Rationing Healthcare!

[GHook93]

I keeping hearing this night and day on the radio that the government will ration healthcare! That experimental drugs and treatments will be denied. That people in need of treatment will be denied.

Guess what people, ration already happens in the private system:
(1) Preexisting conditions :
If you have individual insurance, then they deny you coverage for the condition you actually need! Think about it. You need insurance for your health. Say you have a condition like MS, you need insurance to cover that! Yet the company tells you sorry we need to ration this way, because its unprofitable to us. If you work in a small business, you could have to under go a physical and get the same treatment. If this is not rationing, then WHAT IS?

(2) Increasing Premiums or Dropping Coverage:
Look busters we agreed to cover you as long as you didn't get sick or injured and request any claims. You made too many claims last year now we are dropping you? OK that was harsh, we are only raising your premium 200% no biggie! Hey small business owner in the corner, don't hide, because your people keep making claims, like that Asshole Joe Cancer! Joe Cancer either needs to go or we raise your premium 300%, while taking away things we cover (Note: more than likely Joe Cancer is out on the street with a gigantic Cobra expense!). If this is not rationing THEN WHAT IS?

(3) Removing coverage from a group plan:
In large companies its typical to not cover treatments such as OT, physical therapy or speech therapy, because only a small segment of the workforce will ever encounter them. I am sorry your son can't talk, but its more profitable for us to not cover it, how about you just give him some lolly-pops and tell people he would talk, but he has a lolly-pop in his mouth! If this is not rationing THEN WHAT IS?

(4) Denying experimental treatments and drugs:
This is what I find amusing about the R attacks on UHC, because the private healthcare denies experimental treatments and drugs all the time! Bone marrow transplants for cancers victims are routinely denied because the probability of it working is low and the cost is high! Experimental drugs get the same results. People do know that the HIV drug that has been prolonging people's lives (and is extremely expensive) was for a long time viewed as experimental and not covered. Even today many plans don't cover it! AMAZING! Who are the pundits on the radio crappin! If this is not rationing, THEN WHAT IS?

(5) The HMO:
The HMO has one purpose, INCREASE profits by denying as much as you can. I had an HMO for a little bit and its was pain to get anything. I was denied allergy shot coverage! ALLERGY shots! They said I didn't have allergies! Amazing! Ask anyone with an HMO, they make it difficult to get coverage and routinely get denied needed coverage. When if comes between 2 options they ALWAYS go with the more inexpensive option. If this is not rationion, THEN WHAT IS?

(6) The 80/20 copay PPO:
The PPO, the great alternative to the HMO! You get choice! Great! But it comes a huge cost. The 20% out-of-pocket! I am going to have a child in 1 month. Every other child I my take was $1,000 (note: I pay more for the 90/10 PPO plus). The total hospital bills come can out to $10K and neither of my kids had any complications. We were in and out of the hospital on a regular schedule! I had shoulder surgery. The total bills came out to $22,000, my take again was $2200. If you don't think a 20% copay deters many people from getting needed treatments and surgey you are crazy. The copay is an self-rationing mechanism! Again if this is not rationing, THEN WHAT IS?


Conservatives if you are going to make a case against UHC, then fine do it, but don't do it disingeniously! Don't toss out that healthcare will be rationed, while ignoring the fact that its rationed now!

 

[GHook93]

I am surprised no one is refuting this, because this is such a widely used talking point for the anti-UHC crowd!

 

[vharlow]

People only have pre-existing condition clauses in policies when they were not covered by some policy for a period of 63 days, or whatever...can't recall the exact period, but FYI that is a government regulation. There may be a time period when that clause is in effect, say for a year or something...it's not for always. If you lose a job and coverage, you can and should purchase a temporary policy which can be quite inexpensive, or choose COBRA coverage.

If you are expecting a government takeover of health care to cover OT, speech therapy, etc., think again. It won't happen.

If government takes over health care, and they determine you don't have allergies, do you really think government will pay for allergy shots for allergies you don't have? Think again. it won't happen.

