Obama's Healthcare Plan Explained

[El Guapo 8]

We've got Blue Cross, and I think UHC. I don't know if any other HMO type organizations operate in MN. There used to be one or two others, but they are gone. There are certainly plenty of private companies, but few if any companies offer them as a choice. And that's what it comes down to for most people -- what does my company offer. For most people, that is a maximum of 3 choices.

Well Duh. That is a ridiculous argument, especially coming from you. If you don't like the insurance your company is providing you, go out and purchase your own.If I owned a company I am not going to provide 17 different options for my employees. A. It is confusing. B. It is expensive.

[Jeepster80125 0]

Well Duh. That is a ridiculous argument, especially coming from you. If you don't like the insurance your company is providing you, go out and purchase your own.If I owned a company I am not going to provide 17 different options for my employees. A. It is confusing. B. It is expensive.

I think people's lack of choice comes if they have health conditions. Again, anyone will be accepted within a group policy, even those with cancer etc. I think the people who are uninsurable in the private market are the ones who complain when there aren't a million options to choose from. If private insurance was guarantee issue instead of medically underwritten, carriers would pull out of the market and everyone would suffer. It's too bad that lawmakers don't seem to realize this. Plus, most people want something for nothing. They like the idea of the government picking up the tab, and they don't care about the costs, as long as they don't have to pay for anything.

[hblask 1]

Well Duh. That is a ridiculous argument, especially coming from you. If you don't like the insurance your company is providing you, go out and purchase your own.If I owned a company I am not going to provide 17 different options for my employees. A. It is confusing. B. It is expensive.

But that was the point -- realistically, we don't have that competitive of a market, because of the tax break given to companies that is not available to individuals. Instead, a few HR managers decide between a couple of plans for everyone else in the company.Combine that with state laws that sayl what can and cannot be carried, and really there is only a tiny amount of competition. Instead of building dozens of plans to suit a variety of consumers, insurance companies/HMOs/etc just create a couple plans that please HR managers and state regulators.

[LincolnK 1]

... stossel did a piece on this with whole foods not too long ago. it's worth watching,...

link to articlethis sounds awesome and ridiculously simple.cliff's notes:whole foods change their insurance policy to a high deductible one.to help employees offset the deductible, they give them money to pay for health related stuff.employee can spend the contribution as they see fit. they can also hold on to it for later useresult is people shopping around for health services and comparing prices.

[Jeepster80125 0]

link to articlethis sounds awesome and ridiculously simple.cliff's notes:whole foods change their insurance policy to a high deductible one.to help employees offset the deductible, they give them money to pay for health related stuff.employee can spend the contribution as they see fit. they can also hold on to it for later useresult is people shopping around for health services and comparing prices.

