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"The economy" 2 trillion dollars is extracted from our economy per year because of healthcare costs. "Jobs" without healthcare reform to help those smaller business control health insurance costs, jobs are going to get tougher to find, more difficult to start up a business, stifle entrepreneurship or employ more Americans."terrorism" Did you know that health insurance companies have in their bylaws exclusions for premium paying members (civilians) that if hurt by terrorist attack by a declared or undeclared war on our shores they can deny coverage to said member? So, whither Americans realize it or not we need reform now.
above bolding mine.
There shouldn't be that kind of exclusion...just as groundwater infiltration flooding the basement to a foot of water should not be an exclusion. Just as flood insurance calling 4' of water (or whatever the measurement is) in the house not a flood until it gets to 6', or to the first floor, or whatever they conjure up as a safe margin for themselves. Sometimes I do wonder what we are paying for. I know they're there to make a profit, but I'm not a big fan of insurance companies.
That kind of exclusion is like property insurance policy excluding hurricane damage in coastal areas or tornadoes along "Tornado Alley".
We could rather quickly become "Terror Alley" the way things are going.
emilybh, thank you for giving me all this information I can research. This is kind of you. It is just a start, but I didn't know these terms and now I can research them.
No Problem and sorry for the use of Ariel Black font the last time. I wasn't shouting-- just didn't know how to make my answers to your questions stand out from your questions without taking twice as much time as it took to simply change the font.
Good luck with your research. I use United Healthcare for group sales and they own Golden Rule. The concept of the "Continuity" product isn't bad but as individual carriers go, Golden Rule is weaker from the standpoint of giving you as much control as possible over access to doctors and hospitals as other carriers. They don't offer true PPO plans. Instead they have their version of that called a "network" plan where you may or may not be able to go outside the network. So that would be the compromise.
However, you could certainly sign up for it now, and when you retire if you still have your health, still apply to a different carrier for a true PPO plan that gives you a choice of PPO networks; has no primary care physician requirements and since it would be a true PPO plan, would let you go outside the PPO network for an additional out of pocket cost.
John Alden, Time (both Assurant subsidiaries) and Celtic would offer true PPO plans as would Aetna and Blue Cross and others where you could go to any doctor or hospital both inside or outside your chosen network. Also I haven't checked recently but Golden Rule used to have waiting periods for some of their benefits like a six month wait for a hernia operation or before you could have a check-up.
Just make sure you read the exclusions and limitations BEFORE you decide to apply for coverage. I ALWAYS make my prospective clients do that while I watch them so I can explain any questions they have. Better yet if you can, get a specimen policy where the exclusions will be more thoroughly explained. In any even, you always have a 10 day free look so if you don't like the policy when you get it, just tell them you want to cancel your coverage for a refund. A nominal application fee would be the only thing you might not get back.
What can we do that will be palatable to everyone? Does everyone at least agree that there are some fundamental problems? Here are the issues I want to see fixed from where I sit:
1. Provide a less expensive option to continue coverage between jobs.
2. Do away with pre-existing conditions altogether.
3. Find some way to reduce costs so that our premiums don't keep increasing 20-30% each year.
4. Do away with lifetime maximums.
5. Lower cost coverage for out of network benefits in cases of severe (not routine) disease and injury.
Can we have a partisan-neutral discussion of what the problems are and some ideas to fix it?
how about leaving it to the states. if you want to live in a state with universal coverage move to a state like mass. if you don't like the idea of paying for other people's healthcare through taxation, move to a state which doesn't tax you for it
how about leaving it to the states. if you want to live in a state with universal coverage move to a state like mass. if you don't like the idea of paying for other people's healthcare through taxation, move to a state which doesn't tax you for it
The states regulate the insurance companies. Insurance companies enjoy the Anti-Trust exemption. This is one reason we are in a mess in the first place because insurance companies, when being forced to be humane by a particular state, just split the scene, jack rates, drop people until we're at the point we are at now when only one major player dominates a state--no competition. Also, many states have low populations forcing rates to skyrocket because the groups of covered folks are small.
If there were no pre-existing restrictions, what would prevent people from just waiting until they were really sick to join the insurance pool? It would be far cheaper to self-insure when healthy and then turn to the insurance company when really sick.
Any meaningful reform will have to address this. There should be no exclusions, but there needs to be other mechanisms to ensure that everybody contributes over time. Insurance companies needs healthy people paying in also.
