Affordable Care Act Scare!
Replies
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The penalty for not having health insurance should be $1,000, it should be guaranteed refusal of emergency care. That will wake everybody up to the need for single payer real quick.
I don't think anyone should be denied coverage if it is an emergency. However, if it isn't an emergency I think hospitals should have a right to deny them to the ER. The amount of people who go to the ER for runny noses and coughs is outrageous.0 -
Lol, who could have guessed that? Guess everyone's premiums won't be going down as promised
wait, you mean we were misled?
shocking.0 -
Currently the cheapest plan with the highest deductible and out of cost expenses and no out of net work coverage. It makes up about 2% of my gross income.
Why would that not still qualify? I have a HDHP here in MA, which qualifies - and is about $2000 a year (my share; my company pays the rest) plus a $4000 deductible, which we always hit. But a lot of that is routed through an HSA and thus totally tax-free.
I'm going to ignore the political angle.0 -
Well from my perspective this is actually a much larger systemic question. Insurance companies work out rates individually with every provider in the area currently. If there are universal rates, or rates based on quality of service, then that would impact the cost of coverage just as much if not more than the quantity of services provided.
Really there is no easy answer how to pay for high risk individuals, but should they not have to pay more since they are higher risk? Insurance pools risk, the most risky should have to pay more vs having a universal rate.
-In 2002, the 5 percent of people with the greatest health care expenses in the U.S. population spent 49 percent of the overall health care dollar.
-The lower 50 percent of spenders accounted for 3 percent of the total national health care dollar.
-The proportion of spenders who remained among the top 1% of spenders for two years in a row doubled between 1996-97 and 2002-03.
-The five most expensive health conditions are heart disease, cancer, trauma, mental disorders, and pulmonary disorders.
(Source: http://www.ahrq.gov/research/findings/factsheets/costs/expriach/index.html)
The belief is that providing people with comprehensive health coverage many of these conditions can be caught earlier, allowing for treatment and lower overall costs. When things like (some) mental disorders, cancer, and heart disease are caught in the early stages they can be largely prevented from advancing to the advanced stages that send people out on disability and compounding into larger health problems.
For example, catching early high blood pressure and pairing it with case management can help someone get it under control with inexpensive medication and lifestyle changes before it becomes a chronic problem that leads to expensive surgeries.0 -
http://kff.org/interactive/subsidy-calculator/
Put on by kaiser foundation calculates if you qualify for subsidies
Kaiser is aweful. I'm surprised they're still in business.
I was just about to post something similar. As a physician biller, let me tell ya, Kaiser wasn't trying to pay anybody's claims! Every single patient that had Kaiser.... was like pulling each of my teeth out twice without any anesthesia! In the end, they wouldn't pay and I'd be forced to push the claims back to patient responsibility.
Also, there's a documentary (forgot the name) where Kaiser is presented as one of the WORST insurance companies out there.0 -
From the article:
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In California, a 40-year-old who makes less than four times the federal poverty level - that is, $95,000 for a family of four or $46,000 for an individual - would pay as little as $40 per month for a mid-level plan in which about 70 percent of medical costs and all preventive care is covered. This excludes additional costs to cover children or a spouse.
The same plan for a person who makes too much to qualify for a subsidy would run about $300 per month on average, the state said. In addition, the total amount consumers would have to pay each year for co-payments and other out of pocket costs would be limited to $6,350 or less, depending on income.
Patients could choose plans that offer lower co-pays if they wished, but would pay higher premiums. In some cases, particularly for low and moderate income workers in their 20s, the premiums are free once a federal subsidy is factored in.
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Maybe you need to move to super expensive CA?0 -
I think we would be better off doing the following:
1) Securing the border
2) Auditing all forms of current government health care (Medicaid, Medicare, etc.) for fraud, waste, and abuse.
3) Limiting lawsuits
It seems the AHCA is more about governmental control than any real health care reform.
Remember, "we have to pass it to find out what's in it."
