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No they arent.. the exchanges are just insurance companies operating on the governments behalf. Most states already contract out these services to medicare, medicaid etc..
Just adding one more "exchange" into the system isnt going to add competition when the reinbursement rates are set by the federal govenrment and paid by the insurance companies.. Do you even understand that?
If company A pays $100 for a procedure, and company B, pays $100 for a procedure, they are both paying the same price. The fact that you add into the equasion C, who will also pay $100 for the same procedure doesnt add any more competion, no more than adding gas stations reduce the price of gasoline.
Do you just pull garbage out of your backside? The insurance companies aren't "operating on the governments behalf." All the exchanges are is a centralized location where you can buy health care. The pros, cons, cost and coverage of every company is spelled out, side by side, so consumers can see exactly what they're buying, and how much it costs for what you get. The companies on the exchange are certified to meet certain standards for coverage and affordability before they can participate. No consumer can be turned down by a company. By making it easy to comparison shop, the companies who offer the best deal get the business. THAT'S how premiums will go down--if you don't offer a competitive product to consumers, you won't get the business. The competition doesn't come in on how much they pay for a procedure--it's the margin of profit they make on providing a service.
The push to make insurance companies actually deliver services is why the rebate system is in place now as well. If your insurance company is taking your premium, but spending less than 80% of those funds on actually providing health care, they're having to rebate the difference to consumers. Right now there are plans out there on the market that take advantage of consumers by taking your premium, covering very little, and pocketing the rest. If you're going to be in the business of providing health care coverage in this country, then you should actually cover health care. It's not complicated.
As someone who's worked extensivly in the insurance industry, who contracted work on behalf of the government, I very well understand the problem, always have.. and always said Obamacare wasnt the solution because it does NOTHING to curb the cost..
There's a reason why you're not working in that field now, because you haven't got the vaguest idea of how any of this works.
I'm totally lost. I'm not familiar with this at all. Who is getting rebates and what happens to me if I cash it? Also, what is this $1975 in fees you are talking about?
I don't want to cash anything if it is gonna come back and hunt me...
Please explain for me so I understand.
Our insurance went up a lot and I have not seen any check.
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If you have insurance from a company that spends less than 80% of their premiums on actual health care delivery, you will get a refund based on the cost of your premiums, and the percentage that your health insurer falls below that 80%. If your employer pays part of your health care coverage, the rebate will be divided between you on a prorated bases. If your insurance company already spends at least 80% of your premium on services, you won't get a refund. If you get a refund, why would anything happen to you if you cash it? The process was put in place to make sure that if you're paying for health insurance, the company you buy from actually provides a reasonable amount of coverage and services.
The process was put in place to make sure that if you're paying for health insurance, the company you buy from actually provides a reasonable amount of coverage and services.
Basically a way to ensure (no pun intended) that your "insurance" is not really "insurance" but a full on health care plan.
Thereby destroying the option to acquire basic catastrophic coverage at any reasonable price.
The cost of insurance has risen on average $1975 since Obamacare has been put into law. When an insurance company doesnt spend 80% of their revenues on treatment, they are required to reinburse some of this excesss back to the consumers.
If you're getting a rebate check, its simply because they overcharged you all year.. Some people here are celebrating their $100 rebate, (on average), while ignoring their cost went up almost $2,000.
Yes, its as dumb as it sounds..
It's dumb to make companies rebate if they overcharge? That's a new one on me! I just LOVE it when companies rip me off!
Do you just pull garbage out of your backside? The insurance companies aren't "operating on the governments behalf." All the exchanges are is a centralized location where you can buy health care. The pros, cons, cost and coverage of every company is spelled out, side by side, so consumers can see exactly what they're buying, and how much it costs for what you get. The companies on the exchange are certified to meet certain standards for coverage and affordability before they can participate. No consumer can be turned down by a company. By making it easy to comparison shop, the companies who offer the best deal get the business. THAT'S how premiums will go down--if you don't offer a competitive product to consumers, you won't get the business. The competition doesn't come in on how much they pay for a procedure--it's the margin of profit they make on providing a service.
The idea of having a place to compare health care plans is not new. It is something that was already available. How anyone can portray this as some type of revolutionary idea is beyond me.
Again, for a couple thousand and ten bucks for a domain name I'll throw together my own online "exchange" right now.
Basically what you're trying to assert is that there was no competition in health care before. Ergo the government must step in to give people a list of companies to choose from. This will revolutionize the market.
It's nonsense.
Quote:
Originally Posted by mb1547
The push to make insurance companies actually deliver services is why the rebate system is in place now as well. If your insurance company is taking your premium, but spending less than 80% of those funds on actually providing health care, they're having to rebate the difference to consumers. Right now there are plans out there on the market that take advantage of consumers by taking your premium, covering very little, and pocketing the rest.
Some of us do not want our money back every year. Some of us would prefer to pay a lower rate with the tradeoff being that we only get something back if we absolutely need it.
And some of us are not such idiots that we will purchase a high priced plan that covers nothing. Requiring companies to provide a certain service therefore pinning their prices within a specific range is an assault on my freedom of choice to purchase a plan that fits my particular needs.
I do not want 80% of my money back. I am perfectly fine with a cheap plan that gives me nothing but kicks in when I need something that costs upwards of $10,000 or so. That is my choice.
Quote:
Originally Posted by mb1547
If you're going to be in the business of providing health care coverage in this country, then you should actually cover health care. It's not complicated.
Insurance and health care are two completely separate things. I'd love to hear your definition of insurance - because the idea that so much should be covered is antithetical to the concept.
