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FACT CHECK: White House ignores health concession

Redress said:
The reason the plan ran out of money is because it was wildly popular. Damn that Obama for coming up with a massively popular program!
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You're confusing popularity with effective concpetion, planning and execution.
 
Goobieman said:
You're confusing popularity with effective concpetion, planning and execution.
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Exactly the point I'm trying to make. To take this analogy to the extreme, the government could hand out free firearms to everyone who wanted one. Would it be wildly popular? Probably. Does that mean it's a good idea?
 
Goobieman said:
All of these things are rooted in the idea that the health care is a business, and that businesses exist to make a profit.

And so, I'm not sure how these things indicate a "problem", with the "only" solution found in government.
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I think many of the issues are a direct result of having your health insurance tied to your employer. As long as this tie exists it puts many at a disadvantage. If you could take away this "tie" and every single person had the option to choose from a wide array of plans then the free market would take care of the rest. As it stands now there's no need for large insurance companies to deal competitively when handling any contracts that don't involve large employers with many employees. Obviously in the free market you will always have substantial discounts when buying in bulk but when it comes to health and health care that's unacceptable, IMO. A self employed person should not have to pay 5x the cost for 1/4 of the coverage. Also no employee should fear switching jobs due to pre-existing conditions and possible loss of their insurance.

Furthermore, as stated previously, the fact that private companies routinely drop those with chronic illnesses leaving the government to pick up the slack in the form of medicare/medicaid is wholly unacceptable. The private insurances are collecting huge amount of monies throughout a lifetime only to turn around and dump substantial costs! It's a racket.

Then you also have the issue of large insurance plans, particularly HMOs, signing up huge companies and all their employees and dominating certain cities, neighborhoods. The drs. then are forced to contract with these insurances or have no patients. The insurance company then sets the price the dr has to accept and in order to make up the loss the dr. then turns around and charges the uninsured or the self employed high deductible having patient exorbitant fees to make up the difference.

Why should a self employed landscaper with a high deductible be charged 150 for a dr. visit while a Boeing employee is charged $60 for the exact same visit?
 
Your health insurance isn't "tied" to your employer. I've had more than one job where I refused their coverage and bought my own. I've currently carried my own for years now.
 
Harshaw said:
Your health insurance isn't "tied" to your employer. I've had more than one job where I refused their coverage and bought my own. I've currently carried my own for years now.
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Not many people are going to be able to afford to do that currently.
 
Harshaw said:
Your health insurance isn't "tied" to your employer. I've had more than one job where I refused their coverage and bought my own. I've currently carried my own for years now.
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I have my own as well. But I literally pay 5X as much for 1/4 of the coverage! You don't get good deals unless you have a ton of employees. I pay almost $500 a month, have a $3000-$5000 ind/fam deductible that we never come close to meeting. So essentially I pay $500 a month for the off chance that some expensive emergency occurs and on top of that I pay 100% of the costs of all my family's care throughout any given year via a health savings account.
 
talloulou said:
I have my own as well. But I literally pay 5X as much for 1/4 of the coverage! You don't get good deals unless you have a ton of employees. I pay almost $500 a month, have a $3000-$5000 ind/fam deductible that we never come close to meeting. So essentially I pay $500 a month for the off chance that some expensive emergency occurs and on top of that I pay 100% of the costs of all my family's care throughout any given year via a health savings account.
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Aren't the seeds of a solution being something other than a government program in there somewhere?
 
Also where I live I can't get dental coverage at all for my kids. There are very few pediatric dentists in the area and they do not take any ins. plans or discount plans my family has access to. They don't have to. Most of the folks in my area are military or government employed. So I pay $250 (500 for both)every six months to have their teeth cleaned which is ridiculous because I only pay about $100 for my own. Luckily this racket will end soon as they'll soon be old enough to just go to my dentist.
 
Harshaw said:
Aren't the seeds of a solution being something other than a government program in there somewhere?
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Don't know. For years and years and years folks have been complaining but I see no changes. Short of government intervention/regulation I do not see an end to the racket.
 
talloulou said:
I've listed the reasons previously

insurance tied to job causing problems switching employers
pre-existing conditions causing severely limited access to plans
limited access/affordability for small employers
private insurance dropping folks with chronic debilitating diagnosis, thus these folks are dumped into the medicare/disability system
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I find it remarkable that you lambaste everyone else for falsehoods, then post a whole list of them.

