Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Agree, however keep several chickens on hand to trade with the local doc when its time for a little leach treatment.
I gather leeches down at the creek and keep them handy just for that reason. Unfortunately, a weasel got into the chicken coop last year but, tractor's supply will be getting some more pretty soon (they sell ducks too, like the AFLAC duck).
I was born in a downtown and lived mostly in cities and then suburbs. The older I get, the more I respect the rural life... and in regards to the wild west, thankfully, physically, I can still endure much of the physical rigors. Or maybe I'm just extremely stubborn, physically. Regardless, I've come to appreciate the simpler things of life which is why I left corporate America and 'tuned' out from most of the 'social communication' today. But, when people start talking about healthcare again, although not trying to persuade, I do like to correct some of the common misconceptions and at least point them to where the raw data, when accessible to the public, can be found.
Believe it or not, pre-existing exclusion was federal law per HIPAA in 1996 except in the case of Administrative Services Only (employer pays all medical costs, and those are covered under ERISA not HIPAA), and as long as a person had coverage for 6 months prior to new coverage.
The issue I see with the second paragraph is... well, I've posted about the solutions being offered.
Thank you for your honest response however. I 'pur-she-ate it.
I don't think that's correct;
HIPAA limited the look back period for pre-existing conditions under an employer sponsored health plan. The plan could deny coverage for a preexisting condition only if the employee or dependent was diagnosed, received care or treatment, or had care or treatment recommended within 6 months before the enrollment date. HIPAA prohibited group health plans and issuers from excluding an individual’s preexisting medical condition from coverage for more than 12 months (18 months for late enrollees) after the individual’s enrollment date. It never applied to individual policies sold to consumers. But seriously, are you claiming that was adequate? What about a cancer patient? Under HIPAA they could quite possibly wait 12 months for coverage for that condition, which could mean the difference between life and death, or if they couldn't get a group policy and had to buy an individual one, it would probably come with a lifetime exclusion. HIPAA: Your rights to health insurance portability
I've always considered the ACA to be a first step toward single payer as reflected in my previous posts on the subject. What have you and your "ilk" proposed in order to fix our obviously broken healthcare system?
If you truly want a system on a Federal level you're going to need to decentralize pretty much everything. There are too many factors involved in each state for a benevolent government to solve with broad strokes.
Instead of large hospitals who try to plan for the worst (and charge you accordingly) we should move more towards a clinic type system where you'll have general medicine and then you'll have specialist who go where they're needed the most. For example where I live there is a very large number of retirees (a good portion of which have money). Because of that there are large numbers of bone doctors in the area. It's kind of crazy how many bone doctors there are here. Anyways, there's other areas as well where money is blown on silly things like huge lit parking decks and big screen TVs in private rooms.
One-size-fits-all payment plans do not work and the reason for that's simple. The COL varies greatly across the US. Because of that reason alone it makes the disbursement of services and monies paid unfair.
How about letting Insurance companies not hold monopolies in one or more states. If insurance has no competition there's no pressure on any of them to lower cost to stay competitive while still providing coverage you need.
Plans should be able to be highly customized. If you want $1,000,000 insurance policy in case you have a child that was affected by the newest latest greatest pandemic (no matter how small the odds) you should be able to choose that plan. You want every single possible thing to bdo covered and you're willing to pay? You can have that.
You should be able to purchase insurance plans and towards the end of your life you should be able to cash in whatever is left (if any) and pass it along to whomever you wish, including the Federal Government.
There's plenty of other ways to provide more efficient and better service at a cheaper costs than to get the Federal Government involved. Once you do that, you'll have zero choice besides moving out of the country. Once you set up a system like single payer, or whatever, it will become a third rail no one will touch. We'll be in the exact same place as we are with SS right now. Year after year the Trustees have been issuing reports on how to fix SS and how much worse it will be if you continue on the path you're on (and have always been on since its inception) if you continue to wait and see what happens. No one will touch it because hordes of old people with maul them. Here we are, though, still having done nothing to shore it up so that it's there for future generations. And that's the crux of it. If the lot of you are not going to be honest with us and yourselves why should we get behind your idea of some sort of one-size-fits-all solution that never works.
