverage is going up and his co-pays and deductibles will present a hardship should he become ill. I don't think these people are selfish. I think they have little money and I hate that they (we) live in a country where it is so hard for everyone to have something so basic.

I am not and was not a do or die single payer advocate. Ironically, I am what would have been seen as a pragmatist until just these past couple of years. During the primary health care reform was #1 on my hot button list. Health care has been the issue of my life-professionally and personally. I am not so naive as to think we would see single payer, although that would be lovely. I did see where the plan President Obama campaigned on could work to bring down premium costs and get more people covered in a way they could afford. It was the precise reason I supported him over Clinton-that was it. In almost all other areas, I saw little difference between the 2. And I am of the opinion, based on his behavior during the HCR debate, and the report in the NYT last August where the AHA lobbyist stated he had a deal with the White House to keep the PO out and he had no doubt it would be honored. No one has any proof one way or another but I saw the results and they seem to support what AHA's lobbyist said. I saw no strong advocacy for the PO on the part of the President once the debate got under way.

As for the Dutch system, it would take on hell of a lot of tweaking for this bill to result in anything like their system.

As for the help the bill provides, I see it will help those who are financially able to afford health insurance but have been shut out by pre-existing conditions. The very poor, like us, will be helped by extending Medicaid if they live in a state where Medicaid covers childless adults (many don't) and there are providers who accept Medicaid patients. Those falling between these 2 income levels will still struggle until changes are made. Also, leaving it as a system still largely tied to employer provided benefits, it did not address the downward pressure rising health care costs have put on wages over the last 2 decades nor does it help to level the playing field for American businesses competing on a global scale.

I hope you are right about the bill being improved over time. I believe you are sincere in your belief that the bill is a big help. My POV is born of a lifetime of analyzing unintended consequences and ferreting out loopholes in systems. I don't see many doing much to push our lawmakers that direction, as of yet. I would welcome some indication that there is any groundswell out there for improving the bill.

Peace to you and yours, also :)

[mzmolly]

203. I tell you what.

I will pledge here and now to advocate (in a positive fashion,) for what needs to be improved, over time. The ultimate goal = the dutch model. :patriot:

Ironically, I did not support Obama in the primaries as I felt he was too centrist. Same with Clinton. ;) I ultimately supported Edwards because I believed his health care plan etc. was much more progressive. That said, I'm pleased Obama won the nomination and I honestly feel he's doing a great job under very trying circumstances. Of course, much of what has been accomplished feels like too little, too late for those of us who endured Bush with great pain for eight years ... But I do think that in time, we'll be able to measure the impact of HC reform and say that it's been a great benefit to the country. I realize others disagree.

Certainly, you've been in a position to view the health care system from a perspective that many haven't. I can understand why you'd be more cautious than those of us who've not witnessed as much. At first I was of the public option or bust mindset, but as I examined analysis from impartial bodies, I became convinced that the plan put forth was a good starting place. I know not everyone here shares my optimism on this, however. :silly:

Have a nice evening and thanks for the discussion LL. :hi:

[laughingliberal]

205. That sounds like a deal to me.

I hope it does what you think it will and I hope the passage of this severely flawed bill has not quelled the passion for reform. There is still much to be done.

I am encouraged to find a defender of the bill who is committed to working for the needed changes.

I have enjoyed the discussion and am happy to have found some common ground.

Take care, mzm.

[mzmolly]

206. I do believe that I'm not alone in both supporting the bill and committing to its improvement.

You take care as well LL. :hi:

[LWolf]

120. That's what our benefits board predicted for us last spring.

Our union got the 15% - 26% figures from them. They passed them on to us in their newsletter.

The new plans offered arrived from the benefits board in my mailbox last week, and I got the rates for those plans from my employer.

It's hard to determine the % of increase, since the plans aren't the same. So I shared my options: keep premiums the same, and double everything else, or pay 8 times my current premium for the next cheapest plan, which has the same deductibles, copays, etc. plus extra costs with new tiers) I've already got and don't use because I can't afford them.

It's not an argument. It's a fact.

Here's another fact: Our benefits have been increasing every year. We've seen a 1-3% increase every year for the last 5. It's this year that the increases have sky-rocketed.

[mzmolly]

127. It sounds like they're politically motivated to lie and/or listen to their insurer vs. shop around?

The http://www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf">CBO: estimates indicated that employer based plans would see a 1-2% increase in premiums.