1. Why would switching jobs cause a problem? I've changed jobs several times over the past few years and never had a moment's trouble with health insurance.

2. Pre-existing condition are covered if you had insurance from another carrier in the past 63 days. If you wait past 63 days, then you have no one to blame but yourself.

3. I was a small employer for 12 years and never had any trouble getting and paying reasonable premiums. One of my employees had numerous conditions that required expensive prescriptions and doctor's visits.

4. I've never heard of anyone losing their insurance due to an illness. If you can't pay your premium because your sick, well that's a different matter. You can't expect them to keep covering you if you don't pay the premiums.

P.S. Under this health bill, you will no longer be able to have your health savings account.
 
Harshaw said:
You would need data to back that up.
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See Talloulou's post above. How many people can afford an extra 500 $ a month? Not many in my area.
 
Gill said:
I find it remarkable that you lambaste everyone else for falsehoods, then post a whole list of them.

1. Why would switching jobs cause a problem? I've changed jobs several times over the past few years and never had a moment's trouble with health insurance.

2. Pre-existing condition are covered if you had insurance from another carrier in the past 63 days. If you wait past 63 days, then you have no one to blame but yourself.

3. I was a small employer for 12 years and never had any trouble getting and paying reasonable premiums. One of my employees had numerous conditions that required expensive prescriptions and doctor's visits.

4. I've never heard of anyone losing their insurance due to an illness. If you can't pay your premium because your sick, well that's a different matter. You can't expect them to keep covering you if you don't pay the premiums.

P.S. Under this health bill, you will no longer be able to have your health savings account.
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The guidelines around pre-existing conditions tend to be more severe depending on the severity of the condition. My stepfather is virtually not insurable if my mother lost her job and their coverage.

AIDs, certain cancers, certain chronic illnesses, etc tend to get dropped from private insurance companies and end up on medicaid.

If you're healthy or your pre-existing condition is minor you won't have trouble switching jobs. If your pre-existing condition is costly it's a whole other story.

As far as being self employed I don't feel I have access to a decent plan. We make up for it by stock piling money away in a health savings but I don't' think access to a decent plan is asking too much. Kudos to you that your experience was better than mine, doesn't mean I'm lying about mine.
 
Redress said:
See Talloulou's post above. How many people can afford an extra 500 $ a month? Not many in my area.
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I don't know. For how many people does that increase apply, and how much per month do they make? This is why you need reliable data. Anecdotal evidence doesn't make the point.
 
Goobieman said:
You're confusing popularity with effective concpetion, planning and execution.
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The program was well concieved, provable by it's success in putting large numbers of people in more efficient vehicles than they already had. Planning and execution had the usual flaws that implementing any large program tends to have.

By the way, your arguing against this program still is amusing. Isn't the reaction to your pronouncement that CARS, despite putting people in more efficient vehicles, raised fuel demands kinda scare you off from commenting on things you know nothing about?
 
talloulou said:
The guidelines around pre-existing conditions tend to be more severe depending on the severity of the condition. My stepfather is virtually not insurable if my mother lost her job and their coverage.

AIDs, certain cancers, certain chronic illnesses, etc tend to get dropped from private insurance companies and end up on medicaid.

If you're healthy or your pre-existing condition is minor you won't have trouble switching jobs. If your pre-existing condition is costly it's a whole other story.

As far as being self employed I don't feel I have access to a decent plan. We make up for it by stock piling money away in a health savings but I don't' think access to a decent plan is asking too much. Kudos to you that your experience was better than mine, doesn't mean I'm lying about mine.
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That is not true. Insurance companies can not refuse anyone for a pre-existing condition if they have been insured within 63 days.

That's the law.

From the BCBS booklet:

Is there ever a reduction in the waiting period?
The pre-existing conditions waiting period will be reduced for any member who had comprehensive medical/surgical insurance coverage that was either still in effect, or was terminated within 63 days of his/her initial enrollment eligibility date with BCBSNM.
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Most plans have only a 1 year waiting period even if you didn't have coverage within 63 days.

Like I said, you can kiss your HSA goodbye if this plan passes.
 