The more we find out, the more we need a do-over.0 -
I think we would be better off doing the following:
1) Securing the border
2) Auditing all forms of current government health care (Medicaid, Medicare, etc.) for fraud, waste, and abuse.
3) Limiting lawsuits
It seems the AHCA is more about governmental control than any real health care reform.
Remember, "we have to pass it to find out what's in it."
The more we find out, the more we need a do-over.
You're a second grade teacher. That is a great profession (that I wouldn't have the patience for). So what experience do you have to say "the AHCA is more about governmental control than any real health care reform."?
Have you spent hours reading the ACA? Have you spoken to politicians or asked questions of your lawmakers?
Have you read fearmongering blogs and message boards like this one?0 -
Well from my perspective this is actually a much larger systemic question. Insurance companies work out rates individually with every provider in the area currently. If there are universal rates, or rates based on quality of service, then that would impact the cost of coverage just as much if not more than the quantity of services provided.
Really there is no easy answer how to pay for high risk individuals, but should they not have to pay more since they are higher risk? Insurance pools risk, the most risky should have to pay more vs having a universal rate.
-In 2002, the 5 percent of people with the greatest health care expenses in the U.S. population spent 49 percent of the overall health care dollar.
-The lower 50 percent of spenders accounted for 3 percent of the total national health care dollar.
-The proportion of spenders who remained among the top 1% of spenders for two years in a row doubled between 1996-97 and 2002-03.
-The five most expensive health conditions are heart disease, cancer, trauma, mental disorders, and pulmonary disorders.
(Source: http://www.ahrq.gov/research/findings/factsheets/costs/expriach/index.html)
The belief is that providing people with comprehensive health coverage many of these conditions can be caught earlier, allowing for treatment and lower overall costs. When things like (some) mental disorders, cancer, and heart disease are caught in the early stages they can be largely prevented from advancing to the advanced stages that send people out on disability and compounding into larger health problems.
For example, catching early high blood pressure and pairing it with case management can help someone get it under control with inexpensive medication and lifestyle changes before it becomes a chronic problem that leads to expensive surgeries.
There is a lot of merit to that argument of prevention and early detection saving money in the long term, but also what do you think of the moral hazard of having more people covered?0 -
Well from my perspective this is actually a much larger systemic question. Insurance companies work out rates individually with every provider in the area currently. If there are universal rates, or rates based on quality of service, then that would impact the cost of coverage just as much if not more than the quantity of services provided.
Really there is no easy answer how to pay for high risk individuals, but should they not have to pay more since they are higher risk? Insurance pools risk, the most risky should have to pay more vs having a universal rate.
-In 2002, the 5 percent of people with the greatest health care expenses in the U.S. population spent 49 percent of the overall health care dollar.
-The lower 50 percent of spenders accounted for 3 percent of the total national health care dollar.
-The proportion of spenders who remained among the top 1% of spenders for two years in a row doubled between 1996-97 and 2002-03.
-The five most expensive health conditions are heart disease, cancer, trauma, mental disorders, and pulmonary disorders.
(Source: http://www.ahrq.gov/research/findings/factsheets/costs/expriach/index.html)
The belief is that providing people with comprehensive health coverage many of these conditions can be caught earlier, allowing for treatment and lower overall costs. When things like (some) mental disorders, cancer, and heart disease are caught in the early stages they can be largely prevented from advancing to the advanced stages that send people out on disability and compounding into larger health problems.
For example, catching early high blood pressure and pairing it with case management can help someone get it under control with inexpensive medication and lifestyle changes before it becomes a chronic problem that leads to expensive surgeries.
There is a lot of merit to that argument of prevention and early detection saving money in the long term, but also what do you think of the moral hazard of having more people covered?
