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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....
Yanno what? The Supreme Court has already ruled on the health care for criminals issue, so give up on that one. California decided it was acceptable to provide less than adequate health care in it's prisons and got spanked hard by the court. And honestly, can you name even one illegal who would turn down citizenship if it was offered to them?
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.
Yes, we covered individual policies about 2 paragraphs later. I do like that another is using KAISER as the source of all things healthcare... people do know how intertwined they are with the industry? Nothing against them but, if it said 'http://Anthem.org/private-insurance.... would there be more skepticism?
$50,000 is a very low yearly cap. As stated, the ACA had a couple of good things, and some bad things. Overall, it did not change much. Medicaid expansion actually changed more than the ACA, except for the arguing and finger pointing back and forth. But, since it was a state by state decision, and each state sets its own rules, it's too much work for the media to actually report on it vs just 'framing' it as R vs D, house vs. Obama, etc....
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.
The mammogram contention has been highly debated. Many (I haven't done the study from pre to post for plans) group plans already offered the mammo with no cost sharing, kind of like your yearly dental cleaning. But, for those that didn't, it was factored into the premium, which ACA did not address. So, up front or on the back, it was still there. But, again, many plans already offered it. For Medicare, Traditional began paying full cost in 2011 and MA Plans in 2012 so it is 'trumpeted' as a big change but in effect was already there. Not putting it down and thankful it is.
Without going into the full depth, 'well care' made free at POS is kind of a misnomer and there are multiple places people can find out how that broad category was actually effected by ACA as to the requirements they actually had to change. But I won't contend the general statement. Business wise, not a lot changed, for someone who is used to drastic change, but my perspective may be different than others.
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?
Want to lower the cost of healthcare in the US?
1) Reduce the cost of billing and administration by simplifying insurance requirements and specifications. Duke University Hospital has 900 beds... and 1300 billing clerks.
2) Change Medicare Part D so that it has the right to use its power to negotiate drug prices. Right now it doesn't. This alone would save about 10 billion per year and would lower drug prices for millions of people.
3) Reduce the practice of defensive medicine through tort reform. Right now about 650 Billion dollars of basically unnecessary procedures are performed every year in the US because doctors are afraid of getting sued. Texas implemented tort reform and Department of Insurance data shows medical malpractice claims, including lawsuits, resolved in a year fell by nearly two-thirds between 2003 and 2011 to 450. The average payout declined 22 percent to about $199,000.
There are other things that can be done as well, but this would be a very good start. And most of it involves getting the government out of the medical business.
1) Reduce the cost of billing and administration by simplifying insurance requirements and specifications. Duke University Hospital has 900 beds... and 1300 billing clerks.
2) Change Medicare Part D so that it has the right to use its power to negotiate drug prices. Right now it doesn't. This alone would save about 10 billion per year and would lower drug prices for millions of people.
3) Reduce the practice of defensive medicine through tort reform. Right now about 650 Billion dollars of basically unnecessary procedures are performed every year in the US because doctors are afraid of getting sued. Texas implemented tort reform and Department of Insurance data shows medical malpractice claims, including lawsuits, resolved in a year fell by nearly two-thirds between 2003 and 2011 to 450. The average payout declined 22 percent to about $199,000.
There are other things that can be done as well, but this would be a very good start. And most of it involves getting the government out of the medical business.
The above will not happen as long as PHARMA and the Health care Insurers donate money to Washington DC.
The only Republican in world history that can see this is Donald Trump and as expected the Republican Party wants him out. I wonder why?
Absolutely NOT, why should I have to pay to take care of aliens, I mean we don't even know how big the universe is, how are we going to provide health care for the whole thing?
The above will not happen as long as PHARMA and the Health care Insurers donate money to Washington DC.
The only Republican in world history that can see this is Donald Trump and as expected the Republican Party wants him out. I wonder why?
Julian, how does Part D (which i'm not for the subsidy by the way) donate to keep prices up which means more payout? Why the push for generics whenever possible as it relates to prescriptions?
3) Reduce the practice of defensive medicine through tort reform. Right now about 650 Billion dollars of basically unnecessary procedures are performed every year in the US because doctors are afraid of getting sued. Texas implemented tort reform and Department of Insurance data shows medical malpractice claims, including lawsuits, resolved in a year fell by nearly two-thirds between 2003 and 2011 to 450. The average payout declined 22 percent to about $199,000.
Yeah I'm familiar with the tort reforms here in Texas. It may have reduced costs to doctors but to date, those savings have not been passed along to patients. Our medical costs have risen right along with everyone else's. I remember the push to get that passed. Politicians were falling all over themselves promising it would make healthcare affordable.
The mammogram contention has been highly debated. Many (I haven't done the study from pre to post for plans) group plans already offered the mammo with no cost sharing, kind of like your yearly dental cleaning. But, for those that didn't, it was factored into the premium, which ACA did not address. So, up front or on the back, it was still there. But, again, many plans already offered it. For Medicare, Traditional began paying full cost in 2011 and MA Plans in 2012 so it is 'trumpeted' as a big change but in effect was already there. Not putting it down and thankful it is.
Without going into the full depth, 'well care' made free at POS is kind of a misnomer and there are multiple places people can find out how that broad category was actually effected by ACA as to the requirements they actually had to change. But I won't contend the general statement. Business wise, not a lot changed, for someone who is used to drastic change, but my perspective may be different than others.
"free" well care encourages people to go the doctor. The end result of that is that some diseases and chronic conditions can be detected and treated early, before they become enormously expensive to treat.
"free" well care encourages people to go the doctor. The end result of that is that some diseases and chronic conditions can be detected and treated early, before they become enormously expensive to treat.
Yeah... insurance companies have been pushing things likes that for a LONG TIME precisely for that reason. Same with nurse outreach when people leave the hospital... those annoying calls asking people how they are doing, scripts filled, any assistance needed in making follow up appointments, etc. Why? To prevent the need for readmission. It saves money.
not to shill for payors but there are whole departments at payors, at least the one I worked out for 10 years, the 2 that I had extensive w2 contracts with, the 4 I helped redesign either payor systems or EDI, etc... to work with members on things like.... yearly checkups (routine E&M), vaccines (including flu), mammos, gyno visits, the lovely male version of the gyno visit at 40/45/50, etc... and in the data world, basically tracking down members, say of kids under 5, and looking at exactly what vaccines they were behind on.
Now coverage, people have to keep in mind: the plan a person or employer buys is where the coverage is. I don't like using the analogy but if one only carries liability coverage on their vehicle, Geico won't pay if someone does a hit and run the vehicle. It's not right, wrong, or indifferent, it's just how it works.
Why do you think employers were more up in arms over ACA then the major payors? Because employer groups, and no fault to them, have been scaling back on the coverage they are buying their employees for years. And, for those that work for the payors, WE ARE THE GUINEA PIGS FOR COVERAGE. Meaning, what is being offered to the public now is what we had to live with 10 years ago. My individual deductible was 3K in 04.... when I got married, it went to 6300 in 06. People still don't see those numbers.
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