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Pretty much the best argument that I've read FOR Obamacare. Yes, the Obamacare legislation is not perfect, but repeal is not the answer. "Health insurance should remain a choice" is just a fallacy of an argument, because for millions of Americans, it is not currently an option. Unless you have a job that offers you health insurance, it is very difficult to buy it as an individual.
It is wrong to assume that the millions of uninsured Americans are uninsured because they don't want health insurance.
" My daughter was denied because she takes regular medication for a common teenage issue. "
That is a pre-existing condition.
I have carried health insurance privately for over ten years.
Danno, I know you know the complexities about coverage but most people don't. Many get side swiped by the whole process during a bad time. At a time when people are very sick and don't have the time to ruffle through all the complexities that compound the delivery of care in this country. It is simply a cluster-f#$%.
I have seen the contrast between an HMO and a PPO in a different manner. My wife had an HMO and what I saw first hand was most doctors would not diagnose my wife's condition, didn't have a clue, but they did. Others just brushed her off. Some even insulted her by saying she has a mental disorder, or prescribed asprin for the most painful condition. She changed her insurance to a PPO and then the doctors diagnosed and helped her. The insidious thing was under the HMO many would not even broach a diagnoses, knowing full well what she had. They didn't want to open that can of worms. Because of this her condition worsened, not a little but a lot. She is now totally disabled receiving SSDI and medicare.
I do not like the way or trust our system of health care delivery in this country what so ever.
That's why using a qualified broker is a good idea. They can steer you away from a plan that's not going to work well for you in your situation. They can often help you with the process during a "bad time" if you contact them. I've always helped my clients or their friends/family when they call me regardless of whether or not, I'll be making any money from it...it's just good business...good Karma.
I find most brokers don't like to sell individual health insurance though because it's too much trouble (understanding it, explain it, getting it underwritten, keeping up with the changes, etc.) and they'll usually sell some other type of insurance instead like auto or life/financial planning. Some like to have something they can offer a client if one of them inquires about it (rather than send them away), so they often find one individual product they can offer to everyone.....which unfortunately they don't realize is rarely the best choice for their clients individual situation.
The whole idea with using a broker is that they represent the client (you) and not the insurer...which makes the self employed. They sign agreements with insurance companies that allow them to sell their products and get paid on a commisssion basis for doing so in return. An on the other hand, agent usually works for an insurance company in some way....they may actually be employees of that company....sometimes they receive commissions but, they also receive some kind of base salary as well. They usually can only sell the product(s) that the insurance company they're an agent for will allow them to sell.
In order to find a broker that's well qualified to help you with health insurance, you need to find one that pretty much only handles health insurance and therefore can sell you every product available that's marketed in the region you live in. If they have every product there is that you can possibly buy, they then should be able to tell you all the pros and cons of each plan and how they would apply to your specific situiation so, that you can make an informed choice. They have no reason to not be completely honest with you, since you're going to buy something and they sell everything. That includes anything negative you should be made aware of that may be enough of an issue for you in your situation to consider choosing a different plan. If they're a good broker, they understand that it's to their benefit to help you that way since they have nothing to lose (they sell ever product any way, it's just a question of which one you're going to buy).....and everything to gain (your future and continued business with them, by showing you that they're working in your best interest).
There's usually that one broker in an area that ends up immersing themselves in selling health insurance, since so few care to deal with it if they have other lines of insurance they normally sell. That's the broker you need to do business with for your health insurance and not the one that's the one stop shop for all your insurance needs.
^^I have to say danno, that while I don't always agree with you, I'm glad you come on here and post b/c you do know insurance.
If you want to know how something works, they say you should ask the people that actually make it work....they're the ones that know what they have to do (and why they have to do it that way) in order to make it work. I've found that those people narrow down to two groups. In a big company or corporation, it's all the little people (employees....full-time permanent employees) and sometimes their immediate supervisors because, as mid level management, they often got there by starting at the bottom. Upper level management and the executives they answer to, often have no clue how and why things work the way they do. They know how to manage the people that do the work, rather than know how to actually do the work (at least not enough to do it themselves if they ever had to).
The second group of people that know how things work, are the hands on self employed. In order to be successful enough to make a living they have to be efficient at doing their job correctly without sacrificing quality. A good portion of that comes from knowing the people that are among that first group, when dealing with the suppliers they need to use in order to do their job. I fall into this second group being self employed as a broker. By dealing with and establishing a business relationship with employees that work in the claims, underwriting and sales departments at the home office's of the insurance companies I'm contracted with, I have an accurate knowledge of what really happens in the health insurance industry.
The industry has been inaccurately portrayed to the public by politicians discussing and debating (and campaigning) over healthcare reform. I can't decide if it's being done intentionally to satisfy their party's agenda or if it's because of a actual lack of knowledge about the inner workings of the industry...or a combination of both. It's like they all have no idea of what's really going on but, they've all managed to learn just enough about it to be able to really screw things up. They don't lie, they instead use omission to mislead the uninformed and ultimately achieve the same goal as if they lied.
