Reform of the U.S. Healthcare System (Part IV)

JimfromPennsylvania · 02-08-08, 04:23 PM

V)
One very important fact that should be of high concern to those Americans that want to see the U.S. Healthcare system work for all Americans is the fact that one-third of all Americans who have employer sponsored health care have only one health insurance plan offered from their employer to choose from for health insurance coverage. This obviously isn’t a good arrangement for many of these Americans whose preferred doctor isn’t on the in-network physician list or who have high co-pays or high co-insurance. It would be better for many of these Americans if they could take the premium dollars their employer is paying for their employer sponsored health insurance plan and go buy health insurance on their own. The law should mandate that they can do exactly this. To avoid the situation where insurance companies for the employer-sponsored health insurance plans then go back to the employers and say the premium quote we had given you for the health insurance plan was based on high participation amongst your employees since this hasn’t been the case your premiums are being increased by X number of dollars. The law should ban this practice by insurance companies, insurance companies have to stick with their initial quote; however, the law should allow employer sponsored health insurance plans to offer health insurance plans to their employees with premium arrangements like the proposed communal pricing arrangement suggested above where there is as high as 33.33% discount for young employees under the age of 33 that make under 40 K/year and modest premium increases for employees that have expensive pre-existing conditions and have high incomes. This will probably result in many single health insurance plan employers offering an insurance plan whose overall premiums (both employer and employee portion) are only slightly less than communal premium pricing health plans offered by insurance companies for people that buy health insurance on their own and thus an increase from their current premium rate it is still the right course for the nation to take because it will give these large number of American workers an opportunity to get health insurance that fulfills their needs. To avoid the situation where employers just come out with two or more health insurance plans to skirt being affected by this policy, the law should mandate that this policy applies also to all middle and small size companies (companies with fewer than 1000 employees) who offer health insurance plans who either have co-pays or co-insurance that are equal or worse than the median of the worst 25 % of health plans sold in the state that includes plans by employers that have at least 15 percent of its employees participating or a non-employer sponsored plan that has at least 2 percent of a community enrolled in the plan {hereinafter referred to as credible health plans} or whose amount of employee portion of the premium is higher than what 75 % of the employees in a state are paying who are covered by employer sponsored health insurance or it applies to all such companies who offer one or more health insurance plans that are deemed inadequate because of lack of coverage of medical treatments or for any legitimate reason. To avoid the situation where an employer just decides to drop offering employer sponsored health insurance because it doesn’t want to deal with this whole issue after the legislation is enacted giving these workers these fair choice rights the legislation should mandate that for seven years after passage of this legislation employers cannot drop offering employer sponsored health insurance and they must increase on a yearly basis their portion of the premiums by the average yearly premium increase by the employer during the five years prior to passage of the legislation unless they can demonstrate the survival of their business demands it and the legislation can mandate hefty fines be imposed on employers for non-compliance on these matters.

VI)
The analysts are right there is no one item that can be done to solve the cost problem in the U.S. Healthcare system; it is the cumulative effect of many changes in the system and related to the system that will solve this problem. Currently, if a person goes into the hospital for any sort of various treatments they are often charged 50 %, 70% or even a 100% more for the treatment they receive compared with what someone is charged who has insurance with a very sharp insurance company. This reality is indefensible to say the least. With respect to price differentials a reasonable person can understand how a hospital could give a price break up to twenty-five percent (25%) for an insurance company if lets say that insurance company was going to cause a lot of patients to use that hospitals services but that 25 % would be the limit. With the price differentials going on for hospital services in this country a reasonable person is inclined to ask what are hospitals actual costs?; are some insurance companies only being charged less than hospitals actual costs?, if so, this isn’t fair. Our country recognizes the concept of fair pricing it outlaws price gouging for example, the pricing a patient receives from a hospital shouldn’t be so dependant on their negotiating leverage or their savvy on medical pricing matters. The federal government should bring the principles of fair pricing into the pricing of services by hospitals in the U.S.. Washington should pass a law mandating that hospitals can’t charge any patient more than one-third they charge their lowest charged patients, the exception for lowest charged patients would be for Medicaid, Medicare Advantage and financial hardship patients for obvious reasons. Also, hospitals should be prohibited from charging patients for benefits or services that are already included in other charges a patient has received, savvy insurance companies know about this hospital slickness and don’t stand for it and the Federal Government should come to the aid of all patients here and outlaw such practices.