The legislation would have much smaller effects on premiums for employment-based coverage, which would account for about five-sixths of the total health insurance market. In the small group market, which is defined in this analysis as consisting of employers with 50 or fewer workers, CBO and JCT estimate that the change in the average premium per person resulting from the legislation could range from an increase of 1 percent to a reduction of 2 percent ... Employment-Based Coverage 6 In the large group market, which is defined here as consisting of employers with more than 50 workers, the legislation would yield an average premium per person that is zero to 3 percent lower ...(relative to current law).

Perhaps you should inquire with your board about where they got their estimates and/or if there is a more competitive plan available? I can't help but wonder if some insurance companies are abusing the current system to quell support for reform?

Best of luck.

[LWolf]

135. The CBO is wrong.

Politically motivated? Who is lying?

ORS243.866 requires us to be a member of OEBB, the benefits board, and to get our insurance through them. Their job is to find us the best and most affordable options for insurance.

https://www.oregonlaws.org/ors/243.866

http://www.leg.state.or.us/10ss1/measpdf/hb3600.dir/hb3667.intro.pdf

[mzmolly]

140. In your case perhaps, but I still question why this is and what specifically it has to do with HC

reform. In other words, how can some companies continue to provide like care without such an increase in premiums?

It does appear that the TOP choice increased 27% but the lower tier it was 9%. You do have advantages however, as you noted above.

http://www.oregon.gov/DAS/OEBB/docs/Rates/2009/Rates/Rates2009.pdf">2009 rates.

http://www.oregon.gov/DAS/OEBB/docs/Rates/2010/2010RatesRevised060110.pdf">2010 rates.

Looking at the plan choice for 2010 above, I wonder why you're limited to four? :shrug:

[LWolf]

144. An insurance committee representing our region chooses plans

from those allowed by OEBB. They choose 4 out of those available. Why the number 4? I don't know. Perhaps too many plans would make the size of the group too small for the rates offered? Just a guess.

I have to point out, again, that the plans change. Plan 3 (or any of the others) in '09 is not the same as plan 3 in '10. The plans, as well as the rates, have changed. So what we are paying for this year is different than what we paid for last year.

[mzmolly]

146. I noticed that they included children up to 25 already.

That's a good thing for some of your co-workers I imagine? I'm sorry that your premiums went up. However, I do hope you see a cost benefit overall LWolf. :hi:

[LWolf]

150. Thanks.

Extending the age of coverage for children is a good thing.

I'd like to be able to afford to actually see a doctor this year. That's the goal.

[mzmolly]

151. Visits for preventive care are supposed to have a zero copay now.

I hope again that you will see enough of an overall benefit to offset any increase in premium costs.

Peace

[LWolf]

154. I heard that.

It wasn't listed on the "health care reform" changes, and "Preventive Care Services" on the benefit charts still show a deductible. There's an information meeting next week to discuss the new plans. I'll be asking that question.

[mzmolly]

155. Best of luck.

:)

[nashville_brook]

103. this ought to be criminal. but instead, not having insurance will be punished by law.

so glad we got that health care reform!

[Lorien]

147. "HCR"-otherwise known as "extortion"

Paying out an enormous amount of money you don't have for services that may or may not be provided after you pay the deductible that you can't afford. Change-o-rific!

[INdemo]

105. Insurance companies spent millions to defeat real healthcare reform

we are now paying for it. I get so tired of hearing what a great accomplishment this was for Obama and the Democrats.This is the kind of healthcare reform that Bush could have pushed through because it gives the insurance companies an even stronger monopoly.
Rather than push this kind of junk legislation through Congress we would have been better off if the healthcare issue was dropped.
Oh I know everything will be better in 2014..What a joke. Just like the oil dissipated

[Lorien]

148. +1. And obviously the "we can fix it later" crowd is on that.

:eyes:

[bvar22]

159. I disagree. Bush could NOT have gotten this passed.

Like the coming Social Security "Reform", it takes a Centrist Democrat to pass something this BAD.

[INdemo]

169. Well the Democrats went along with every major bill that Bush wanted.There

was no fillibuster It was Bush simply asked and he received..Oh yes there was the usual showmanship and of course the media had to get involved and invite a few Democrats to get their picture up on the screen. But for the most part yes Bush could have gotten this Republican styled bill through easily. And remember that Bush never vetoed one spending bill and it was the Democrats that went along with every one of them...

[bvar22]

177. The Democrats DID manage....

... to block Bush from "reforming" Social Security.

Can you imagine the UPROAR from the "Democratic" Party if Bush had tried to FORCE every American to BUY mostly useless "insurance" from For Profit Corporations?
Just like it took a Nixon to go to China, it takes a Centrist Democrat to do something THAT bad.

[roxiejules]

111. Congressional benefits should be heavily cut or eliminated

until us "little people" have health care.