HIPAA limited the look back period for pre-existing conditions under an employer sponsored health plan. The plan could deny coverage for a preexisting condition only if the employee or dependent was diagnosed, received care or treatment, or had care or treatment recommended within 6 months before the enrollment date. HIPAA prohibited group health plans and issuers from excluding an individual’s preexisting medical condition from coverage for more than 12 months (18 months for late enrollees) after the individual’s enrollment date. It never applied to individual policies sold to consumers. But seriously, are you claiming that was adequate? What about a cancer patient? Under HIPAA they could quite possibly wait 12 months for coverage for that condition, which could mean the difference between life and death, or if they couldn't get a group policy and had to buy an individual one, it would probably come with a lifetime exclusion. HIPAA: Your rights to health insurance portability
You are correct on the individual policies... they always get overlooked. So good catch.
And, in regards to the change from then to now, yes, i believe it was adequate because it was the employer rider in the benefit plan that actually made that distinction, not the 'health insurance company'. It's like buying gap coverage on your auto plan.
of course, again, no one bothers saying that nationally because it's easy to demonize the payors.
Believe it or not, pre-existing exclusion was federal law per HIPAA in 1996 except in the case of Administrative Services Only (employer pays all medical costs, and those are covered under ERISA not HIPAA), and as long as a person had coverage for 6 months prior to new coverage.
The only problem with this is that people who became unemployed often could not afford to maintain their insurance under the HIPAA rules. It was just too cost prohibitive as you can imagine. If they happened to be unemployed for longer than six months they were effectively screwed.
Those coming into the insurance market for the first time would be denied coverage for certain things if they had been diagnosed before. I've read stories where people would intentionally avoid going to the doctor because they didn't want that "pre-existing conditions" label hanging over their heads. That's no way for a civilized country with the medical technology we have to operate.
I blame insurance companies for most of the problems we have with our healthcare system. I'm really no fan of the ACA because it didn't fix a lot of what needed to be fixed. I am, however, strongly opposed to it being repealed even with all of its faults. As long as it's law there will be a strong incentive for changes. Hopefully for the better next time.
Actually in the future HUMANS will not have a need to work. The right wing folks will go insane and long for the WILD WEST. The work week is going down globally.
The problem with futurist is they speak in platitudes and never have to be correct. Since you live in the here and now let's talk about the now and the immidiate future taking note of the past.
Ok, I have to ask... what exactly did the ACA radically change about healthcare, coverage and administration, besides the 1% or $95 tax penalty per IRS Filing for coverage? I'm not 'attacking' the bill... I've stated in multiple places it had some good and some bad. I'm just curious, from your perspective, what you see as actual change.
Which brings an interesting question: I wonder how much it COST for the IRS and businesses to implement and administer the collection, processing, integration, and submission, of the 1095 verification form, country wide? I wonder if it was 'budget neutral'?
It made a lot of preventive services "free" at the POS, e.g. mammograms, immunizations, etc. It made well care free at POS. The immunization/well care coverage was a godsend to pediatrics. No more co-pays to get your kids immunized = no more excuses! And to be fair, for some young families just starting out, a co-pay of $20 for each immunization visit is a lot of money.
You are correct on the individual policies... they always get overlooked. So good catch.
And, in regards to the change from then to now, yes, i believe it was adequate because it was the employer rider in the benefit plan that actually made that distinction, not the 'health insurance company'. It's like buying gap coverage on your auto plan.
of course, again, no one bothers saying that nationally because it's easy to demonize the payors.
I knew people whose private policies were cancelled due to rescission which means looking back at an application and finding some reason to call a current condition pre-existing, i.e. you need a knee replacement but there is evidence that you could have damaged your knee in a car accident you didn't disclose. And those policies covered a lot of people. About 22.6 million nonelderly people had nongroup coverage in at least one month during 2011.
The other thing that the ACA changed, and this is pretty significant - it removed annual and lifetime caps on care. One of my neighbors whined like crazy when she had to get an ACA policy which cost her twice what her old policy did. I had her dig out her old policy and it had a $50,000 annual cap on coverage, that wouldn't even cover most surgery, let alone a catastrophic illness or accident.