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Redress said:
I think I


Will trust factcheck.org over

your

word. One has a

history of being factually

accurate, the other cannot even

manage

to

use paragraphs and sentences to

make their

posts more readable. And

you are not nearly as credible as factcheck.org.
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and yet you manage to understand me totally

LOL!

sorry, but 12 million of the 47 contemplated by obama are illegals

how do you think he gets to 47 million?

why did he SUDDENLY, for the first, last and only time, drop the figure to "uhhh, 36 million, uhhh, 37, i don't wanna misrepresent..."

in portsmouth last tuesday?

In New Hampshire, Obama Defends Health Care Plan : NPR

he was questioned by the "paraprofessional," the lady he WINKED at

LOL!
 
theangryamerican said:
I'd be happy to. Check the actual pages if you think this is just fear mongering.

• Page 22: Mandates audits of all employers that self-insure
• Page 30: A government committee will decide what treatments and benefits you get
• Page 42: The “Health Choices Commissioner” will decide health benefits for you.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 58: Every person will be issued a National ID Healthcard.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange
• Page 91: Government mandates linguistic infrastructure for services (for illegal aliens)
• Page 102: Those eligible for Medicaid will be automatically enrolled
• Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly.
• Page 127: The government will set all wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll.
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesn’t’ have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any non-resident alien is exempt from individual taxes.
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
• Page 203: “The tax imposed under this section shall not be treated as tax.”
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.
• Page 241: Doctors, no matter what specialty, will all be paid the same.
• Page 253: Government sets value of doctors’ time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: If doctors treat a patient during an initial admission that results in a readmission, they will be penalized by the government.
• Page 317: Doctors are now prohibited for owning and investing in healthcare companies.
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restrict enrollment of special needs individuals.
• Page 379: Telehealth Advisory Committee - healthcare by phone.
• Page 425: Advance Care Planning Consult: Senior Citizens - counseling and hospice, end-of-life
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc.
• Page 425: Government provides approved list of end-of-life resources guiding you towards death.
• Page 427: Government mandates program that orders end-of-life treatment
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an order for end-of-life plans.
• Page 430: Government will decide what level of treatments you may have at end-of-life..
• Page 489: Government will cover marriage and family therapy.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.
* PG 502 Line 5-18 Government builds the “Center” to conduct, support, & synthesize research to define our HealthCare Services.
* PG 502 Section 1181 Center for Comparative Effectiveness Research Established.
* PG 503 Line 13-19 Government will build registries and data networks from your electronic medical records.
* PG 503 Line 21-25 Government may secure data directly from any department or agency of the USA including your data.
* PG 504 Line 6-10 The “Center” will collect data both published & unpublished (that means your public & your private info)
* PG 506 Line 19-21 The Center will recommend policies that would allow for public access of data.
* PG 518 Line 21-25 The Commission will have input from HealthCare consumer reps.
* PG 524 18-22 Comparative Effectiveness Research Trust Fund set up.
* PGs 525-620 deals with the Govt basically taking over nursing homes, long-term care facilities (assisted living) through regulations of the facilities, the owners of sd facilities, the employees of sd facilities and even the land owners of that sd facilities reside on. Additionally as you read these 90+ pages you can come to the conclusion that any Health related services will be determined and rationed by the Govt for our senior citizens and others in nursing homes.
* PG 620 Line 1-9 The Government will define, prioritize, and nationalize your Health Care Services.
* PG 621 Lines 20-25 Government will define what Quality means in HealthCare.
* PG 622 Lines 2-9 To pay for the quality Standards Government will transfer money from to other Government Trust Funds.
* PG 624 “Quality” measures shall be designed to assess outcomes & functional status of patients.
* PG 628 Section 1443 Government will give “Multi-Stake Holders” Pre-Rule Making input into Selection of “Quality” Measures.
* PG 630 9-24/631 1-9 Those Multi-stake holder groups including Unions & groups like ACORN deciding HealthCare quality.
* PG 632 Lines 14-25 The Government may implement any “Quality measure” of HealthCare Services as they see fit.
* PG 633 14-25/ 634 1-9 The Secretary may issue non-endorsed “Quality Measures” for Physician Services & Dialysis Services.
* PG 635 – 653 Physicians Payments Sunshine Provision
* PG 654-659 Public Reporting on Health Care-Associated Infections.
* PG 660-671 Doctors in Residency – Government will tell you where your residency will be, thus where you’ll live.
* PG 676-686 Government will regulate hospitals in every aspect of residency programs, including teaching hospitals.
* PG 686-700 Increased Funding to Fight Waste, Fraud, and Abuse.
* PGs 701-704 Section 1619 If your part of HealthCare plan that isn’t in Government HealthCare Exchange but you qualify for Federal aid, no payment.
* PG 705-709 SEC. 1128 If Secretary gets complaints on HealthCare provider or supplier, Government can do background check.
* PG 711 Lines 8-14 The Secretary has broad powers to deny HealthCare providers/suppliers admittance into HealthCare Exchange.
* Pg 719-720 Section 1637 any Doctor who orders durable medical equipment or home medical services must be enrolled in Medicare.
* PG 722 Section 1639 Government Mandates Doctors must have face-to-face with patient to certify patient for Home Health Services.
* PG 724 23-25 PG 725 1-5 The same Government certifications will apply to Medicaid & CHIP. Pg 735 lines 16-25 For law enforcement purposes, the Secretary of Health & Human Services will give Attorney General access to all data.
* PG 724 Lines 16-22 Government reserves right to apply face-to-face certification for patient to ANYany other HealthCare service.
* PG 740-757 Government sets guidelines for subsidizing the uninsured
*Pg 757-762 Fed Government will shift burden of payments to Disproportionate Share Hospitals (DSH) to States.
* PG 763 1-8 No DS/EA hospitals will be paid unless they provide services without regard to national origin