Quote:
the act, system, or business of insuring property, life, one's person, etc., against loss or harm arising in specified contingencies, as fire, accident, death, disablement, or the like, in consideration of a payment proportionate to the risk involved.
It wasn't complicated when we had the option to define our own contingencies. It's no less so now, someone else is just making that decision for us.
Quote:
Originally Posted by mb1547
It's dumb to make companies rebate if they overcharge? That's a new one on me! I just LOVE it when companies rip me off!
Apparently the point is flying completely over your head.
No, it's dumb for YOU to make an arbitrary definition of what "overcharging" is and using it to stomp on the freedom of choice of the consumer.
Logic. Use it.
Do you have home insurance? Do they give you back 80% of your money every year? Somehow I doubt it. You're getting screwed mb1547, Obama should do something about this.
Basically a way to ensure (no pun intended) that your "insurance" is not really "insurance" but a full on health care plan.
Thereby destroying the option to acquire basic catastrophic coverage at any reasonable price.
How is a health care plan not insurance? The way the affordable care act makes the process work financially for insurance companies is that everybody has to have insurance. Without broad coverage that includes healthy people, the mandate to cover people with preexisting conditions creates too much financial risk for insurers. .
I followed the debate on this closely in the 1990s when the Clinton administration was proposing a broad program where the government became the health insurer, not unlike medicare and medicaid today. The ACA that we have today is pretty much identical to the plan proposed by the GOP and Newt Gingrich as a private industry led alternative (it was developed by the Heritage Foundation) and very close to what Romney went on to put in place in Massachusetts. If you want to keep the process part of private industry vs. government run, then you have to make it profitable for the private companies providing the services by lowering their risk through broad coverage. You don't get it both ways--you can't get lower premiums PLUS the ability to option out. The GOP framed the debate then in terms of dealing with "dead beats" who don't want to pay for care, but then expect the government to carry the costs if they get sick.
Once the health care exchanges are put in place and consumers have more choices, the companies are going to have to lower premiums to get business because of the competition, but they're still going to be required to provide a certain standard of care. That competition should lower premiums for everyone. Right now catastrophic care is popular because the cost of a more comprehensive insurance policy is so high. When prices go down, that shouldn't be an issue any more.
There isn't the option of doing nothing--premiums have been rising so high and so fast that health insurance is unattainable for lots of people who don't get benefits through an employer. That puts a huge strain on the system when those people don't seek services until they're already very ill, and they rely on government programs vs. dealing with a medical condition that could have been managed affordably if they'd been treated earlier. When they receive charity care from hospitals, it raises the costs for the rest of as the providers pass on the costs to consumers. Some people simply don't get care at all and die. That's not how a developed country should manage health care.
The cost of insurance has risen on average $1975 since Obamacare has been put into law. When an insurance company doesnt spend 80% of their revenues on treatment, they are required to reinburse some of this excesss back to the consumers.
If you're getting a rebate check, its simply because they overcharged you all year.. Some people here are celebrating their $100 rebate, (on average), while ignoring their cost went up almost $2,000.
Yes, its as dumb as it sounds..
Ok, well my husbands company covers 95 % so we pay 5 % out of pocket. I am not getting any check.
How is a health care plan not insurance? The way the affordable care act makes the process work financially for insurance companies is that everybody has to have insurance. Without broad coverage that includes healthy people, the mandate to cover people with preexisting conditions creates too much financial risk for insurers.
Because the idea of insurance is that you do not get your money back outside of a specific set of scenarios. By restricting the specificity of those scenarios across the board, you are diminishing the concept of insurance. You are turning health insurance into something more than some of us want it to be.
I'm not arguing the financial risk. It may very well be there. My point is clear.
Quote:
Originally Posted by mb1547
I followed the debate on this closely in the 1990s when the Clinton administration was proposing a broad program where the government became the health insurer, not unlike medicare and medicaid today. The ACA that we have today is pretty much identical to the plan proposed by the GOP and Newt Gingrich as a private industry led alternative (it was developed by the Heritage Foundation) and very close to what Romney went on to put in place in Massachusetts. If you want to keep the process part of private industry vs. government run, then you have to make it profitable for the private companies providing the services by lowering their risk through broad coverage. You don't get it both ways--you can't get lower premiums PLUS the ability to option out. The GOP framed the debate then in terms of dealing with "dead beats" who don't want to pay for care, but then expect the government to carry the costs if they get sick.
That is one of numerous way to keep things profitable for the private companies. And it just so happens to involve the unilateral re-definition of what "health insurance" actually is.
The argument about "dead beats" is more associated with the requirement to purchase health insurance than the 80/20 rule.
Quote:
Originally Posted by mb1547
Once the health care exchanges are put in place and consumers have more choices, the companies are going to have to lower premiums to get business because of the competition, but they're still going to be required to provide a certain standard of care. That competition should lower premiums for everyone. Right now catastrophic care is popular because the cost of a more comprehensive insurance policy is so high. When prices go down, that shouldn't be an issue any more.
Nonsense.
An exchange will provide little to no benefit over what is already available. The idea of comparing health care plans against each other (ie shopping around) is not a new idea. This is, quite frankly, a ridiculous claim. This is not revolutionary, and is currently available for anything for health care to cheap prepaid cell phones.
ObamaCare does absolutely nothing to increase competition. We already have competition. Putting together a list of insurance companies is something that any idiot can do in his spare time over a weekend.
So if you pay for your own insurance as self employed will you get a $100 rebate check? If so i havnt gotten on yet and my insurance has gone up 80-90% in the last 2 yrs.
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