There is always a moral hazard, and that will have to be accounted for. Once again, I think that may be a larger question, and I really don't have a good answer for that one off the top of my head.0 -
Under this act, employers will have to make your insurance actually affordable (I did the math on mine and my employer will have to drastically change our premiums) or we will be able to go through the exchange (Federal here in Tennessee) to get affordable healthcare and our employers will face HUGE fines if that happens. Only problem in a state that has accepted a federal exchange is that God only knows when they will get the federal exchange set up. October is coming awfully fast with nothing set up yet!!!0
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IBTL!
Because this won't end well.
Right there with ya
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This whole healthcare debate is so flawed. People confuse health INSURANCE for health CARE. They are NOT the same. Many people, especially in the US, receive excellent health CARE without the benefit of health INSURANCE. An insurance card does not heal you when you are sick - doctors and medicine do that. Insurance is merely a means of payment for care that has been received.
The US has by far the most cutting edge medicine and medical technologies, and the most well-trained physicians in the world, particularly with regard to specialists. The majority of the most highly-regarded hospitals in almost every specialty are in the US. The US is responsible for the majority of the miracles of modern medicine that benefit the entire world, even though the US only comprises only 5% of the world's total population. There is no question that the health CARE in the US is the best.
Now with regard to health INSURANCE, which is an absolute DEBACLE in the US, there are tons of things that could be done to make the system better, but the "Affordable Care Act" did almost NONE of them.0 -
This whole healthcare debate is so flawed. People confuse health INSURANCE for health CARE. They are NOT the same. Many people, especially in the US, receive excellent health CARE without the benefit of health INSURANCE. An insurance card does not heal you when you are sick - doctors and medicine do that. Insurance is merely a means of payment for care that has been received.
The US has by far the most cutting edge medicine and medical technologies, and the most well-trained physicians in the world, particularly with regard to specialists. The majority of the most highly-regarded hospitals in almost every specialty are in the US. The US is responsible for the majority of the miracles of modern medicine that benefit the entire world, even though the US only comprises only 5% of the world's total population. There is no question that the health CARE in the US is the best.
Now with regard to health INSURANCE, which is an absolute DEBACLE in the US, there are tons of things that could be done to make the system better, but the "Affordable Care Act" did almost NONE of them.
I agree with you 100%0 -
Well from my perspective this is actually a much larger systemic question. Insurance companies work out rates individually with every provider in the area currently. If there are universal rates, or rates based on quality of service, then that would impact the cost of coverage just as much if not more than the quantity of services provided.
Really there is no easy answer how to pay for high risk individuals, but should they not have to pay more since they are higher risk? Insurance pools risk, the most risky should have to pay more vs having a universal rate.
-In 2002, the 5 percent of people with the greatest health care expenses in the U.S. population spent 49 percent of the overall health care dollar.
-The lower 50 percent of spenders accounted for 3 percent of the total national health care dollar.
-The proportion of spenders who remained among the top 1% of spenders for two years in a row doubled between 1996-97 and 2002-03.
-The five most expensive health conditions are heart disease, cancer, trauma, mental disorders, and pulmonary disorders.
(Source: http://www.ahrq.gov/research/findings/factsheets/costs/expriach/index.html)
The belief is that providing people with comprehensive health coverage many of these conditions can be caught earlier, allowing for treatment and lower overall costs. When things like (some) mental disorders, cancer, and heart disease are caught in the early stages they can be largely prevented from advancing to the advanced stages that send people out on disability and compounding into larger health problems.
For example, catching early high blood pressure and pairing it with case management can help someone get it under control with inexpensive medication and lifestyle changes before it becomes a chronic problem that leads to expensive surgeries.
There is a lot of merit to that argument of prevention and early detection saving money in the long term, but also what do you think of the moral hazard of having more people covered?
There is always a moral hazard, and that will have to be accounted for. Once again, I think that may be a larger question, and I really don't have a good answer for that one off the top of my head.
From my understanding of the law, there is nothing to prevent someone who is young and healthy from just paying the penalty for not having insurance, then if they were to get sick or injured get health insurance since you cannot deny people with pre existing conditions and there is a cap on what you can charge, so essentially you can game the system if you so choose. Frankly the weak penalty is one of the flaws, they should have either made it much harsher or not included the mandate/penalty at all.0 -
I am shocked that anyone thought this was going to be "affordable". Think about it.
