Rozman
Gold Member
If Obama Care is so great how come so many people/States/Unions etc are getting waivers so they don't have to get it?
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Momanohedhunter said:I have been very sick with out insurance, got treated with very expensive medication (got it free) and was cured. I am pretty sick again and it is costly, but the insurance is doing what it is supposed to do. The cost of the insurance has gone up by around $100.00 a person in my family since 'Bammers reform bill, but we deal with it. As for leaving it all in the hands of the insurance companies, Thats a hell of allot better then having it in the hands of the government like it is now.
The growth rate of health insurance premiums failed to reach double digits this year, the first time that's happened since 2000. Still, premiums rose much faster than overall inflation and wage growth, the Kaiser Family Foundation reported Wednesday.
The foundation, which specializes in healthcare research, said premiums increased 9.2 percent between the spring of 2004 and the spring of 2005. Such an increase could devour much, if not all, of the 2.7 percent increase that the average employee saw in wages.
"There is some good news, I suppose. The rate of growth is slightly lower than last year," said Drew Altman, the foundation's president and CEO. "The bad news is that's the only good news, because premiums are still going up 3 times faster than wages."
However, the rules were intended to force the private sector out. Insurance is based on risk which can be calculated. That is why there are lifetime caps in many policies and why folks with pre-existing conditions find it difficult to buy insurance.
By removing caps and forcing insurance companies to insure all at the same rates, this denies the reality of the economics of the health care industry.
Ironically, the actuaries at Insurance companies analyzed the details of Obamacare and concluded that costs would rise. The economy, strangled by the policies of Obamanomics has made people so poor that they cannot afford health care even if they are insured.
Obamanomics is the economic cure for the economic disaster that is Obamacare.
In this sense, then, Obama has answered the question of Obamacare. Reduce the national payroll to the extent that nobody can afford care and cost of insurance will go down.
Maybe he is a genius.
For one thing, insurance exchanges means that health insurances companies will be competing for business, which of course means coverage and fees therefor. It would be counterproductive if they all were forced to charge the same amount.
Regarding lifetime and annual caps, here's the regulation concerning those. And from my read, it appears to have plenty of wiggle room for insurance companies and at the same time provides relief for a person who would have reached a "limit" by perhaps only one surgical procedure which could involve as much money as the cap, for example.
Eliminating Lifetime and Annual Limits on Your Benefits | HealthCare.gov
If Obama Care is so great how come so many people/States/Unions etc are getting waivers so they don't have to get it?
Since when is everyone entitled to health care? If the government would let the market operate without interference then we would have many more options for health insurance. This is the slippery slope we have been on for years - the unintended consequences of government action cause problems (like rediculous health care costs) and the solution everyone screams for is more government!! WAKE UP!
Welfare
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD [American Heritage Dictionary]
I know that it's really sad, but the reality is that we can't afford unlimited care for everyone who needs it, and this will worsen even more with Obamacare on the horizon. I feel for your friend's baby, but there is (by necessity) a limit to what can be spent just to keep seriously and critically ill folks alive. We will be seeing more and more of this phenomenon as the country starts to see the real costs of unlimited health care coverage.
So no, I don't think we should have congress legislate this issue. It's a reality of living and dying.
CURRENT employer paid health insurance, where the consumer is not the customer THAT PAYS THE BILLS OR PREMIUMS, Medicare and Medicaid ARE ALL BLANK CHECK HEALTH CARE.
We pay 2 1/2 times MORE than other industrialized nations as a result of our dysfinctional HEALTH CARE system.
Disease care is another matter. We have the best disease care in the world.
We should. We use 60% OF ALL HEALTH CARE DOLLARS IN THE US to pay for disease care of 5% of the population. And 7 of the top 8 diseases treated ARE PREVENTABLE.
The other 95% of the population have substandard health and health care.
WAKE UP DUMB ASS AMERICANS.
So isn't cost control the solution? But Heaven Forbid we should tinker with the medical profession's right to the highest profits it can get. That's one of the evil parts of capitalism.
Since when is everyone entitled to health care? If the government would let the market operate without interference then we would have many more options for health insurance. This is the slippery slope we have been on for years - the unintended consequences of government action cause problems (like rediculous health care costs) and the solution everyone screams for is more government!! WAKE UP!