It's pretty shameful that we have so many in this country who are uninsured yet we boast how great America is. You are so worried about who is going to pay for it instead of worrying about those who are suffering and dying without it.
Yanno what, I don't believe anyone begrudges anyone who is suffering and dying....
what people are so sick and angry about are those who abuse it, those who get it and are criminals, illegals, and refuse to become an american citizen...
that has to stop....
so yes indeed, give it to people who are suffering and dying...but make certain they are American Citizens...illegals here in America are draining our systems.
The only problem with this is that people who became unemployed often could not afford to maintain their insurance under the HIPAA rules. It was just too cost prohibitive as you can imagine. If they happened to be unemployed for longer than six months they were effectively screwed.
Those coming into the insurance market for the first time would be denied coverage for certain things if they had been diagnosed before. I've read stories where people would intentionally avoid going to the doctor because they didn't want that "pre-existing conditions" label hanging over their heads. That's no way for a civilized country with the medical technology we have to operate.
I blame insurance companies for most of the problems we have with our healthcare system. I'm really no fan of the ACA because it didn't fix a lot of what needed to be fixed. I am, however, strongly opposed to it being repealed even with all of its faults. As long as it's law there will be a strong incentive for changes. Hopefully for the better next time.
The main thing I did like about it was the 824 Transaction...darnit, there I go again, the Hub... darnit, there I go again. The 'exchange' as so expertly pointed out by our 'experts'. But, it was actually put together pretty well and the transaction set is one of the simplest (besides the 270,271 which is eligibility and eligibility response... why providers still use the phone, I 'gotz' not idea).
Yes, C.O.B.R.A. is a bear. C.O.B.R.A. does allow for elevated, sky high, rates of continued coverage but, again, it was also set up and regulated by the government which put a surcharge on the employer who was then allowed to defer most of the payment to the member to instead of picking up most of the tab. So when people would see the cost, they'd go... wha, wha, what!!!!!
Premiums are set by a simple formula, well, relatively simple, called per member, per month. This is the year average of the given population of cost... or allowed charges, paid charges, utilization, etc... there are other key ingredients but that's the primary. I won't get into the other because certain mods are payor demographic, or service industry, or another variable specific.
Now all the bids to become an MA Plan, or an MCO (medicaid version) submits a proposal to the state (and a corresponding plan to the DOI for coverage verification to ensure it is covering the state mandated minimums) which includes a PMPM. If a state DOI says NO, plan can't be offered. So it's kind of disingenuous to blame 'insurance' companies. I totally understand why people do but, as I stated in multiple other places, there are 3 primary players in 'healthcare' and each points it's fingers at the other. This is picked up on by politicians who don't understand it, tell their constituency what they want to hear to keep or get their office, and things keep going along without more than incremental change.
The second, some would contend first, largest industry in this country is not going to change without everyone feeling the pain. As an example, banking is either the first, or second, largest industry in the country. So the real estate bubble pretty much ... well, I'll be kind with my words. And what changed there? ABSOLUTELY nothing... and that was with creating XXXX amount of trillions of dollars to not 'bail out' you and I, but to keep the government .... oh, banking industry... afloat. So, those that think Mr. Sanders fine words and speeches are going to amount to any real change, either in the way I'd like to see it go, or how those who promote ACA/Single payor/UHC/sunshines and rainbows (no negativity meant, I just thought of the movie Rockie Balboa when he's talking to his kid about life) are setting themselves up to be let down.
Kind of like the individuals that vote people in for IRS reform and nothing ever really changes.
If ANY CITIZEN WANTS TO AFFECT (not effect) CHANGE, VOTE ONLY THOSE INDIVIDUALS WHO PLEDGE TO ADD A TERM LIMIT AMENDMENT TO THE CONSTITUTION FOR REPRESENTATIVES AND SENATORS or agree to public molestation by angry, governo-centric space gorillas. Until then, nothing is really changing except continual erosion of personal responsibility and liberty via increased scope of the Federal Government... it's called the Vampire theory. lol
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