Actually I live in MA, we've had to have insurance for years and, though there are some flaws, overall it has lead to a higher quality of health and availability of care to residents.
I agree that quality of health has likely improved for the general population and availability of care, but then there are the folks (like me) who are stuck in the middle.
Health Insurance is still not affordable to me. In fact, since the MA Health Reform has gone into effect I have barely had health insurance. I got insurance when I was under 26 because it was $100/mo (when I was pregnant I also had HI.) After my son was born I lost my insurance because I couldn't afford the premiums. I have also not been penalized for not having insurance, as they fine come tax time if you don't have it. This is because they acknowledge the fact that I am unable to afford health insurance on my own but also that I make too much money to qualify for subsidized insurance through the state. I feel as if I'm in a loophole of "It's okay if YOU don't have insurance, but all these other people have to have it."
Believe me, I would like to have affordable health insurance for me and my family. My son goes to doctor's visits on schedule for which I pay out of pocket. And yes, I pay all my medical bills. Thankfully we haven't had any serious problems healthwise, but if we did, I would be lost. Sadly, I've had to convince myself that paying for 2 dentist visits and 1 well child visit for him is much better than 10% of my salary going to (possibly unused) health insurance instead of food, nice housing, etc.
I agree with the poster above- Yes we have great health care, but our health insurance system is seriously flawed.
End rant I suppose.0 -
I was given this survey by H&R to assess my thoughts on the Affordable Care Act. Now I will say I like the idea, but as I got down to the nitty gritty and the money involved I am scared. This survey actually calculated what I would be paying in premiums with my income (I hope it is a huge conservative estimate). The eye opener I just go frankly would make anyone who is just a hard working middle class tax payer angry :mad:
I am looking at having to pay monthly premiums of nearly $1000 a month or $10,000 a year!!!! That's almost 10% of my gross income before taxes and everything else that is taken out!
How in the holy F_cuk am I an independent contractor expected to pay that amount? There is no way. Seems that the group who will be taken advantage of the most is the middle class. I honestly dont know how we are going to do it? Personally, I'll take the tax penalty of $1000 and hope I dont get sick or pregnant.
This is nothing new. Back in 2007, if we wanted health insurance - both hubby and I were 1099 - we would have had to pay over $1000/mo. After they denied a $3000 surgery, we opted out of health insurance. Why would we pay $10,000 per year to have them deny a $3,000 surgery?
I gave up being a 1099 so I could have health insurance, life insurance and retirement. Sometimes the "dream" of being self employed is actually a nightmare.0 -
This is nothing new. Back in 2007, if we wanted health insurance - both hubby and I were 1099 - we would have had to pay over $1000/mo. After they denied a $3000 surgery, we opted out of health insurance. Why would we pay $10,000 per year to have them deny a $3,000 surgery?
I gave up being a 1099 so I could have health insurance, life insurance and retirement. Sometimes the "dream" of being self employed is actually a nightmare.
And that's what's even worse, say I have insurance, they can still deny coverage of certain treatment. If they don't cover services I need, what am I paying these premiums for? That's too bad you had to give up being self employed.0 -
From my understanding of the law, there is nothing to prevent someone who is young and healthy from just paying the penalty for not having insurance, then if they were to get sick or injured get health insurance since you cannot deny people with pre existing conditions and there is a cap on what you can charge, so essentially you can game the system if you so choose. Frankly the weak penalty is one of the flaws, they should have either made it much harsher or not included the mandate/penalty at all.
Curious though, is there going to be an open enrollment period with this as there is in MA where I live? I think I read that the open enrollment is in Oct (?) if there is one. So for example, the only time I can get new insurance in MA is between July 1 and Aug 1. This prevents people from just getting insurance when they know they'll need it.