In my post on page 21, post #209 I made a passing reference to this thought:
Quote:
Given that perception most of us prefer that public policy on social issues of society be vested to the individual states, albeit meeting a conformity base imposed by national law, again not to control, but to standardize basic protections to the people.
This 'standardization' as I prefer to refer to it by federal law that brings 'uniformity' to "basic" state health law is the ideal. Beyond that states can set their own legal parameters. An example being...Does a state wish to allow insurers licensed in said state to merchandize insurance across state lines? Does a state wish to make total disability income a 'rider' option to existing insurance? Those are the types of decisions that should be seen as a "states' right" power as the Constitution intended.
My idea of "standardization" would make uniform the primary coverages, exceptions and exclusions in ALL health policies, something that is NOT in force at present. I'm not a big government advocate by any means, but mandating a base level of uniformity benefits the people as a whole and can only be accomplished by federal law. It also should not be a partisan issue.
Something else to bear in mind. When you try to eliminate any "pre-existing conditions" limitations from health inusrance you accomplish the diametric opposite of what is desirable. You force them to escalate the premiums out of sight, because you throw all actuarial stats out the window for the insurer. If you advocate for a continuing "private" option in addition to that which government currently makes available, you MUST consider the effect upon insurers and what there self-interest reaction will, of necessity, be.
In my post on page 21, post #209 I made a passing reference to this thought:
This 'standardization' as I prefer to refer to it by federal law that brings 'uniformity' to "basic" state health law is the ideal. Beyond that states can set their own legal parameters. An example being...Does a state wish to allow insurers licensed in said state to merchandize insurance across state lines? Does a state wish to make total disability income a 'rider' option to existing insurance? Those are the types of decisions that should be seen as a "states' right" power as the Constitution intended.
My idea of "standardization" would make uniform the primary coverages, exceptions and exclusions in ALL health policies, something that is NOT in force at present. I'm not a big government advocate by any means, but mandating a base level of uniformity benefits the people as a whole and can only be accomplished by federal law. It also should not be a partisan issue.
I can agree. In order to accomplish this wouldn't the fed have to yank the anti-trust exemption from health insurance companies?
think it's important to note that there is misinformation on both sides. There are people who want to derail health care, not because they think it is a bad idea, but because it will hurt Obama's precidency. (It will be his 'Waterloo'.) They have every incentive to present a false optimistic picture of our current sytem and a false negative picture of the overhaul--just as the White House tries to sell the plan by painting the opposite picture. In fact--the opposition to the overhaul has been very vocal.
In this climate, it's hard to get at the truth.
I want to agree with florida.bob that if people face serious, life-threatening illness, they need care. Period.
We also need a system that doesn't allow some to milk the system and build wealth while paying nothing.
I thought the current bill accomplished a lot of that, while not perfect. I was hoping it would pass.
If you amended this comment:
"that if people face serious, life-threatening illness, they need care. Period."
To read:
"that if people face serious life threatening emergencies, they need care. Period."
Then the system we have has acknowledged that. You cannot be turned away in an emergency room if you have a life threatening emergency. If you are you can sue the dickens out of said hospital.
If you hold to the 'real' meaning of your original statement, you ARE advocating for what is NOT a constitutional right at all. Providing for insurance is a "personal" responsibility no matter how or what we think. Granted there are situations where cost becomes a limiting and impossible obstacle to overcome. For people caught in that circumstance Medicaid as a government option was instituted. I had to use it for nursing home expense for my own Mother. It was unavoidable. You use the assets you have and then the government has provided a bottom line protection.
You may recall my first suggestion for CONSTRUCTIVE improvement I made at page 20, comment post #193. A Castatrophic Major Medical policy would solve the problem you keep coming back to over and over again from different angles. In the negotiations to make up a bill for such there would undoubtedly be some provision for those who couldn't afford the premium and for such, to effect a tax subsidy or some other concession to bring the coverage into effect. If you can imagine such, it would ...over time, almost eliminate the need for Medicaid by having insurance providing for such.
Which is cheaper? To subsidize the needy by a tax subsidy to assist payment of said "private' covearge OR to continue the giant, $$$$$ sucking sound that grows and increases our tax burden forever called Medicaid.
Last edited by doctorhugo; 01-27-2010 at 10:07 AM..
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jmking and 58robbo