I don't have time this morning to look at the video, are they discussing health savings accounts?Some employers offer funds as part of an FSA, or flexible spending account, that employees can use to pay for their healthcare. Those dollars are provided by the employer, not the employee. The negative part of FSAs is the 'use it or lose it' provisions, if the employee doesn't use that money then it goes away at the end of the year.Health savings accounts will become more popular as healthcare gets more expensive. At the end of the day, consumers will be required to put more work into their personal healthcare, to shop around for best prices for procedures, etc. There are two parts to HSAs. The first is a high deductible health plan. This is a catastrophic plan with no copays for office visits, prescriptions, emergencies, or anything like that. The average deductible is $3000 for individuals and $5950 for families. These premiums are anywhere from 25-45% cheaper than similar deductible plans with copays. The second part of these is an eligible savings account, which can be opened at most banks. It's assumed consumers deposit that 24-45% savings into an account which they use to fund their healthcare. This savings account is in their name, not a companies, and it belongs to them. If they switch jobs or don't spend that money, it's theirs to keep or take with them. Deposits made into these accounts are pre-tax too. HSAs have also been referred to as medical IRAs. You can use these HSA dollars for anything medically related. They're still fairly new and I don't know of any audits. If my doc says I need more exercise, I could buy a mountain bike or workout machine with my HSA money. If I want to use this money for non-medical things, it's subject to penalties. You can fund this savings account up to the amount of your deductible. What I like about these plans is that if I max fund my HSA as an individual, that money rolls over if I don't use it. We have healthy clients who have thousands of dollars sitting in these accounts, and if they ever have a major medical event, there's money there to pay the bills. Of course, some people get these high deductible plans and never open an account, which isn't smart. If they ever have claims, they're paying out of pocket until the deductible is satisfied.I can confirm that this report was discussing HSA's at Whole Foods. This is going to be the future of healthcare in our country, without a doubt.As costs continue to increase, consumerism will have to increase too.EDIT: Personal anecdote: My parents are in their late fifties, and have had an HSA for several years. They're healthy and active, not overweight. My mother takes some iron deficiency prescriptions, but no other meds. They max fund their HSA Jan 1 every year, $5,950. Since they are over 55, they can contribute an extra $1,000 apiece, called a catch up provision. They average about $1,500 a year in medical expenses, so they have thousands of dollars left over, and this money accumulates interest. If they ever have a major medical event like a car crash, the money is there to pay the deductible, so they won't spend a dime out of pocket, they'll use the HSA money. It's really a fantastic system.However, it's only really good if you're healthy. If you're unhealthy, you'll always pay your deductible, which can be several thousand dollars. But it's better than being uninsured.

[El Guapo 8]

For the most part I have not seen HSA's to be worth it unless you have a high income to generate extra tax deductions.The premiums sometimes are higher than comparable PPO's.Once they tweak HSA's so they make sense, they will be the norm.

[Jeepster80125 0]

For the most part I have not seen HSA's to be worth it unless you have a high income to generate extra tax deductions.The premiums sometimes are higher than comparable PPO's.Once they tweak HSA's so they make sense, they will be the norm.

I agree, most of our clients who have HSAs are looking for additional tax shelters.

[Sheiky 0]

Ok, lets say i'm a 25 year old single parent working full time at a minimum wage job, I barely make enough to pay the bills and can't afford health insurance for either myself of my child. One day, my child has a seizure and badly damages his head against the floor, he's bleeding and unconscious, but still alive.What does this person do? Can she go the hospital and ask to have her kid checked over? This is the people you don't seem to recognise. You imagine that everyone in your country lives like you do and that those without health insurance are just irresponsible, lazy or foolish. What can this person and millions like her do in such an event with no health insurance?

[Jeepster80125 0]

Ok, lets say i'm a 25 year old single parent working full time at a minimum wage job, I barely make enough to pay the bills and can't afford health insurance for either myself of my child. One day, my child has a seizure and badly damages his head against the floor, he's bleeding and unconscious, but still alive.What does this person do? Can she go the hospital and ask to have her kid checked over? This is the people you don't seem to recognise. You imagine that everyone in your country lives like you do and that those without health insurance are just irresponsible, lazy or foolish. What can this person and millions like her do in such an event with no health insurance?

Simple. Go to the ER or call an ambulance. This child will get treated, without a doubt. You can google or wiki EMTALA. There are lots of programs for uninsured children. Medicaid is one. In Colorado, we have SCHIP, special (as in program, not retard) children's health insurance program. Also, if you're really in a position to need help, you can get help with bills like heating and other neccessities. Is that what you're looking for?Of course, this person is going to incure a debt with this. Emergency room treatment and ambulance trips are very expensive. Let's say this fall ends up costing $10,000 in medical bills. Let's assume it costs about $1,000 to insure a child for the year. Now, what do you think this person would rather pay, a grand for insurance or ten grand after something happened?It's not that I think people without insurance are lazy. But their priorities aren't in the right place. Lots of young people think they're bulletproof, but the average American has a major medical event every seven years. Sure, lots of people without insurance stay healthy and out of trouble, but lots of those people also choose to have cable television or high speed internet. Those people, in my opinion, are foolish and irresponsible. Not in your example, but it happens far too much.In my opinion, the parent(s) in your example should make insurance a priority, not an afterthought. Make sense?It's also aggravating to me to see Americans use the ER as a primary care facility. They'll receive treatment with no plans to pay the bill, using fake names or whatever it is they do to get care. Because the people who end up paying for the uninsured are people like myself, who pay their insurance every month. We subsidize and pay higher insurance rates because of things like this, and it's maddening.