Don't get me wrong, I think there are problems aplenty with healthcare, but THIS was not the way to fix it.
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Yeah, that doesn't tell me you read it. It tells me you cut and pasted from one of those chain emails or websites.
 
Gill said:
That is not true. Insurance companies can not refuse anyone for a pre-existing condition if they have been insured within 63 days.

That's the law.

Most plans have only a 1 year waiting period even if you didn't have coverage within 63 days.

Like I said, you can kiss your HSA goodbye if this plan passes.
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You've stated this before, but you've also pointed out that this is BC/BS policy, not necessarily the law in itself. Quote me the piece of federal legistlation that specifies a timeline bywhich people w/pre-existing medical conditions can get quality health care either through their employer or on their own and I'll agree with you that it can be done under the law. Until then, this is merely the policy of one health insurer (and a rather generous provision I might add).
 
Gill said:
That is not true. Insurance companies can not refuse anyone for a pre-existing condition if they have been insured within 63 days.

That's the law.

From the BCBS booklet:



Most plans have only a 1 year waiting period even if you didn't have coverage within 63 days.

Like I said, you can kiss your HSA goodbye if this plan passes.
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I think you're wrong. There is no law protecting folks in all cases. For example with my mother's plan and job if her work switches insurance plans my stepfather's coverage is switched over to the new plan during open enrollment with a short waiting period for his pre-existing condition.

However if she switches jobs and becomes a brand new subscriber to a brand new insurance plan my stepfather may be entirely excluded for coverage all together.

Do you honestly believe many folks are just raising a ruckus over the whole pre-existing condition fiasco without reason?
 
Redress said:
See Talloulou's post above. How many people can afford an extra 500 $ a month? Not many in my area.
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and yet that's the "solution" proposed by waxman/rangel

folks gotta buy the stuff THEMSELVES

and if they can prove they got a CLUNKER of an income (LOL!), they MIGHT qualify for a pittance of assistance from uncle sam

but you better fill out the paper work perfect, cuz word is ms nance is playing hardball with it

she's only kicked back 2% of the clunker cash she's promised, for example

families without insurance, under waxman/rangel, are still in the main ON THEIR OWN

the bill MANDATES those uninsured PURCHASE coverage

exactly as driving is handled in CA

and if you're caught driving, err, breathing without insurance you're FINED as a criminal

The Associated Press: A look at health care plans in Congress
 
Objective Voice said:
You've stated this before, but you've also pointed out that this is BC/BS policy, not necessarily the law in itself. Quote me the piece of federal legistlation that specifies a timeline bywhich people w/pre-existing medical conditions can get quality health care either through their employer or on their own and I'll agree with you that it can be done under the law. Until then, this is merely the policy of one health insurer (and a rather generous provision I might add).
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Yes, and unless he is self employed this is probably the contract for his particular group employer and may not carry over to every person who has BC/BS. Generally large employers can work out better contracts for their people.
 
