We don't need to force everyone to buy insurance if this were already available. Why not offer this first, then see where we stand?
A. Because people are demanding an overhaul of the health system. B. Because medical costs are rising too fast to sit around and wait to see how it pans out anymore. C. Because B. is due, in very large part, to people not buying insurance and saddling the rest of us with the cost of their care.
A. I do think it needs an overhaul, but not something so drastic as what 's going on now. B. and C. Even with the new ACA, we are still saddled with paying for those without health insurance or subsidized insurance.
This is something that DH and I were talking about- do you think that it might end up being cheaper in the long run because people would have insurance for preventative care, and not end up in the ER all the time?
This is something that DH and I were talking about- do you think that it might end up being cheaper in the long run because people would have insurance for preventative care, and not end up in the ER all the time?
Yes.
This is documented, and why many insurers were already covering preventive care 100% before the requirement.
Ever been incentivized to do an online health survey by your employer/insurance company? It's all related.
Post by thebuddhagouda on Jun 28, 2012 13:35:45 GMT -5
So people that understand this better than me, will this mean that I can get affordable private maternity coverage? Right now, the ONLY option in my state is BCBS which requires me to pay $200 extra a month to have a $5,000 deductible before they even start covering anything. Since my last pregnancy spanned two calendar years, we spent over $10,000.
Will this force companies to cover maternity as part of their regular plans?
How long until some people say that's it cheaper for them not to get insurance and just wait for the IRS to come after them, since they're not getting a refund anyway? IRS wants to take things away? They have nothing to take. IRS wants to take money from their paycheck? Quit work. So, they can quit work, and get government financial aid as well as health insurance. You KNOW people are going to do this, whether it really works or not.
What was stopping scores of people from doing this before Obamacare? Oh right, because being poor sucks.
Exactly. No change.
How can people pay the penalty (tax) for no insurance if they don't file taxes? Or pay taxes?
What was stopping scores of people from doing this before Obamacare? Oh right, because being poor sucks.
Exactly. No change.
How can people pay the penalty (tax) for no insurance if they don't file taxes? Or pay taxes?
I would like you to present actual numbers on people defrauding the government for healthcare. Not truly low income families, but those who just opt to quit jobs for the sweet life provided by the gubmint.
And, if they do prove to be a large number (which they aren't), then I want you to tell me how bad it is that women now pay the same rates as men - vs. being charged more because they are women, that people are given preventive care in an affordable way, and that people who are just unlucky enough to have a pre-existing condition can now be guaranteed health coverage.
For me in means my parents may actually be able to get health insurance for the first time in their lives and before they hit the age for medicare. Neither of their employers carry plans and based on the current plan they'd fall into the category for a subsidized plan. Since both put off health issues due to costs I'm sure there are underlying preexisting conditions.
For me, it doesn't mean too much. Both mine and fiance's healthcare are through huge employers and those insurance plans won't change much.
So people that understand this better than me, will this mean that I can get affordable private maternity coverage? Right now, the ONLY option in my state is BCBS which requires me to pay $200 extra a month to have a $5,000 deductible before they even start covering anything. Since my last pregnancy spanned two calendar years, we spent over $10,000.
Will this force companies to cover maternity as part of their regular plans?
Yes.
This is part of an email that I received today that I think helps explain it-
The Patient Protection and Affordable Care Act requires that every health insurance plan offered to an individual or small business must cover a minimum level of benefits in each of the ten broad categories of services listed below. This minimum coverage standard is referred to as “essential health benefits.” Health insurance plans may cover additional services at their own discretion.
Essential Health Benefit (EHB) Service Categories
1. Ambulatory patient services 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services, including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative services and devices 8. Laboratory services 9. Preventive and wellness services and chronic disease management 10. Pediatric services, including oral and vision care
Each state is responsible for selecting a benchmark plan as the standard for the essential health benefits package. After this selection, all other health insurance plans available in the state for either individuals or small businesses will be required to offer benefits that are “substantially equal” to the benchmark plan. Plans will have the flexibility to adjust the specific services that are included as part of the benefit, as well as any quantitative limits on certain services, as long as the coverage has the same value as the benchmark plan.
From my understanding, most states are holding forums and decided what their state's exact benchmark plan is going to look like.
Post by thebuddhagouda on Jun 28, 2012 14:08:33 GMT -5
Is the maternity thing something that goes into effect in 2012? We were planning on TTC in Nov to have the pregnancy in one calendar year, but I will gladly wait a few more months if it means I can get a new plan with maternity covered in 2012.
Post by kellbell191 on Jun 28, 2012 14:18:06 GMT -5
MIL had a really hard time two years ago, lost her job and lost her insurance. The medical bills just for basic meds were astronomical so she couldn't afford them and wound up hospitalized, which was even more astronomical. I'm hoping this will help her take better care of her health going forward.
floyd -- they can't impose a limit. That's like saying "Why doesn't Congress make my cable bill lower?". Congress can't restrict commerce.
well - before this law, they couldn't force you to buy something either. haha
I guess I just think it's crazy to have OC and leave it unprotected right out of the gates.
Correct me if I am wrong, but initially when this bill was introduced a public option was part of the package. It essentially was the creation of a government insurance program offered at affordable rates with the thought that insurance companies would keep their prices in line to retain customers. Enter screams of socialism and it basically was scrapped.