The kind of rationing that conservatives are concerned about is for the elderly. How many transplants will not occur because you are over 60? How many surgeries will not be done because you are over a certain age...how many hip replacements that allow people to walk won't be done, how many pacemakers will be denied., etc. You get the picture. The elderly will be heavily rationed, according to Obama's own words.

 

[GHook93]

Right off of townhall.com, where many of the pundits write for!

 

[GHook93]

People only have pre-existing condition clauses in policies when they were not covered by some policy for a period of 63 days, or whatever...can't recall the exact period, but FYI that is a government regulation. There may be a time period when that clause is in effect, say for a year or something...it's not for always. If you lose a job and coverage, you can and should purchase a temporary policy which can be quite inexpensive, or choose COBRA coverage.

If you are expecting a government takeover of health care to cover OT, speech therapy, etc., think again. It won't happen.

If government takes over health care, and they determine you don't have allergies, do you really think government will pay for allergy shots for allergies you don't have? Think again. it won't happen.

The kind of rationing that conservatives are concerned about is for the elderly. How many transplants will not occur because you are over 60? How many surgeries will not be done because you are over a certain age...how many hip replacements that allow people to walk won't be done, how many pacemakers will be denied., etc. You get the picture. The elderly will be heavily rationed, according to Obama's own words.

Well said!

 

[Centrism'sVoice]

People only have pre-existing condition clauses in policies when they were not covered by some policy for a period of 63 days, or whatever...can't recall the exact period, but FYI that is a government regulation.

Doesn't help if you're not employed again by the time your COBRA runs out. Depending on the pre-existing condition, it really can be impossible to get any temporary insurance at all. My sister was in a car wreck 5 years ago, in which she broke several bones and had to have some leg muscles reconstructed. She's completely able-bodied now, but nobody would insure her aside from her employer's policy.

 

[vharlow]

Her medical claims should rightly be paid by the car insurer of whoever was to blame for the accident, not her health plan in the first place. The health carrier would go after the car insurance to pay for anything they paid out. That's the way insurance works. No health coverage for the pre-existing condition caused by that accident would not be a problem. If she was looking for a policy that had that pre-existing condition written in, it would only be for a specified period of time for that condition only, and would cover her for other problems.

People don't understand insurance at all, that's why it's so easy for politicians to demagogue and blame "insurance companies" as "evil" when most of the restrictions on them were created by the government regulations in the first place.

Insurance is not easy to understand. That's why insurance reps have to have hours and hours of training before they can get licensed. Ordinary people find it very difficult to understand all the ins and outs of tort law, etc.

 

[Centrism'sVoice]

Her medical claims should rightly be paid by the car insurer of whoever was to blame for the accident, not her health plan in the first place. The health carrier would go after the car insurance to pay for anything they paid out. That's the way insurance works.

The initial claims were never an issue, and what happened at that point was exactly as you described.

No health coverage for the pre-existing condition caused by that accident would not be a problem. If she was looking for a policy that had that pre-existing condition written in, it would only be for a specified period of time for that condition only, and would cover her for other problems.

This is the part you're missing: apparently no such policy exists. I should mention at this point that my sister is a longtime career journalist, and she is well aware of how to research a situation. If she says nobody will insure her due to problems from the accident, I'm prepared to accept that.

 

[vharlow]

HMO's MUST accept her. They cannot turn her down. Some are fairly good.

 

[veritas]

Her medical claims should rightly be paid by the car insurer of whoever was to blame for the accident, not her health plan in the first place. The health carrier would go after the car insurance to pay for anything they paid out. That's the way insurance works. No health coverage for the pre-existing condition caused by that accident would not be a problem. If she was looking for a policy that had that pre-existing condition written in, it would only be for a specified period of time for that condition only, and would cover her for other problems.

People don't understand insurance at all, that's why it's so easy for politicians to demagogue and blame "insurance companies" as "evil" when most of the restrictions on them were created by the government regulations in the first place.