[El Guapo 8]

Actually Jeep, if that scenario really happened that person woudl most likely not pay anything. Due to all the social welfare we have.

[Sheiky 0]

Simple. Go to the ER or call an ambulance. This child will get treated, without a doubt. You can google or wiki EMTALA. There are lots of programs for uninsured children. Medicaid is one. In Colorado, we have SCHIP, special (as in program, not retard) children's health insurance program. Also, if you're really in a position to need help, you can get help with bills like heating and other neccessities. Is that what you're looking for?Of course, this person is going to incure a debt with this. Emergency room treatment and ambulance trips are very expensive. Let's say this fall ends up costing $10,000 in medical bills. Let's assume it costs about $1,000 to insure a child for the year. Now, what do you think this person would rather pay, a grand for insurance or ten grand after something happened?It's not that I think people without insurance are lazy. But their priorities aren't in the right place. Lots of young people think they're bulletproof, but the average American has a major medical event every seven years. Sure, lots of people without insurance stay healthy and out of trouble, but lots of those people also choose to have cable television or high speed internet. Those people, in my opinion, are foolish and irresponsible. Not in your example, but it happens far too much.In my opinion, the parent(s) in your example should make insurance a priority, not an afterthought. Make sense?It's also aggravating to me to see Americans use the ER as a primary care facility. They'll receive treatment with no plans to pay the bill, using fake names or whatever it is they do to get care. Because the people who end up paying for the uninsured are people like myself, who pay their insurance every month. We subsidize and pay higher insurance rates because of things like this, and it's maddening.

Ok, so they get treated in an ER centre. The child has a severe medical condition that needs expensive treatment. What happens then? Surely the hospital isn't footing the bill for that.You say they can get covered by Medicaid, but Medicaid and Medicare are just democratic pipe-dream initiatives that take all the rich people's money and spend it on lazy poor people and children right? Isn't the whole point of this thread that you don't believe the Federal government should provide this cover? I've asked this question twice now. Copernicus just dismissed it people he doesn't care about people who aren't rich enough to afford health insurance. You've given a more thoughtful answer, but it comes back to the Federal government providing for these people, which from what i've read no one but TimWakefield and Checky actually approve of.

Actually Jeep, if that scenario really happened that person woudl most likely not pay anything. Due to all the social welfare we have.

Are you saying that is a bad thing?

[Sheiky 0]

It is this simple, you socialize medicine and over time you will weed out the top doctors. They will not spend 12+ years in college and 300-500K on debt if they are going to make 80K a year. It is just not going to happen.

It's not this simple. Medical university places are the most sought after in Britain (where we have national health care), we are not running out of top doctors.

[Loismustdie 0]

Ok, lets say i'm a 25 year old single parent working full time at a minimum wage job, I barely make enough to pay the bills and can't afford health insurance for either myself of my child. One day, my child has a seizure and badly damages his head against the floor, he's bleeding and unconscious, but still alive.What does this person do? Can she go the hospital and ask to have her kid checked over? This is the people you don't seem to recognise. You imagine that everyone in your country lives like you do and that those without health insurance are just irresponsible, lazy or foolish. What can this person and millions like her do in such an event with no health insurance?

Easy. Do what my mom did when this happened to me. Call an ambulance. Get me into a program, one of the many, for sick kids, that cost a parent nothing, or very little. I have been there, I lived the welfare life. Stop pretending that no kind of help exists, it does.

[El Guapo 8]

Are you saying that is a bad thing?

Debatable, but what I am saying is that it already exists.

It's not this simple. Medical university places are the most sought after in Britain (where we have national health care), we are not running out of top doctors.

But you will over time, as the cost of care increases and the pay decreases.