Sergeant Stinger1 · 02-08-08, 04:29 PM

Quote:

Originally Posted by JimfromPennsylvania

V)
One very important fact that should be of high concern to those Americans that want to see the U.S. Healthcare system work for all Americans is the fact that one-third of all Americans who have employer sponsored health care have only one health insurance plan offered from their employer to choose from for health insurance coverage. This obviously isn’t a good arrangement for many of these Americans whose preferred doctor isn’t on the in-network physician list or who have high co-pays or high co-insurance. It would be better for many of these Americans if they could take the premium dollars their employer is paying for their employer sponsored health insurance plan and go buy health insurance on their own. The law should mandate that they can do exactly this. To avoid the situation where insurance companies for the employer-sponsored health insurance plans then go back to the employers and say the premium quote we had given you for the health insurance plan was based on high participation amongst your employees since this hasn’t been the case your premiums are being increased by X number of dollars. The law should ban this practice by insurance companies, insurance companies have to stick with their initial quote; however, the law should allow employer sponsored health insurance plans to offer health insurance plans to their employees with premium arrangements like the proposed communal pricing arrangement suggested above where there is as high as 33.33% discount for young employees under the age of 33 that make under 40 K/year and modest premium increases for employees that have expensive pre-existing conditions and have high incomes. This will probably result in many single health insurance plan employers offering an insurance plan whose overall premiums (both employer and employee portion) are only slightly less than communal premium pricing health plans offered by insurance companies for people that buy health insurance on their own and thus an increase from their current premium rate it is still the right course for the nation to take because it will give these large number of American workers an opportunity to get health insurance that fulfills their needs. To avoid the situation where employers just come out with two or more health insurance plans to skirt being affected by this policy, the law should mandate that this policy applies also to all middle and small size companies (companies with fewer than 1000 employees) who offer health insurance plans who either have co-pays or co-insurance that are equal or worse than the median of the worst 25 % of health plans sold in the state that includes plans by employers that have at least 15 percent of its employees participating or a non-employer sponsored plan that has at least 2 percent of a community enrolled in the plan {hereinafter referred to as credible health plans} or whose amount of employee portion of the premium is higher than what 75 % of the employees in a state are paying who are covered by employer sponsored health insurance or it applies to all such companies who offer one or more health insurance plans that are deemed inadequate because of lack of coverage of medical treatments or for any legitimate reason. To avoid the situation where an employer just decides to drop offering employer sponsored health insurance because it doesn’t want to deal with this whole issue after the legislation is enacted giving these workers these fair choice rights the legislation should mandate that for seven years after passage of this legislation employers cannot drop offering employer sponsored health insurance and they must increase on a yearly basis their portion of the premiums by the average yearly premium increase by the employer during the five years prior to passage of the legislation unless they can demonstrate the survival of their business demands it and the legislation can mandate hefty fines be imposed on employers for non-compliance on these matters.

VI)
The analysts are right there is no one item that can be done to solve the cost problem in the U.S. Healthcare system; it is the cumulative effect of many changes in the system and related to the system that will solve this problem. Currently, if a person goes into the hospital for any sort of various treatments they are often charged 50 %, 70% or even a 100% more for the treatment they receive compared with what someone is charged who has insurance with a very sharp insurance company. This reality is indefensible to say the least. With respect to price differentials a reasonable person can understand how a hospital could give a price break up to twenty-five percent (25%) for an insurance company if lets say that insurance company was going to cause a lot of patients to use that hospitals services but that 25 % would be the limit. With the price differentials going on for hospital services in this country a reasonable person is inclined to ask what are hospitals actual costs?; are some insurance companies only being charged less than hospitals actual costs?, if so, this isn’t fair. Our country recognizes the concept of fair pricing it outlaws price gouging for example, the pricing a patient receives from a hospital shouldn’t be so dependant on their negotiating leverage or their savvy on medical pricing matters. The federal government should bring the principles of fair pricing into the pricing of services by hospitals in the U.S.. Washington should pass a law mandating that hospitals can’t charge any patient more than one-third they charge their lowest charged patients, the exception for lowest charged patients would be for Medicaid, Medicare Advantage and financial hardship patients for obvious reasons. Also, hospitals should be prohibited from charging patients for benefits or services that are already included in other charges a patient has received, savvy insurance companies know about this hospital slickness and don’t stand for it and the Federal Government should come to the aid of all patients here and outlaw such practices.

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Any one searching for health insurance on their own will pay much, much more of a premium than the companys offered insurance plans.