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#27 Sep 23 2010 at 12:03 PM Rating: Good
yossarian wrote:
You might think they are going to allow access for people with pre-existing conditions. Since they say they are:

"Ensure Access For Patients With Pre-Existing Conditions:"

But then you read after the colon and get this:

"Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans."

Emphasis mine.


My problem with this (and with the current healthcare reform bill as I understand it) is that they say nothing about making it affordable. Right now in Tennessee (probably other places, as well) insurance companies cannot deny someone coverage because of a pre-existing condition (if you've had prior insurance for the last 12 months, of course). However, they can (and do) rate the premium up so high that you can't afford it even when your deductibles and out-of-pocket amounts are ridiculously high.
#28 Sep 23 2010 at 12:07 PM Rating: Excellent
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Belkira the Tulip wrote:
My problem with this (and with the current healthcare reform bill as I understand it) is that they say nothing about making it affordable. Right now in Tennessee (probably other places, as well) insurance companies cannot deny someone coverage because of a pre-existing condition (if you've had prior insurance for the last 12 months, of course). However, they can (and do) rate the premium up so high that you can't afford it even when your deductibles and out-of-pocket amounts are ridiculously high.

In theory, this will be the purpose of the government overseen pool option once that gets off the ground. To provide an option for people who can't otherwise afford it.
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#29 Sep 23 2010 at 12:11 PM Rating: Good
Jophiel wrote:
Belkira the Tulip wrote:
My problem with this (and with the current healthcare reform bill as I understand it) is that they say nothing about making it affordable. Right now in Tennessee (probably other places, as well) insurance companies cannot deny someone coverage because of a pre-existing condition (if you've had prior insurance for the last 12 months, of course). However, they can (and do) rate the premium up so high that you can't afford it even when your deductibles and out-of-pocket amounts are ridiculously high.


In theory, this will be the purpose of the government overseen pool option once that gets off the ground. To provide an option for people who can't otherwise afford it.


I wonder what sort of requirements you'd have to meet. For example, if I make $75,000 a year but I still can't afford health insurance, could I use the risk pool? Or is it only for people who make under $20,000?

I wish we'd just been given a real public option.
#30 Sep 23 2010 at 12:40 PM Rating: Good
Belkira the Tulip wrote:
yossarian wrote:
You might think they are going to allow access for people with pre-existing conditions. Since they say they are:

"Ensure Access For Patients With Pre-Existing Conditions:"

But then you read after the colon and get this:

"Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans."

Emphasis mine.


My problem with this (and with the current healthcare reform bill as I understand it) is that they say nothing about making it affordable. Right now in Tennessee (probably other places, as well) insurance companies cannot deny someone coverage because of a pre-existing condition (if you've had prior insurance for the last 12 months, of course). However, they can (and do) rate the premium up so high that you can't afford it even when your deductibles and out-of-pocket amounts are ridiculously high.
There is a provision in the bill that limits the only factors insurance companies can vary individual consumer cost by to age (max 3:1), tobacco use (max 1.5:1), and individual vs family rates (effective starting Jan 1, 2014), so in order to raise coverage costs on persons with pre-existing conditions to cost prohibitive levels they would have to raise coverage costs on everyone to cost prohibitive levels, which would drive customers away and destroy their business.
#31REDACTED, Posted: Sep 23 2010 at 2:35 PM, Rating: Sub-Default, (Expand Post) Yossi,
#32 Sep 23 2010 at 2:44 PM Rating: Default
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Belkira the Tulip wrote:

My problem with this (and with the current healthcare reform bill as I understand it) is that they say nothing about making it affordable. Right now in Tennessee (probably other places, as well) insurance companies cannot deny someone coverage because of a pre-existing condition (if you've had prior insurance for the last 12 months, of course). However, they can (and do) rate the premium up so high that you can't afford it even when your deductibles and out-of-pocket amounts are ridiculously high.


That's because it costs them a lot more to cover someone with a pre-existing condition. The insurance industry is able to provide coverage on the basis of a large number of people buying insurance. The assumption with insurance is that most of the people buying it are healthy right now, but are insuring against a potential future medical expense.

Let's take a simple example: I buy insurance to cover a broken arm. It costs $500 to treat a broken arm. The insurance company calculates that the average person will break 1 arm every 20 years on average. Thus, it can charge $25 per year in insurance and break even. Let's say it charges $30 so it can cover it's expenses and make a profit. So if I fall down and break my arm, I'm covered. If I *don't* fall down and break my arm, I'm losing money on my insurance (but I'm healthy, so there is that).

If I get to wait to buy insurance until after I break my arm, and the insurer charges me the normal $25, the insurer loses money. If the government passes a law which mandates that the insurer *must* cover someone with an already broken arm, then why would anyone ever buy insurance ahead of time? They'd all wait until they had a broken arm and then show up and demand coverage, right? Who wouldn't? And the insurance company goes bankrupt because it can't possibly afford to pay for all those broken arms.