Insurance is not easy to understand. That's why insurance reps have to have hours and hours of training before they can get licensed. Ordinary people find it very difficult to understand all the ins and outs of tort law, etc.

What? You don't understand it much either. Pre-existing conditions can and are slapped on by INSCOS all the time, sometimes retroactively. Subrogation should occur in the car accident scenario, but many times it doesn't. Sometimes the carriers are the same and then things can get really convoluted. Each state has its own laws which makes for an overwhelming C*F if an accident happened in a state where the policy was not initially issued. Most states and policies require an administrative remedy before a legal one, state insurance administrations are full of revolving door insurance execs, lobbyists, adjusters, etc.

 

[GHook93]

Her medical claims should rightly be paid by the car insurer of whoever was to blame for the accident, not her health plan in the first place.

For her original insures yes, not for continuing insurance payments!

No health coverage for the pre-existing condition caused by that accident would not be a problem. If she was looking for a policy that had that pre-existing condition written in, it would only be for a specified period of time for that condition only, and would cover her for other problems.

Not necessarily most pre-existing riders last for the life of the policy!

People don't understand insurance at all, that's why it's so easy for politicians to demagogue and blame "insurance companies" as "evil" when most of the restrictions on them were created by the government regulations in the first place.

And some people (YOU) give the insurance companies too much slack and idiotic faith!

 

[GHook93]

HMO's MUST accept her. They cannot turn her down. Some are fairly good.

You have proof of that! Because I smell BULL SHIT that any insurance policy must accept her. Either way they will put in a rider to not cover her pre-existing condition. You know the thing that she actually needs treatment for.

Also HMOs are by their very nature are healthcare rationing systems. Therefore Centrism's sister would have a fatcat insurance company rationing her healthcare! Either way the conservative argument is faltering here!

 

[Big Black Dog]

(6) The 80/20 copay PPO:
The PPO, the great alternative to the HMO! You get choice! Great! But it comes a huge cost. The 20% out-of-pocket! I am going to have a child in 1 month. Every other child I my take was $1,000 (note: I pay more for the 90/10 PPO plus). The total hospital bills come can out to $10K and neither of my kids had any complications. We were in and out of the hospital on a regular schedule! I had shoulder surgery. The total bills came out to $22,000, my take again was $2200. If you don't think a 20% copay deters many people from getting needed treatments and surgey you are crazy. The copay is an self-rationing mechanism! Again if this is not rationing, THEN WHAT IS?

This 80%/20% thing isn't out of reach if you purchase a plan that kicks in to pay what ever the 80% plan doesn't cover. In the last 10 years I have had two seperate surgeries that cost in excess of $120,000.00 each and the additional insurance paid everything my main policy did not cover except for about $1,000.00. I don't want, and I don't need the government with their fingers in my health care plans. If you're stupid enough to believe that lie that they tell about if you like your plan you can keep it, I feel sorry for you. Obama is on the record, regardless of what he's telling these days, as to wanting a single payer system in America. It's bad juju and I don't want anything to do with it and Obama and his lies. Hope you don't fall for his crap.

 

[veritas]

when most of the restrictions on them were created by the government regulations in the first place.

Got an example? Insurance is a contract. In the case of insurance this is mainly a unilateral contract. You pay the money, they set the terms. The contracts are forms. They vary depending on what state the policy is issued. You have a loss, they send an adjuster, then they can deny the claim. Then you can go to appraisal [sometimes required] or file an administrative complaint, or file suit. One in 30 valid claims that are denied are ever pursued further. That's VALID claims.

 

[veritas]

Obama is on the record, regardless of what he's telling these days, as to wanting a single payer system in America. It's bad juju and I don't want anything to do with it and Obama and his lies. Hope you don't fall for his crap.

Bad juju, eh? That's a convincing argument, NOT!!!!


Single payer makes sense. Why do we need INSCOs skimming 20% off the top to pay for paper pushing and denials and lobbyists? Why can't it go straight to the doctors, nurses and hospitals? Why do we need 50 different sets of rules for coverage in each state? What if we move? What if we lose our jobs? The insurance industry already gave Wall St. a high colonic. Instead of investing in sound instruments they were eating their own tail by buying up questionable vehicles. Then we had to bail them out.