[hblask 1]

Ok, lets say i'm a 25 year old single parent working full time at a minimum wage job, I barely make enough to pay the bills and can't afford health insurance for either myself of my child. One day, my child has a seizure and badly damages his head against the floor, he's bleeding and unconscious, but still alive.What does this person do? Can she go the hospital and ask to have her kid checked over? This is the people you don't seem to recognise. You imagine that everyone in your country lives like you do and that those without health insurance are just irresponsible, lazy or foolish. What can this person and millions like her do in such an event with no health insurance?

In the US they can do what everyone else does: go to the emergency room and get their child treated. What would you suggest?

[hblask 1]

Ok, so they get treated in an ER centre. The child has a severe medical condition that needs expensive treatment. What happens then? Surely the hospital isn't footing the bill for that.

If the person has any morals, they will work out a payment plan for the next 5 or 10 or 30 years. If they have *some* morals, they will avail themselves to the myriad social programs available to them. If they have no morals, they will let the hospital pass it on to other customers.

[strategy's_touch 0]

I had a trip to the ER not long ago. my insurance didn't cover it and the total bill was $3000. I just filled out their financial assistance form and explained my poor college kid status and they forgave the debt entirely. I will pay that back when I am pulling a regular paycheck in a year or so.

[Jeepster80125 0]

Court Limits Patient Billing for E.R. CareCalifornia's high court ruled that emergency-room patients can no longer be billed by doctors and hospitals for care that isn't fully paid by their health plans.The court on Thursday struck down a practice known as "balance billing," in which doctors and hospitals seek to collect from patients any amounts that their managed-care plans refuse to pay. Instead, the providers must either absorb the costs themselves, or get the insurance companies to pay.Balance billing is controversial because patients are sometimes hit with emergency-room bills because they go to the nearest hospital or other medical facility regardless of whether it accepts their insurance. Health-care providers argue that they need some way to guarantee that they can be paid for their services.In its decision, the California Supreme Court overturned a lower-court ruling and found that billing disputes over emergency medical care must be resolved solely between providers and health plans.Connecticut, Pennsylvania and Alabama also have banned balance billing, according to the California Department of Managed Health Care.From Movin' Meat, whose take on this is very good.Patients are "hit" with bills! Oh Noes! Isn't that awful that patients might actually have to PAY for services rendered? That's just not American! We need to stop that. Tell you what, here's a reasonable solution, let's just let the insurance companies decide what to pay. They know the cost of care and I'm sure they'll be fair, don'tyouthink?Gaah.For those of you who don't run physician practices, this is a disaster in the making. Currently, if an insurer does not want to pay a fair amount for our services, we drop out of their network (go "non-par") and the patient will get a bill for the full charge for their ER visit. That averages about $400. The insurer will pay some random amount, and the patient is responsible for the rest. Patients hate this, so they complain to their employer and insurer, and in most cases the complaints will bring the docs and insurer back to the table to find a common ground. In those cases, the docs will usually allow a discount from their gross charge, anywhere between 10-40% depending on the market clout of the insurer, in return for prompt hassle-free payment.Now, however, the option of going non-par in California is simply off the table. If that happens, the docs have to accept whatever pittance the insurer pays as full payment. But the doctors can no longer negotiate with insurers either, since they no longer have any credible leverage to demand reasonable payment for their services, so they wind up having to accept whatever pittance the insurer offers.The result of this is that all commercial payers in CA are going to trend rapidly down to the medicare rate, which is barely at or below costs for most docs. You might as well just go to single payer, since then at least the crappy reimbursement would be slightly offset by the fact that medicare never denies claims, which I am sure the insurers will continue to do. Either way, it's terrible news for physicians. It's particularly bad for ERs, as it is ER docs who generally have the most trouble with this balance billing issue. See, if you are an office doc, and a patient wants to make an appointment, you can check their insurance in advance and if you don't take their insurance, they either get sent elsewhere or have to pay cash. But ER docs have to take all comers; under this ruling they now must either contract with every single insurer out there or run the risk of non-payment as out of network providers.CalACEP and CalAMA need to be all over this. They need to get themselves some well-connected lobbyists in Sacramento and get some legislation which would restore some balance to the negotiations.It's a pity that none of the players in this dispute were able or willing to make the case that is is acceptable for patients to bear some financial responsibility for their health care. That's the real underlying problem here -- the entitlement mentality that health care must always be free. It boggles my mind that the Cal Supreme Court agreed with this. Maybe Symtym can explain the reasoning behind the legal decision, but that won't change the fact that it was wrong.