Thoughts?0 -
We had to cut back hours on some PT workers to stay under cap fro health care provisions in the ACT, or that would have added an additional $13+ million to our health care budget....and our premiiums went up again this year.0
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The penalty for not having health insurance should be $1,000, it should be guaranteed refusal of emergency care. That will wake everybody up to the need for single payer real quick.
I don't think anyone should be denied coverage if it is an emergency. However, if it isn't an emergency I think hospitals should have a right to deny them to the ER. The amount of people who go to the ER for runny noses and coughs is outrageous.
I also work in the ER doing registration. It is OUTRAGEOUS how many people are using the ER like it is a dentist office. I have also had mothers bring their children in for a skinned knee (they were on Medicaid) Or better yet, we actually had a guy come in via ambulance for...get this...HEMORRHOIDS. Yes, he wasted not only the EMT's time but we the taxpayer are the ones who picked up the tab (he is on Medicaid).0 -
The way I see it, we're paving the way for a better system in the future and there will be bumps along the way. I agree with the general concept that everyone being insured eventually leads to lesser expenses for all but it will be interesting to see how it all plays out in 2014.0
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:drinker: :drinker: :drinker:The way I see it, we're paving the way for a better system in the future and there will be bumps along the way. I agree with the general concept that everyone being insured eventually leads to lesser expenses for all but it will be interesting to see how it all plays out in 2014.0 -
Hate to break it to you, but the lawmakers didn't spend hours reading it either.I think we would be better off doing the following:
1) Securing the border
2) Auditing all forms of current government health care (Medicaid, Medicare, etc.) for fraud, waste, and abuse.
3) Limiting lawsuits
It seems the AHCA is more about governmental control than any real health care reform.
Remember, "we have to pass it to find out what's in it."
The more we find out, the more we need a do-over.
You're a second grade teacher. That is a great profession (that I wouldn't have the patience for). So what experience do you have to say "the AHCA is more about governmental control than any real health care reform."?
Have you spent hours reading the ACA? Have you spoken to politicians or asked questions of your lawmakers?
Have you read fearmongering blogs and message boards like this one?0 -
We had to cut back hours on some PT workers to stay under cap fro health care provisions in the ACT, or that would have added an additional $13+ million to our health care budget....and our premiiums went up again this year.
Just this past Monday the business where my mother works cut about 40 employees to 29 hours to stay under the 50 employee 30 hour average and at the same time put help wanted signs up. How screwed up is that?
Why did they do it now? Because the look back period is 6 months to determine your full time employee count come Jan 1.
Look for this to be a widespread practice.
Imagine being the owner of a growing small business that has 49 full time employees and needs to hire a few more. What are they going to do?0 -
WASHINGTON: Many people who buy their own health insurance could get surprises in the mail this fall: cancellation notices because their current policies aren’t up to the basic standards of President Barack Obama’s health-care law.
...
The National Association of Insurance Commissioners says it is hearing that many carriers will cancel policies and issue new ones because administratively that is easier than changing existing plans.
http://www.ohio.com/news/like-your-health-care-policy-you-may-be-losing-it-1.4018170 -
Rate Shock: In California, Obamacare to Increase Individual Health Insurance Premiums by 64-146%-
http://www.forbes.com/sites/theapothecary/2013/05/30/rate-shock-in-california-obamacare-to-increase-individual-insurance-premiums-by-64-146/0 -
We had to cut back hours on some PT workers to stay under cap fro health care provisions in the ACT, or that would have added an additional $13+ million to our health care budget....and our premiiums went up again this year.
Just this past Monday the business where my mother works cut about 40 employees to 29 hours to stay under the 50 employee 30 hour average and at the same time put help wanted signs up. How screwed up is that?
Why did they do it now? Because the look back period is 6 months to determine your full time employee count come Jan 1.
Look for this to be a widespread practice.
Imagine being the owner of a growing small business that has 49 full time employees and needs to hire a few more. What are they going to do?