What was stopping scores of people from doing this before Obamacare? Oh right, because being poor sucks.
Exactly. No change.
How can people pay the penalty (tax) for no insurance if they don't file taxes? Or pay taxes?
See, the losers out there that have always sucked the system dry won't see a change. Everything in their life is already free, and will continue to be so. It is the working person that barely makes it paycheck to paycheck, and just can't afford to pay for health care, yet don't qualify for free healthcare, that will get fucked.
I live in a small area, and the amount of welfare bums is disgusting. And they all seem to live pretty ok, as sad as that is. They have houses, they have cars, their kids have all of the newest of electronics.
I think those of you declaring that no one would screw the government because being poor sucks needs to look at another neighborhood than the one you live in. It is everywhere, and people fuck the government for less of a reason than healthcare.
I mean, its great that my fiance, with his Type 1 diabetes and seizure issues, will always be able to "get' insurance. In theory.
But at what cost? And what level of care? What good is an individual mandate if he can't afford the premiums? Or he's stuck with the crappy student health insurance we had when I was in law school which didn't cover jack shit?
I like the bill in concept. I'm concerned in execution.
Rome wasn't built in a day Sprky. Not directed at your personally, but THIS type of "glass half empty" opinion is what stalls forward progress..."eh, maybe it's good, maybe it's bad, lets just keep talking about it for YEARS."
How can people pay the penalty (tax) for no insurance if they don't file taxes? Or pay taxes?
See, the losers out there that have always sucked the system dry won't see a change. Everything in their life is already free, and will continue to be so. It is the working person that barely makes it paycheck to paycheck, and just can't afford to pay for health care, yet don't qualify for free healthcare, that will get fucked.
I live in a small area, and the amount of welfare bums is disgusting. And they all seem to live pretty ok, as sad as that is. They have houses, they have cars, their kids have all of the newest of electronics.
I think those of you declaring that no one would screw the government because being poor sucks needs to look at another neighborhood than the one you live in. It is everywhere, and people fuck the government for less of a reason than healthcare.
there is a minimum level that you must make in order to be taxed.
omfg people UNDERSTAND THE LAW BEFORE SPEWING OUT NONSENSE.
I think we're going to see a lot of bitching and moaning in the next 10 years about wait times and poor availability of primary care doctors/ER care (it infuriates me that I even have to group those 2 types of care together), because they will be even more poorly reimbursed than they are now. Med school graduates will have even less incentive to go into it because they won't be able to make enough money to pay their mortgage, much less pay back the $150k+ in student loans.
I think you'll see an even greater divide among the haves and have-nots in terms of quality and availability of care.
I think you'll start to see more doctors (maybe even some hospitals) stop taking insurance all together and just take on patients who pay cash, so they don't have to deal with insurance companies calling the shots w/r/t reimbursements and their pay, and how many patients they have to see in a work day.
Pretty much, I think everyone is all "YAY! This means I'll get awesome affordable healthcare forever and ever!" when really the people who are on the fringes now will continue to get effed by the system, just in a different way.
ER utilization should go down, now that people will have access to care at the PCP level. This is going to decrease costs drastically.
What we'll actually see is a shift toward nurse practitioners taking on more of the doctor's work - which is already happening. We're going to see more proactive care aimed at keeping people out of the hospital (which is more costly).
This reform bill isn't happening in a vaccuum. There are many other facets, including a move toward Patient Centered Medical Homes and Accountable Care Organizations which are already happening - all of the tenets of the legislation and the accreditation and best practices guidelines are aligned. They are supported by years of research.
This is not as short sighted and off the cuff as people believe.
But I'm betting it won't. Because what *should* happen will probably NOT happen, for a number of reasons. 1) current/future availability of pcp's, as well as NP's. There aren't enough RN's graduating to staff a hospital, let alone some massive influx of under-utilized NP's (who have to have their BSN/RN, to even apply to the 2-3 year master's program that allows them to become NPs).
2) many states restrict the practices of NP's so it isn't worth it for a lot of people to pursue that route, and the doctors in the practice have to deal with their paperwork as well.
3) compensation for PCPs SUCKS. And they work like dogs. Would you rack up $150k+ in med school debt (not to mention potential undergrad debt) to make $160k/year, pre-tax, $100k/year post tax, working 60 hours a week? Not likely. For some people who love it, it is worth it. For more and more, it isn't.
And yes, we're seeing doctors being more proactive and encouraging patients to take preventative measures in terms of healthy lifestyle and such. But the simple truth is that doctors can encourage and be proactive all they want, but until people decide for themselves to actually take the advice they're given (be it about weight, smoking, exercise, std prevention, taking the damn meds the doctor prescribes....yes, people do just fill the prescription and not take the medication), nothing will change.
I love how people are acting as if we are the VERY FIRST COUNTRY EVER to dip our toe in the direction of a socialized health care system. Fuck, how do we know what we're doing with no other countries doing this!!!
My hope one of the trickle down effects is that education for Dr's becomes cheaper in order to attract skill and talent. And let's be honest - there are NO shortage of Dr's these days. Many can't find jobs and take contract positions in ER's just to get work. Dot and Buzz, I 100% respect your opinion but I think your statements are a bit hysterical...and at the same time are expected as a reaction to any large scale change that will bring a bit of the unknown.