 

[Cecilie1200]

I keeping hearing this night and day on the radio that the government will ration healthcare! That experimental drugs and treatments will be denied. That people in need of treatment will be denied.

Guess what people, ration already happens in the private system:
(1) Preexisting conditions :
If you have individual insurance, then they deny you coverage for the condition you actually need! Think about it. You need insurance for your health. Say you have a condition like MS, you need insurance to cover that! Yet the company tells you sorry we need to ration this way, because its unprofitable to us. If you work in a small business, you could have to under go a physical and get the same treatment. If this is not rationing, then WHAT IS?

(2) Increasing Premiums or Dropping Coverage:
Look busters we agreed to cover you as long as you didn't get sick or injured and request any claims. You made too many claims last year now we are dropping you? OK that was harsh, we are only raising your premium 200% no biggie! Hey small business owner in the corner, don't hide, because your people keep making claims, like that Asshole Joe Cancer! Joe Cancer either needs to go or we raise your premium 300%, while taking away things we cover (Note: more than likely Joe Cancer is out on the street with a gigantic Cobra expense!). If this is not rationing THEN WHAT IS?

(3) Removing coverage from a group plan:
In large companies its typical to not cover treatments such as OT, physical therapy or speech therapy, because only a small segment of the workforce will ever encounter them. I am sorry your son can't talk, but its more profitable for us to not cover it, how about you just give him some lolly-pops and tell people he would talk, but he has a lolly-pop in his mouth! If this is not rationing THEN WHAT IS?

(4) Denying experimental treatments and drugs:
This is what I find amusing about the R attacks on UHC, because the private healthcare denies experimental treatments and drugs all the time! Bone marrow transplants for cancers victims are routinely denied because the probability of it working is low and the cost is high! Experimental drugs get the same results. People do know that the HIV drug that has been prolonging people's lives (and is extremely expensive) was for a long time viewed as experimental and not covered. Even today many plans don't cover it! AMAZING! Who are the pundits on the radio crappin! If this is not rationing, THEN WHAT IS?

(5) The HMO:
The HMO has one purpose, INCREASE profits by denying as much as you can. I had an HMO for a little bit and its was pain to get anything. I was denied allergy shot coverage! ALLERGY shots! They said I didn't have allergies! Amazing! Ask anyone with an HMO, they make it difficult to get coverage and routinely get denied needed coverage. When if comes between 2 options they ALWAYS go with the more inexpensive option. If this is not rationion, THEN WHAT IS?

(6) The 80/20 copay PPO:
The PPO, the great alternative to the HMO! You get choice! Great! But it comes a huge cost. The 20% out-of-pocket! I am going to have a child in 1 month. Every other child I my take was $1,000 (note: I pay more for the 90/10 PPO plus). The total hospital bills come can out to $10K and neither of my kids had any complications. We were in and out of the hospital on a regular schedule! I had shoulder surgery. The total bills came out to $22,000, my take again was $2200. If you don't think a 20% copay deters many people from getting needed treatments and surgey you are crazy. The copay is an self-rationing mechanism! Again if this is not rationing, THEN WHAT IS?


Conservatives if you are going to make a case against UHC, then fine do it, but don't do it disingeniously! Don't toss out that healthcare will be rationed, while ignoring the fact that its rationed now!

Guess what, idiot? No one ever said that health care isn't rationed now, or that it won't be in the future. We just said we don't want the GOVERNMENT deciding how it's rationed.

If you're going to make a case for UHC, or against conservatives, then fine. Do it. But don't do it disingenuously, based on what you WANT to argue against, instead of what's actually being said.

 

[Cecilie1200]

I am surprised no one is refuting this, because this is such a widely used talking point for the anti-UHC crowd!

No, it's not. It's just a widely-used talking point in your own head, because you so desperately want a point you can win, as opposed to the REAL issues surrounding the topic.