If Obama Care is so great how come so many people/States/Unions etc are getting waivers so they don't have to get it?
The cost would be astronomical for individual plans, as is the FEMA flood insurance, which is why few people have it. The reason the "uninsurable" (I'm not sure what you mean by that) will be covered is because they will become part of a pool of insured, which always lowers premiums for individual members of the pool.
Always is a big word. If there is a work force of 150 idividuals and 149 are 25 year old single males and one is a 30 year old woman, that woman will enjoy lower rates.
Reverse that demographic and the single 25 year ol male will suffer vastly increased rates.
Any group is comprised of individuals and the risks and experience of that composite dictate the cost of each individual that comprises that group. This is why the participation in a national healthcare plan must be mandatory for all so the relatively healthy young can in effect subsidize the cost of the pregnant women, those with ongoing conditions and the infirm.
The truth is that the costs are averaged and some will rise while others will fall.
Maybe the definition of insurance pools has changed then. I actually used to put out bids for company health insurance when our existing contract expired and if the current provider had plans to raise the rates on renewal. The bids were always segregated based strictly on a cost factor for a single person, a family of two, and slightly increased as more were added to the family. In other words, flat fees (premiums) for all employees for identical coverage.
If Obama Care is so great how come so many people/States/Unions etc are getting waivers so they don't have to get it?
They still have to meet the basic requirements. They just want to be in control and manage it themselves.
Since when is everyone entitled to health care? If the government would let the market operate without interference then we would have many more options for health insurance. This is the slippery slope we have been on for years - the unintended consequences of government action cause problems (like rediculous health care costs) and the solution everyone screams for is more government!! WAKE UP!
So tell us how leaving it strictly to the market to run has worked out? How do you think this subject has been a national issue for decades?
I personally believe health care for all Americans is a RIGHT, not a PRIVILEGE. I know I'll get whacked by the strict Constitutionists who love their interpretation and no one else's on this, but what do you suppose the framers of the Constitution had in mind in their opening statement (preamble) to the Constitution with the words "promote the general Welfare"?
What is "general welfare" if not first and foremost the health of people, which enables them to go forward and fulfill the myriad clauses of the Constitution?
wel·fare   
1. the good fortune, health, happiness, prosperity, etc., of a person, group, or organization; well-being: to look after a child's welfare; the physical or moral welfare of society. [Dictionary.com Unabridged]
The Constitutional Dictionary - The U.S. Constitution Online - USConstitution.net
Welfare
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD [American Heritage Dictionary]
Always is a big word. If there is a work force of 150 idividuals and 149 are 25 year old single males and one is a 30 year old woman, that woman will enjoy lower rates.
Reverse that demographic and the single 25 year ol male will suffer vastly increased rates.
Any group is comprised of individuals and the risks and experience of that composite dictate the cost of each individual that comprises that group. This is why the participation in a national healthcare plan must be mandatory for all so the relatively healthy young can in effect subsidize the cost of the pregnant women, those with ongoing conditions and the infirm.
The truth is that the costs are averaged and some will rise while others will fall.
Maybe the definition of insurance pools has changed then. I actually used to put out bids for company health insurance when our existing contract expired and if the current provider had plans to raise the rates on renewal. The bids were always segregated based strictly on a cost factor for a single person, a family of two, and slightly increased as more were added to the family. In other words, flat fees (premiums) for all employees for identical coverage.
With your experience in doing this, did the bidding companies ever ask for the demographics of your population? Experience ratings? Your goals for coverage? The important components to be included in the plans to be defined?
All of these questions are definers of the costs that the insurer will incur. If your population is generally young, less than 35 and they all currently carry family insurance, pregnancy and the possible problems with delivery, pre and post natal care are definite considerations.
The premiums for the group are identical within categories. If one member of the group is diagnosed with cancer and has 10 operations in one year and is in the ICU for ten months, everyone's premiums will rise next year and they will be identical within categories.
Insurance companies do nothing more than figure the odds.
If Obama Care is so great how come so many people/States/Unions etc are getting waivers so they don't have to get it?
They still have to meet the basic requirements. They just want to be in control and manage it themselves.
The waivers to excuse them from following the law are granted to do what?