[DireStrike]

123. Sheesh, it's a good thing you can always choose to go without insurance

Oh wait...

[still_one]

125. The HCR bill was about insurance reform, not really about better, cost effective healthcare

Most people we are currently covered with health insurance through their employer will either be getting less benefits or paying more the same coverage

Rates have already started going up for health insurance, and there is no real enforcement to prevent that from happening

[LWolf]

128. Exactly why

I was not a supporter. :(

[L0oniX]

133. Public option = decide you can't make the co-payments.

[DirkGently]

136. Yep. Health Insurance's collective grip on our nethers

seems strangely no looser after reform than it was before.

[Lorien]

138. Welcome to our world (The world of the self employed-as your new policies sound like ours)

that's exactly why I was forced to drop my insurance as well. I had always paid for it out of pocket, but the premiums just kept rising and rising while my wages keep falling. The 10k deductible was always a struggle, but now it's impossible. Because of that deductible I paid over 80k in insurance premiums over the years and received all of $200.00 in coverage while adding over $46,000 of debt to my home equity line for my out of pocket deductible costs for minor surgery, ER visits, etc.it's an unsustainable system that, like damn near everything else in this Nation, benefits only those in the top 0.5% of the wealth bracket while destroying the rest of us.

[LWolf]

142. That is more than outrageous.

I hope you stay healthy. :(

[Lorien]

145. Myalgic Encephalomyelitis, hypothyroid disease, adrenal failure, fibromyalgia

and a fractured ankle that I couldn't afford to have treated. But I've found ways of ordering low cost blood tests and I've found some inexpensive physicians who don't even take insurance. It's exhausting, but it's the only way right now. :-(

[LWolf]

149. Wow.

I'm thinking of you.

Here? Type II diabetes and hypothyroid disease, and an ankle issue. I don't know how it would be diagnosed, since I've never had it examined, but my right ankle "rolls" regularly, resulting in a permanently swollen, painful, unstable ankle.

[Lorien]

170. Ouch. That defiantly needs to be looked at. Sounds like you either need

some support or specific exercises for it. I hope that you can find a low cost physician of your own soon! And if you ever need any low cost hypothyroid resources PM me. I have plenty.

[LWolf]

188. Thanks.

I'm currently using a non-prescription porcine thyroid source, which requires quite a bit more than my old Armour prescription did to get the same effectiveness.

Non-prescription because the blood tests the doctor orders are costly; I'm still paying on the last test, and until I pay it off, I'm not getting another, and can't get another prescription.

Trying to go without anything at all was bad. I kept falling asleep in the middle of the day, no matter how much sleep I'd gotten the night before.

[progressoid]

139. Wheeee!

Changerific.

[Greyhound]

156. Too late to rec. HIIPPA is a disaster, true, but it is a slow-motion disaster that

we won't notice until it's too late.

Oh yes, and "we told you so".
:kick:

[xchrom]

171. There will be more of these stories - and more sensible

People will try to tell that CAN'T be your experience.

[uberblonde]

172. Here's what I suggest.

Dump the company plan and buy your own catastrophic illness coverage from any one of your local providers (the company you already use probably has one). It will run somewhere between $300 and $500 a month, depending on the co-pays.

Or: Consider paying cash for your health care. If you have an ear infection, cold, high BP, etc., go to a drugstore walk-in center and get treated for $60 if your doctor's too expensive.

Or, if you live in a large city, find the local federally-funded public health center and use that for primary care.

If you need an x-ray or an MRI, it's a lot cheaper without insurance. They'll negotiate on all these rates if you pay cash.

[Lydia Leftcoast]

223. That's my plan

I talked to a doctor who specializes in treating the uninsured, especially artists. He told me that he could negotiate better prices on most diagnostic tests and many treatments for me if I DIDN'T have insurance.

[mdmc]

186. thehorror

awful to hear..

[Knight Hawk]

191. WOW

Now that is some real change you can believe in!

[inna]

198. too late to rec (darn, too bad I missed this), but....

:kick:

[Skittles]

202. some DUers are still buying this "health care reform" garbage

un-fucking-believable

[LWolf]

215. Yes.

The for-profit insurance companies are still at the wheel. It's still about making profit off of people needing care. It's still about making sure that we pay more than we get care, guaranteeing profit.

For every benefit offered by the bill, I see premiums going up to cover the cost. SOMEONE has to pay for extending the age you can keep your kids on your policy, for dropping lifetime maximums, for dropping copays for preventive care services. Insurance companies aren't going to give up their profit.

[B Calm]

222. Thank the REPUBLICAN PARTY for watering down the bill!!!!@!