What kills me Katiana is that in understanding this issue so well and seeing how it was handled, I now realize how all the issues will get handled....all of which I don't understand like I did this one.
That's why using a qualified broker is a good idea. They can steer you away from a plan that's not going to work well for you in your situation. They can often help you with the process during a "bad time" if you contact them. I've always helped my clients or their friends/family when they call me regardless of whether or not, I'll be making any money from it...it's just good business...good Karma.
I find most brokers don't like to sell individual health insurance though because it's too much trouble (understanding it, explain it, getting it underwritten, keeping up with the changes, etc.) and they'll usually sell some other type of insurance instead like auto or life/financial planning. Some like to have something they can offer a client if one of them inquires about it (rather than send them away), so they often find one individual product they can offer to everyone.....which unfortunately they don't realize is rarely the best choice for their clients individual situation.
The whole idea with using a broker is that they represent the client (you) and not the insurer...which makes the self employed. They sign agreements with insurance companies that allow them to sell their products and get paid on a commisssion basis for doing so in return. An on the other hand, agent usually works for an insurance company in some way....they may actually be employees of that company....sometimes they receive commissions but, they also receive some kind of base salary as well. They usually can only sell the product(s) that the insurance company they're an agent for will allow them to sell.
In order to find a broker that's well qualified to help you with health insurance, you need to find one that pretty much only handles health insurance and therefore can sell you every product available that's marketed in the region you live in. If they have every product there is that you can possibly buy, they then should be able to tell you all the pros and cons of each plan and how they would apply to your specific situiation so, that you can make an informed choice. They have no reason to not be completely honest with you, since you're going to buy something and they sell everything. That includes anything negative you should be made aware of that may be enough of an issue for you in your situation to consider choosing a different plan. If they're a good broker, they understand that it's to their benefit to help you that way since they have nothing to lose (they sell ever product any way, it's just a question of which one you're going to buy).....and everything to gain (your future and continued business with them, by showing you that they're working in your best interest).
There's usually that one broker in an area that ends up immersing themselves in selling health insurance, since so few care to deal with it if they have other lines of insurance they normally sell. That's the broker you need to do business with for your health insurance and not the one that's the one stop shop for all your insurance needs.
Thanks Danno for the info, I appreciate it. My employer is now interviewing brokers so maybe I can now get coverage I have not had in almost 2 years. I just mentioned to my boss what you advised. Thanks again
If just ONE American is forced to buy health-care when they don't want it then the law should be repealed, period. Nobody should be forced by the government to buy something if they don't want it just to be a citizen.
If a hospital could let you die on the sidewalk instead of treat you because you didn't have insurance then I would agree with you.
As it stands, MANY things still get treated even if you are uninsured....it's just that everyone else winds up paying for it indirectly.
It's the same boat we were in before mandatory auto insurance. A bunch of people would drive uninsured, cause accidents that the rest of us would then pay for.
Frankly, I'm shocked more fiscal conservatives don't actually favor a system where the currently uninsured have coverage but ALSO have to pay something into the system. The alternative is that they pay NOTHING in but still get emergency and other care and then don't pay the bill.
If a hospital could let you die on the sidewalk instead of treat you because you didn't have insurance then I would agree with you.
As it stands, MANY things still get treated even if you are uninsured....it's just that everyone else winds up paying for it indirectly.
It's the same boat we were in before mandatory auto insurance. A bunch of people would drive uninsured, cause accidents that the rest of us would then pay for.
Frankly, I'm shocked more fiscal conservatives don't actually favor a system where the currently uninsured have coverage but ALSO have to pay something into the system. The alternative is that they pay NOTHING in but still get emergency and other care and then don't pay the bill.
Exactly the point I have tried to make many times.
We have de-facto UHC. We do not have a fair means of spreading the cost.
I think this is what Obama was trying to do. Unfortunately, I think he got it wrong by compromising with vested interests.
Frankly, I'm shocked more fiscal conservatives don't actually favor a system where the currently uninsured have coverage but ALSO have to pay something into the system. The alternative is that they pay NOTHING in but still get emergency and other care and then don't pay the bill.
Thanks Danno for the info, I appreciate it. My employer is now interviewing brokers so maybe I can now get coverage I have not had in almost 2 years. I just mentioned to my boss what you advised. Thanks again
The broker he chooses to work with should come back with quotes from several insurers...each one of them offering more than one plan (like an HMO or PPO with various deductibles or co-pays, depending on the premium). When I get quotes for an employer, I put them all on a spread sheet and sort them by premium.
Once a broker gets quotes from an insurer for an employer, the insurer will not give any quotes for that employer to another broker that requests one for a certain time period (usually a year). They'll assume that the broker has established a relationship with the employer as being his/her client unless an agent of record letter is submitted to the insurer showing otherwise. An agent of record letter is a letter signed and dated by the employer naming who the broker is that they intend to do business through, thus eliminating the need for the insurer to honor a broker's relationship with an individual or business by assumption.