Although the legislation establishes a basic federal framework for reforming our health insurance system, it leaves the states to decide how much they will be involved in the implementation of the law. The states, for example, have the option of either implementing the health insurance exchanges themselves or allowing the federal government to do so. States may establish their own risk adjustment programs, preexisting condition high risk pools, and excessive premium increase review programs or leave these tasks to the federal government.
The states also have the option of either enforcing the ACAs basic insurance regulatory reforms (the ban on rescissions, the requirement of coverage for adult children and of preventive services without cost-sharing, and others), or letting the federal government do it. If a state chooses to implement the law itself, moreover, it generally has a great deal of flexibility in the approach it takes to implementation, as we are witnessing currently in the widely varying approaches the states are taking to establishing their exchanges.
Since when is everyone entitled to health care? If the government would let the market operate without interference then we would have many more options for health insurance. This is the slippery slope we have been on for years - the unintended consequences of government action cause problems (like rediculous health care costs) and the solution everyone screams for is more government!! WAKE UP!
So tell us how leaving it strictly to the market to run has worked out? How do you think this subject has been a national issue for decades?
I personally believe health care for all Americans is a RIGHT, not a PRIVILEGE. I know I'll get whacked by the strict Constitutionists who love their interpretation and no one else's on this, but what do you suppose the framers of the Constitution had in mind in their opening statement (preamble) to the Constitution with the words "promote the general Welfare"?
What is "general welfare" if not first and foremost the health of people, which enables them to go forward and fulfill the myriad clauses of the Constitution?
wel·fare   
1. the good fortune, health, happiness, prosperity, etc., of a person, group, or organization; well-being: to look after a child's welfare; the physical or moral welfare of society. [Dictionary.com Unabridged]
The Constitutional Dictionary - The U.S. Constitution Online - USConstitution.net
Welfare
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD [American Heritage Dictionary]
This does not mean that and it never has. The word welfare was very much in keeping with the phrase, "Pursuit of happpiness." Welfare, by the definition you apply, would have been termed "charity" by the founders.
Welfare: Samuel Johnsons A Dictionary of the English Language (published in 1755)
1. Happiness; success; prosperity. The definition of welfare in 1787, the year of the drafting of the Constitution, meant you had health, wealth and happiness. Almost 40 years after the Constitutions drafting, Noah Webster 1828 Edition still used this definition. The Constitution was written clearly as applies to states.
animal-farm.us
The phrase, general Welfare, in Article I, Section 8 does not authorize Congress to enact any laws it claims are in the general Welfare of the United States. The phrase sets forth the requirement that all laws passed by Congress in Pursuance of the enumerated powers of the Constitution shall also be in the general Welfare of the United States.
This was affirmed by James Madison when he wrote:
With respect to the words general welfare, I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.
I had group insurance from United Healthcare a few years ago. Our company had about 40 employees. I don't remember all the details but United lumped our employees in with a number of other companies so the insurance pool was quite large. So if there was a huge medical expense, the cost was spread over a large pool which protected our premiums somewhat. The plans seemed expensive and there were very few options.Maybe the definition of insurance pools has changed then. I actually used to put out bids for company health insurance when our existing contract expired and if the current provider had plans to raise the rates on renewal. The bids were always segregated based strictly on a cost factor for a single person, a family of two, and slightly increased as more were added to the family. In other words, flat fees (premiums) for all employees for identical coverage.
With your experience in doing this, did the bidding companies ever ask for the demographics of your population? Experience ratings? Your goals for coverage? The important components to be included in the plans to be defined?
All of these questions are definers of the costs that the insurer will incur. If your population is generally young, less than 35 and they all currently carry family insurance, pregnancy and the possible problems with delivery, pre and post natal care are definite considerations.
The premiums for the group are identical within categories. If one member of the group is diagnosed with cancer and has 10 operations in one year and is in the ICU for ten months, everyone's premiums will rise next year and they will be identical within categories.
Insurance companies do nothing more than figure the odds.
All the employees had to fill out a standard form detailing their personal situations, as if applying for personal health insurance, and those were turned over to the insurance companies under consideration. We (as the employer) could also decide whether or not we wanted them to include an estimate for pregnancy care, and as I recall we said yes but only bare bones, i.e., limited to non-emergency regular doctor visits and no coverage for the actual hospitalization.