They have to charge more when people do that. The whole point of insurance is that you're supposed to buy it ahead of time to cover you *if* the covered event(s) occurs. There's no way around the cost issue here. The proposal to use government funds to pay for it just makes the government (the taxpayers really) the ones who end out paying for all that extra cost. That's why conservatives opposed this. It's just socialized medicine with a bit of misdirection applied.


At the end of the day, Americans need to decide collectively whether they want the government to just pay for all their health care, or not. Up until now, US citizens have rejected that idea on principle. So sneaking it around the back way isn't really the right thing to do. It's dishonest, and frankly it's designed to make our health care system even less efficient and more expensive. Some of us argue that this is by design. If you make the existing system so bad, then just having the government do it all starts to look better in comparison.
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#33 Sep 23 2010 at 2:54 PM Rating: Excellent
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gbaji wrote:
At the end of the day, Americans need to decide collectively whether they want the government to just pay for all their health care, or not.

I say yes!
Quote:
Up until now, US citizens have rejected that idea on principle.

"On principle"? I don't think you know what that means. Public polling for public options is generally quite favorable. Programs such as Medicare are very popular and phrasing a public option question in a manner like "...similar to Medicare" is always good for a boost in the poll numbers. I think you're confusing a muddled fight over a bill that never had a real government-run public option to some sort of... "principled" stance against a true government public option.
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Belkira wrote:
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#34 Sep 23 2010 at 3:03 PM Rating: Good
Quote:
why would anyone ever buy insurance ahead of time?
That whole "we're going to punish you if you don't have insurance" thing?

Healthy people without insurance are ******** over the average too, it only really works as a "fair" system if everyone participates (by whichever means) and pools risk. The healthcare bill accomplishes this by decreasing barriers to entry, eliminating forced exclusion once included, decreasing justifications for not entering, and punishing those who don't enter.
Quote:
Some of us argue that this is by design. If you make the existing system so bad, then just having the government do it all starts to look better in comparison.
Other than the "we trying to put it in in the first place, but got pared down" part?


Conspiracy theorists need to pay more attention to order of events.
#35 Sep 23 2010 at 3:58 PM Rating: Good
varusword75 wrote:

I wish the govn would stop f*cking up the health insurance industry.


Oh they tried that. Worked horribly.

UK-style, Canada-style, Germany-style: no issues.

bvarus wrote:
Wouldn't matter. If you make more than min wage you would not qualify.


Actually, I know people in a high risk pool. They make really good money, however they do not work for a large employer who could handle someone with a serious condition, which one of the couple has. They also live in Colorado. It seems very state dependent. Varrus might be totally right, in Tennessee.

This is the Republican philosophy: bigger government, but at the state level. That way, at a federal level they can say it's a states right issue and if state A cuts back these "high risk pool" benefits and either kills via neglect or forces very, very sick people onto state B, then the good folks in state B who pay for everyone are just suckers. But the whole sorted mess is no longer a federal issue and they can wash their hands of it, at that level.
#36 Sep 23 2010 at 5:29 PM Rating: Excellent
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Let's say it charges $30 so it can cover it's expenses and make a profit.


Let's say it charges $150 so it can make more of a profit then denies 85% of broken arms to further increase profit. Then let's say that it refuses treatment of a second broken arm based on a lifetime arm break maximum to further increase profit.

Then lets say people frequently die from broken arms.

Then we'd have a Pollyanna best case picture of the current state of managed health care in the US.
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#37 Sep 23 2010 at 6:07 PM Rating: Default
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Jophiel wrote:
gbaji wrote:
At the end of the day, Americans need to decide collectively whether they want the government to just pay for all their health care, or not.

I say yes!
Quote:
Up until now, US citizens have rejected that idea on principle.

"On principle"? I don't think you know what that means.


Principle, as in "In principle, I oppose the idea of the government simply providing for everyone's medical care". I didn't think I was being unclear.

Quote:
Public polling for public options is generally quite favorable.


Sure. When it's presented as an "option" and it's assumed that said option will compete fairly in a free market with private options. The more you move towards "The government just pays for all standard health care needs", the less popular it gets.

Quote:
Programs such as Medicare are very popular and phrasing a public option question in a manner like "...similar to Medicare" is always good for a boost in the poll numbers.


Yup. Again, you're playing word games in order to make what you're proposing not sound like what it really is. If you're really talking about socialized medicine (meaning that the government provides health care to everyone for free, with no middle men and no insurance providers involved), support dwindles down to a pretty small number of far left socialists.

Quote:
I think you're confusing a muddled fight over a bill that never had a real government-run public option to some sort of... "principled" stance against a true government public option.