[hblask 1]

Five three Two years from now in California:"Stupid free market in medicine failed us. We need socialized medicine to fix this problem."

[strategy 4]

this'll start you off on the stossel thing I mentioned before:http://www.youtube.com/watch?v=aEXFUbSbg1II've talked with my brother a little on this topic. I've kinda changed my mind on the whole paying back the hospital bill thing. According to him, the costs were probably closer to $150 than $3000 on my one-night stay...

[Balloon guy 158]

I had a trip to the ER not long ago. my insurance didn't cover it and the total bill was $3000. I just filled out their financial assistance form and explained my poor college kid status and they forgave the debt entirely. I will pay that back when I am pulling a regular paycheck in a year or so. get my Obama stimulus check

[Jeepster80125 0]

this'll start you off on the stossel thing I mentioned before:http://www.youtube.com/watch?v=aEXFUbSbg1II've talked with my brother a little on this topic. I've kinda changed my mind on the whole paying back the hospital bill thing. According to him, the costs were probably closer to $150 than $3000 on my one-night stay...

When you don't have insurance, you're paying 'retail', which is why it seems so high. If you would have had insurance, your insurance company would have re-priced the bill at their contracted rates. We regularly see 50-90% reduction in these 'retail' bills once they've been re-priced by the insurance companies.You're mostly right, that the 'actual' cost of your hospital stay was much closer to $150 than the $3000 they originally charged. Henry, you're absolutely right, that this will just push people to say we need socialized medicine. Absurd how people think they shouldn't have to be responsible for some portion of their medical care. In Colorado, new legislation took effect Jan 1, where prior to selling insurance to groups and individuals, we have to have the person or group sign a disclosure document stating they are aware of our commission. It's ridiculous, because the only thing it does is make people question why a percentage of their monthly premium is paid to us as agents, and it gives the idiots amongst us ammunition to say we need socialized medicine.

[Dagata 0]

I like how for some reason people consider it a 'right' to have healthcare, and that you are somehow entitled to be able to get it regardless of if they have any money or not.Healthcare is a service, medicine is a product, you aren't entitled to access to these.The majority of situations where people are simply unable to get healthcare are caused by many decisions in the past that led up to this tradegy, the rare cases where the person truly got screwed do not occur enough to base the law around them, and as people have pointed out, there are programs people can get in to.Do I think we should leave these people to die? No, my heart goes out to them, I would hope that the community would step up to help them, but this should be based in the community where the situation happend, not set to a national level.

[Jeepster80125 0]

I like how for some reason people consider it a 'right' to have healthcare, and that you are somehow entitled to be able to get it regardless of if they have any money or not.Healthcare is a service, medicine is a product, you aren't entitled to access to these.The majority of situations where people are simply unable to get healthcare are caused by many decisions in the past that led up to this tradegy, the rare cases where the person truly got screwed do not occur enough to base the law around them, and as people have pointed out, there are programs people can get in to.Do I think we should leave these people to die? No, my heart goes out to them, I would hope that the community would step up to help them, but this should be based in the community where the situation happend, not set to a national level.

I don't think people think they're entitled to it, they just want someone else picking up the tab.That's the argument. As long as someone else pays for it, then they're on board. The same people who argue for socialized medicine never have an argument as to why they want the government to run a program that encompasses 1/7th of our economy.

[strategy 4]

believe it or not BG, I'm anxious to get out of school and start working. you're probably right to assume that most of my generation just wants to hang around in college while this mess clears itself up, but not me.