OK so if you have 49 employees now, and you aren't offering them the option of getting basic medical insurance... Who is paying for their medical care?
I AM.
YOU ARE.
THE OWNER OF THE COMPANY IS
ALL TAX PAYERS ARE -
PLEASE UNDERSTAND that NOTHING IS MAGIC HERE. THE HIGHEST BILL RATE IS USED and the bill goes directly to the insured, the taxed and the wealthy.
Our country decided back in the thirties that health insurance would be an employment benefit not a government one. Was this because we're all red-blooded "we work and earn our care!"? Nope - it was because labor unions would be able to wield this a MAJOR BENEFIT of being a UNION MEMBER. yep. Union politics. So now are stuck with this economically ridiculous approach to medical coverage and we're trying to make it work without REALLY freaking out the population by totally overhauling it. We're trying to require employment to provide a shared cost method even if you aren't in a union or working for an organization that WANTS to provide insurance.
This isn't evil it's not a conspiracy it's not big government trying eff up your life - it's an attempt to fix an effed up system to make the costs 'smarter' and provide better outcomes for all of us.0 -
Hate to break it to you, but the lawmakers didn't spend hours reading it either.
OK how does the this possibly justify being uninformed of the actual content? I quiz my congressional members, if only through their staff that answers the phone- you can do the same. You can demand they know as much as they need to but you need to do more than just post fear and rage because an uninformed population is really just a mob. We have ALL THIS INFORMATION right at our FINGER TIPS! It's not like our parents day - when you would have to drive to your state capital or DC to get a hard copy to read. We can all read the ACTUAL text and not the paid press's version. But it takes effort and energy which is much harder to muster than just yapping on the internet. You seem bright but maybe you DON'T want to know the truth because it's so fulfilling to be filled with moral indignation!
I have found that when ever you dig deeply into ANY of the big divisive issues in the world, when we wade in and read the details - there is no "clear" answer. REALLY SMART, REALLY COMMITTED, people work hard on BOTH SIDES of almost every issue you can name. And they have some excellent compelling arguments but these arguments are WAY TOO COMPLEX to fit into a news bite on FOX or MSNBC. They won't make you angry and they won't fill your soul with indignation! They're often kinda boring and illicit more of a groan than banner building flag waving emotion.
Information is powerful. Please don't settle for the "preaching to the choir" BS you get on the mega-corp news programs. Read the Wall Street Journal - read the long boring stuff with no pictures. Listen to the WHOLE story on the NPR website not the five minute version they air. Go dig up the sources they use and make sure they used them in context!
In case you hadn't guessed it - I don't have much time to watch TV -:embarassed:
To the person who registrars people at the Emergency Department - your ED may be out of compliance if you register them prior to they're being evaluated by a medical professional to determine if they WILL be treated in an ED. If you do do this, and they're being treated you can be sure your hospital has a policy for this. Some states reimburse at ED rates for all medicaid patients regardless of the reason - this would be a great example of "playing the system" - treat a skinned knee, use pennies of services and bill the state a share of total costs of the department divided by total patients treated. In these situations it PAYS to treat as many non-ill patients on medicaid as you can. If you only reject uninsured and under-insured patients but take ALL the medicaid patients it's a pretty good funding source! By US states, the only service a patient presenting with a skinned knee is entitled to? An evaluation my a medical person to determine how serious. Zero tests, Zero band aids just a check to see if the presenting issue warrants ED usage. If your ED is treating this kind of injury you may be actually witnessing a federal crime if it's federal dollars, more likely with Medicaid it's a state fraud. Here's a link for you (you may be entitled to a % of the ill-gotten funds your ED has pulled in through treating skinned knees! http://oig.hhs.gov/fraud/report-fraud/index.asp AGAIN what you're talking about here is MEDICAID what this board has been discussing is ObamaCare - not remotely the same thing. Trust me, if you see a newly insured citizen, their private for profit healthcare will NOT pay for an ED to treat their skinned knee.0
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