I think you're confusing *why* a "real public option" was rejected in the bill in the first place. The US public consistently rejects a medical system in which the government simply directly provides health care to the people. But that's the *only* method of government involved health care which is more efficient and less expensive. The methods we're using right now (like Medicare) don't work very well. But it's important to recognize that the reason we use those sorts of methods is precisely because the US public so strongly opposes socialized medicine.
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#38 Sep 23 2010 at 7:14 PM Rating: Excellent
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gbaji wrote:
I think you're confusing *why* a "real public option" was rejected in the bill in the first place. The US public consistently rejects a medical system in which the government simply directly provides health care to the people.

Acceptance for a "Medicare like option" was 59-36 in July 2009 (PDF to Kaiser poll). Acceptance for a universal option in which all citizens would be covered by a government plan was essentially the same (58-38).

This is where you start hooting that that poll doesn't count because it didn't use the magic Gbaji language that'd give you the answers you insist are true. I'll let it sit with that since watching you cry about how the polls you disagree with don't count is pretty tedious.
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
#39gbaji, Posted: Sep 23 2010 at 8:41 PM, Rating: Sub-Default, (Expand Post) No. Here is where I point out what I've been saying all along. The farther you get from something that sounds like it has some free market components, the lower the support among the public gets. One might just conclude that US citizens, as a group, tend to like free market solutions and don't like big government. But if you have some other interpretation, by all means let us know.
#40 Sep 23 2010 at 8:47 PM Rating: Excellent
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gbaji wrote:
And when the "like medicare" language is removed, support drops to 50%.

Consistently rejected! A mere 50% support. Boy, I hope no one was undecided because otherwise that would actually be the winning opinion!

Hahaha... so fun :D
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
#41 Sep 23 2010 at 9:04 PM Rating: Good
The public option was killed because the insurance lobby bribed enough politicians to kill it.
#42REDACTED, Posted: Sep 24 2010 at 9:06 AM, Rating: Sub-Default, (Expand Post) Smashed,
#43 Sep 24 2010 at 9:08 AM Rating: Good
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varusword75 wrote:


Of course forcing people to accept the cost of paying for the ever increasing poor health habits of the majority of society will work so much better.
Quit picking on the fat kids.
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#44 Sep 24 2010 at 9:12 AM Rating: Excellent
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Do you think the govn doctors will be as efficient as govn appointed attorneys?
Most doctors in Canada operate their own private practice.
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#45REDACTED, Posted: Sep 24 2010 at 9:34 AM, Rating: Sub-Default, (Expand Post) Elinda,
#46 Sep 24 2010 at 9:42 AM Rating: Good
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varusword75 wrote:
Elinda,

Don't forget the smokers.

But if they all die, or quit smoking who'd buy the tobacco?
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#47 Sep 24 2010 at 9:43 AM Rating: Excellent
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Most Canadian doctors have their own practices because they can. They don't need to worry about whether a patient can pay for the services. they don't need to worry about whether someone is covered, or whether their health insurance will consider the doctor accredited to be able to receive payments from that insurance provider. They have private practices because they can. Because it's affordable. Because it's safe. Because it's a 0 risk situation for them.
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#48 Sep 24 2010 at 9:46 AM Rating: Good
Uglysasquatch, Mercenary Major wrote:
Most Canadian doctors have their own practices because they can. They don't need to worry about whether a patient can pay for the services. they don't need to worry about whether someone is covered, or whether their health insurance will consider the doctor accredited to be able to receive payments from that insurance provider. They have private practices because they can. Because it's affordable. Because it's safe. Because it's a 0 risk situation for them.


I don't think Varus realizes what is meant by "private practice." I think he's confusing that with "private insurance" somehow.
#49 Sep 24 2010 at 11:43 AM Rating: Default
Tulip,

You're right for once.

Mark this day, it may not happen again for a while.

#50 Sep 24 2010 at 11:46 AM Rating: Good
Jophiel wrote:
gbaji wrote:
And when the "like medicare" language is removed, support drops to 50%.

Consistently rejected! A mere 50% support. Boy, I hope no one was undecided because otherwise that would actually be the winning opinion!

Hahaha... so fun :D
Obviously the majority of people in the US are "pretty small number", you just have to be soo big picture that minorities in the US are an even smaller number of people.

varusword75 wrote:
Don't forget the smokers.
You missed the part where I pointed out the gov. already has specific language to charge them more I take it?
#51 Sep 24 2010 at 3:25 PM Rating: Excellent
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Political Wire wrote:
A Political Wire reader spent time looking at the photos included in the GOP's Pledge to America:

"I counted 42 photos with people in them, and in only two are there African-Americans -- and they're tiny specks in a much larger group, barely visible. There are maybe two identifiable people of Asian descent and no one who might be considered Latino. Basically almost all whites in the Pledge, hundreds of them, with barely any noticeable minorities. Most telling is the large auditorium featured on page 12 -- a crowd of maybe 300 and only if you look hard toward the back do you see someone who might be African American."

Hehe.

Edit: He's looking at the "published" version not the draft version linked earlier.

Edited, Sep 24th 2010 4:26pm by Jophiel
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
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