Ironically, we did have a situation where one employee had horrendous medical/surgical expenses involving her situation with scoliosis. She decided she wanted to have the spine straightening operation where they drive a metal rod through the spine and she had to be in a full back cast for an entire year while it fused. The costs were through the roof, just for that one employee. We had a lock on the premiums, though, but you can bet the insurer wanted to either raise the rates when the contract was up or drop us. That's when I went shopping. That year, I found an insurer (Prudential) whose rate estimates were very close to what we'd been paying, plus they would add preventive dental insurance for an additional $10 a month per person and dependent, but everyone had to agree to take both. You can really design your own plan, or at least you could 20 years ago.
Unless the government took control of the healthcare industry or established a single payer system, I don't think it can make any major improvements in the quality of care. In the healthcare law there is a provision that attempts to reward hospitals for higher quality care. If it wasn't deleted there was some money to be used to put patient records online, which would be a major improvement for some institutions.Just curious as to what people here will say about this. Do you think the government should pass legislation to prevent the following example below from happening, and if so what, and if not why not?
I know someone, who's in his mid/late 30s, immigrated here (legally), has held the same job steadily, recently became a US citizen, married a US citizen here, and just had a baby. He's a prime example of somebody coming here for a better life-and an example of the American dream. Did everything the right way. He's a hard worker, and has health insurance for his family through his employer.
His newborn baby however has many medical problems-and needs very expensive medical attention, or will die. The health insurance company has already alerted the company he works for that he's no longer able to stay on the policy.
I think there's something very wrong with this scenario-and it can happen to ANYBODY. I think America can do better for our citizens than this.
edit: to be fair they're not dropping him, but just charging a ridiculous amount, knowing full well he, and the other employees cannot afford it. Adding edit here, rather than my post.
The national origin of the person in the story is not important.
The cost of the medical care is all that matters.
The Obamacare approach has nothing at all to do with medical care. The only thing it addresses, and that it hopes to confiscate, is the insuarance dollars to pay for the medical care.
Liberals proclaim that our "Healthcare System" is the worst in the industrialized world and yet make no moves to change it. All they want to talk about is the dollars paid to the insurance companies.
This is what you are doing.
If the costs are generated by the healthcare providers and the insurance companies are paying those costs, why do you attack those who are paying and not those who are charging?
The price of the care is already established. The insurance company only acknowledges that cost and passes it along.
Until something is done to reduce the costs, the costs will remain high.
Just curious as to what people here will say about this. Do you think the government should pass legislation to prevent the following example below from happening, and if so what, and if not why not?
I know someone, who's in his mid/late 30s, immigrated here (legally), has held the same job steadily, recently became a US citizen, married a US citizen here, and just had a baby. He's a prime example of somebody coming here for a better life-and an example of the American dream. Did everything the right way. He's a hard worker, and has health insurance for his family through his employer.
His newborn baby however has many medical problems-and needs very expensive medical attention, or will die. The health insurance company has already alerted the company he works for that he's no longer able to stay on the policy.
I think there's something very wrong with this scenario-and it can happen to ANYBODY. I think America can do better for our citizens than this.
edit: to be fair they're not dropping him, but just charging a ridiculous amount, knowing full well he, and the other employees cannot afford it. Adding edit here, rather than my post.
Just curious as to what people here will say about this. Do you think the government should pass legislation to prevent the following example below from happening, and if so what, and if not why not?
I know someone, who's in his mid/late 30s, immigrated here (legally), has held the same job steadily, recently became a US citizen, married a US citizen here, and just had a baby. He's a prime example of somebody coming here for a better life-and an example of the American dream. Did everything the right way. He's a hard worker, and has health insurance for his family through his employer.
His newborn baby however has many medical problems-and needs very expensive medical attention, or will die. The health insurance company has already alerted the company he works for that he's no longer able to stay on the policy.
I think there's something very wrong with this scenario-and it can happen to ANYBODY. I think America can do better for our citizens than this.
edit: to be fair they're not dropping him, but just charging a ridiculous amount, knowing full well he, and the other employees cannot afford it. Adding edit here, rather than my post.