The reason I mention all that is because if your employer is "interviewing" brokers by allowing them to get quotes for him/her, the first broker that gets interviewed and starts gathering quotes from insurers, is going to block out all the subsequent brokers your employer interviews that also try to gather quotes to show him/her (unless they're sneaking and slide an agent of record letter in front of your boss to sign). Brokers sometimes do that by stating that it's just a letter that allows them authorization to formally obtain quotes for them on their behalf. Which is true....that's what it does....but, what they don't mention is that it allows only them to obtain quotes on their behalf and no other broker(s) (unless another broker has an agent of record letter that's more recent and overrides the first letter). What can happen is that a good honest broker can end up getting the shaft from another broker that uses the old "agent of record trick" to get clients....one that's often not as good and not working in his/her client's best interest.
So tell your boss to pick the broker that seems the most professional and prepared first and see how many quotes he/she returns with before allowing another broker a shot. If you were here in AZ, I would probably return with quotes from Aetna, United HealthCare, Humana, Cigna, HealthNet and Blue Cross/Blue Shield of Arizona, at a minimum.
Pretty much the best argument that I've read FOR Obamacare. Yes, the Obamacare legislation is not perfect, but repeal is not the answer. "Health insurance should remain a choice" is just a fallacy of an argument, because for millions of Americans, it is not currently an option. Unless you have a job that offers you health insurance, it is very difficult to buy it as an individual.
It is wrong to assume that the millions of uninsured Americans are uninsured because they don't want health insurance.
Who wants insurance for conventional modern medicine that turns out to be a bigger killer than any one disease? People that don't know any better and can't think outside the box and will just do whatever their medical doctor tells them to do ought WAKE UP and begin to realize that drugs, surgery and diagnostics taken and/or performed as prescribed kill far too many Americans to be worth paying the outrageous costs for "treatment" that the medical establishment charges.
Based on only 20% of reported incidents more than 250 times the number of people that died on 9/11, die from their "treatment" that "health"insurance pays for EVERY YEAR!!!!!!
In my opinion, the only thing health insurance ought to be used for is accidents or acute illnesses NOT for chronic conditions like Cancer or heart disease or diabetes or high cholesterol or high blood pressure which are much more effectively treated by Naturopathic Doctors. Health insurance, except in a few states, does not pay for natural medicine. The good news is Natural Medicine is actually affordable WITHOUT insurance.
Before all of you naysayers ( who are in love with their diseases and their prescription drugs and prefer to take prescriptions all their lives rather than actually work to strengthen your bodies' ability to cure itself through natural methods and regain your health so you don't need your Rxs any more) jump all over me, remember that the human race not only survived but thrived with just natural medicine alone for the past hundreds even thousands of years. Prescription drugs are not needed for "health". All they do is cover up symptoms of disease so you can live with your disease. It is Natural Medicine that can restore one to robust health.
Read the statistics yourself! Go to The Life Extension Foundation and do a search for "Death by Medicine". The 30 or so page report was compiled by medical doctors and PhDs and statistics taken directly from medical journals. All the footnotes and references used are there.
Regarding obtaining the actual health insurance and being rejected due to pre-existing conditions, if every state would simply establish a high risk health insurance pool, and have insurance companies in the private market rate based on risk (which is what insurance companies all do for all insurance), you'd find much more affordable rates for the healthy and the reasonably healthy. Those that somehow fall through the cracks or who are finishing up their COBRA coverage after leaving a job and have major health issues that prevent them from qualifying for affordable rates in the private market could get their coverage in the high risk pool.
Most states do this now but you have states in the northeast with legislators who are control freaks and want to force the insurance companies to do everything their way that has prevented this from taking place. Consequently and not surprisingly, this is where you will find health insurance to be the least available and the MOST EXPENSIVE where health insurance premiums are often higher than mortgage payments. Coincidently New York, the home of the New York Times happens to be one of these states. If this article was more objective, it would discuss how the stupid state legislation wreaked health insurance for New Yorkers.
As an independent insurance agent who has specialized in health insurance for more than 20 years and was involved in trying to salvage a northeastern state with legislators who fit the descrption above, who botched up the legislative environment so badly that all the health insurers that used to offer quality affordable insurance to individuals left that state except for one, I know what I'm talking about. Today there are only 2 companies to get renewable health insurance in that state (RI) from and only one if you are a non-business owner.
The moral of the story is: a good way to ruin any industry is to let the government get their foot in the door to begin lording over it. Now with Obamacare just expect higher costs for those that previously had insurance so that they won't be able to afford it due to all the dumb additional mandates for unnecessary coverage which everyone will be forced to pay for. You'll simply end up with fewer Americans who have health insurance. The projected rates on the government healthcare website are OUTRAGEOUS. They are much higher than what the private sector charges for less protection. Obamacare is LOSE/LOSE.
The same thing happened in Massachusetts where I was also licensed. My clients got notices when the so called "reform" went through telling them they had to switch to a lower deductible plan which of course cost them MORE MONEY. This was because the Massachusetts legislators thought their constituents were too stupid to be able to choose a plan and budget for any out of pocket expenses they might have been responsible for.
Last edited by emilybh; 03-05-2011 at 09:14 AM..
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