 

[veritas]

Guess what, idiot? No one ever said that health care isn't rationed now, or that it won't be in the future. We just said we don't want the GOVERNMENT deciding how it's rationed.

Calling someone an idiot doesn't make you sound credible since you have offered exactly nothing to refute the detailed points ghook put up. So you are not refuting it either. I happen to agree with ghook [no surprise]. Government is already rationing and contracting care through the states. Each state has lengthy labyrinthine INS laws. There's no reciprocity. That means 50 different sets of BS for each state. Uniformity in insurance law and contract [policy] law would go a long way in cutting costs. I doubt 10 percent of people who are insured actually can read and understand their insurance policy, less than that know how their state handles the industry. Even less could cogently compare policies. That works well for the INSCos because the more uninformed consumers they have, the better the chance they have in not paying claims.

 

[Political Junky]

Guess what, idiot? No one ever said that health care isn't rationed now, or that it won't be in the future. We just said we don't want the GOVERNMENT deciding how it's rationed.

Calling someone an idiot doesn't make you sound credible since you have offered exactly nothing to refute the detailed points ghook put up. So you are not refuting it either. I happen to agree with ghook [no surprise]. Government is already rationing and contracting care through the states. Each state has lengthy labyrinthine INS laws. There's no reciprocity. That means 50 different sets of BS for each state. Uniformity in insurance law and contract [policy] law would go a long way in cutting costs. I doubt 10 percent of people who are insured actually can read and understand their insurance policy, less than that know how their state handles the industry. Even less could cogently compare policies. That works well for the INSCos because the more uninformed consumers they have, the better the chance they have in not paying claims.

 

[Cecilie1200]

Guess what, idiot? No one ever said that health care isn't rationed now, or that it won't be in the future. We just said we don't want the GOVERNMENT deciding how it's rationed.

Calling someone an idiot doesn't make you sound credible since you have offered exactly nothing to refute the detailed points ghook put up.

::snore:: This old ploy. "You weren't mean, so I win!" No, sorry. BEING an idiot doesn't provide credibility, and trying to focus on my characterization to avoid having to deal with the rest of what I said, just adds to the stupid.

So you are not refuting it either.

Actually, Brain Trust, despite your belief that my post consisted of only the word "idiot", it was in fact entirely a refutation of GHook's ignorant assertion.

I happen to agree with ghook [no surprise].

No, that's entirely in keeping with your inability to comprehend what you read beyond what's necessary to run to Mommy and cry.

Government is already rationing and contracting care through the states. Each state has lengthy labyrinthine INS laws. There's no reciprocity. That means 50 different sets of BS for each state.

So now you not only want the federal goverment to control all healthcare in the US, you also want to do away with the concept of state sovereignty so that you can be a spoiled, whining, coddled brat no matter what region you choose to grace with your presence? Is that it?

Uniformity in insurance law and contract [policy] law would go a long way in cutting costs.

You know what else would go a long way toward that? Cutting out three-fourths of the government interference that causes these conflicts in the first place. What WON'T cut costs is MORE government interference.

I doubt 10 percent of people who are insured actually can read and understand their insurance policy, less than that know how their state handles the industry.

Wah freaking wah. We need Daddy Government to hold our hands and spoonfeed us and wipe our bottoms because we can't be held responsible for understanding the legal contracts we sign. God forbid you lazy-ass freeloaders go out and hire someone to explain to you what you're signing, the way any sane, responsible adult would do. It isn't as though there aren't knowledgeable professionals available to do so.

Even less could cogently compare policies. That works well for the INSCos because the more uninformed consumers they have, the better the chance they have in not paying claims.

I have no intention of giving control of my health care to the government - which isn't exactly a haven of clear, concise contractual language, free of legalese - simply because you and others like you are stupid, uninformed, and too damned lazy to fix it. So your argument of "We need this because people are dumb and get taken advantage of" is falling flat.

I suggest that if you like the idea of being treated like a retarded five-year-old so much, you simply go sign up for Medicaid and leave those of us who can still handle controlling our lives alone.