Objective Voice said:
You've stated this before, but you've also pointed out that this is BC/BS policy, not necessarily the law in itself. Quote me the piece of federal legistlation that specifies a timeline bywhich people w/pre-existing medical conditions can get quality health care either through their employer or on their own and I'll agree with you that it can be done under the law. Until then, this is merely the policy of one health insurer (and a rather generous provision I might add).
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talloulou said:
I think you're wrong. There is no law protecting folks in all cases. For example with my mother's plan and job if her work switches insurance plans my stepfather's coverage is switched over to the new plan with a short waiting period for his pre-existing condition.

However if she switches jobs and becomes a brand new subscriber to a brand new insurance plan my stepfather may be entirely excluded for coverage all together.

Do you honestly believe many folks are just raising a ruckus over the whole pre-existing condition fiasco without reason?
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Two for the price of one. Like I said, I had my own business for many years and became intimately familiar with insurance laws and practices. My sister has been a benefits manager at several major corporations for many years.

It's not just BCBS. Do you think they would have this policy if they didn't have to??

The length of time coverage can be denied for a preexisting condition under HIPAA is limited to no longer than 12 months (18 months if you are a late enrollee). This time can be reduced or eliminated if you were covered by previous health insurance (which qualifies under HIPAA as creditable coverage) and if there was not a break in coverage between the plans of 63 days or more.
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The Health Insurance Portability and Accountability Act (HIPAA) has very specific requirements that health insurance companies and companies must follow.

talloulou, your stepfather can have uninterrupted coverage as long as your mother has continuous coverage for 63 days.... no questions asked.

I believe folks are raising a ruckus because they are uninformed. Asking your agent questions and doing a little research does wonders. This law has been in effect since 1996.
 
Harshaw said:
Your health insurance isn't "tied" to your employer. I've had more than one job where I refused their coverage and bought my own. I've currently carried my own for years now.
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However, your experience is by far the exception rather than the rule. For a great many reasons, but most of all because of the tax treatment of health insurance, the vast majority of people with health insurance have health insurance through their employer.

There is no inherent economic rationale for this, it merely is how the system is today.

However--and I am surprised folks on the liberal side of things have not picked up on this--there is a fundamental iniquity in the taxation of health insurance. Health insurance costs paid by the employer are a tax deductible expense. Health insurance costs paid by employees are tax exempt to the extent they are a part of such a plan. Health insurance of self-employed individuals are exempt. Health insurance costs paid by individuals not self employed not tied to an available employer plan are not tax exempt.

Tax Topics - Topic 502 Medical and Dental Expenses
If you are self–employed and have a net profit for the year, or if you are a partner in a partnership or a shareholder in an S corporation, you may be able to deduct, as an adjustment to income, 100% of the amount you pay for medical insurance for yourself and your spouse and dependents. You can include the remaining premiums with your other medical expenses as an itemized deduction. You cannot take the special 100% deduction for any month in which you are eligible to participate in any subsidized health plan maintained by your employer or your spouse's employer.
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Thus a person pays a tax penalty for choosing not to sign on to the employer-subsidized plan.

Why should health insurance be tax deductible to employers but not tax deductible to employees? Why should workers be penalized in this fashion?

If ever there was a case where a tax benefit should be removed from companies and applied to individuals, it is the tax deductability of health insurance. If employer-subsidized health insurance were stripped of its advantageous tax treatment, and if individually-purchased health insurance received that treatment, the resulting shift in the insurance marketplace would be away from employer-subsidized insurance to individually-purchased insurance. Individuals would be the direct--and sole--customers of insurance companies, which greatly increases their marketing power to demand various things within insurance products. Further reform insurance markets to make it more attractive to new insurance providers to increase the range of choice among insurance companies, and insurance companies will, for the sake of pursuing customers, work out the best economics of risks associated with pre-existing conditions, et cetera.

This would be a real, substantive reform, that would greatly restructure and revamp health insurance markets in this country, to the benefit of individuals. More importantly, it is a small reform, one that does not require 1,000 pages of legislation to bring into being. If the majority party had proposed this reform in July, it would be law by now. The only real group that would likely oppose it would be insurance companies, and even their opposition would be minimal--their marketing efforts would shift, their pricing structures would have to evolve, but there would still be a viable--indeed, an expanded--insurance market place. Hospitals, drug companies, and doctors have little stake in the matter--the continuation of insurance means they still get paid no matter what.

So why is the majority party not talking about this? Why are they passing on an easy health care reform victory?
 
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