WSJ - you won’t be able to “keep your health-care plan”

[jsteele]

Anonymous wrote:Interesting provision to note. Apparently if you leave your job and thus your private insurer, you have to go to the public plan.

If there is a personal mandate, which currently it appears there will be, individuals will not be able to be uninsured. If they leave their job and lose their insurance, they will need to obtain new insurance. That doesn't have to be the public option, though that would likely make the most sense. The point of this is that uninsured people are a big drain on the system. They avoid preventative medicine and show up when things are most expensive to treat and normally use the most expensive option (the emergency room).

[Anonymous]

jsteele wrote:

Anonymous wrote:Interesting provision to note. Apparently if you leave your job and thus your private insurer, you have to go to the public plan.

If there is a personal mandate, which currently it appears there will be, individuals will not be able to be uninsured. If they leave their job and lose their insurance, they will need to obtain new insurance. That doesn't have to be the public option, though that would likely make the most sense. The point of this is that uninsured people are a big drain on the system. They avoid preventative medicine and show up when things are most expensive to treat and normally use the most expensive option (the emergency room).

Under the Massachusett's plan, their costs are still spiraling out of control. In addition, the previously uninsured are seeking more services, not fewer services. See this article in USAToday: http://www.usatoday.com/news/health/2009-07-22-masshealth_N.htm

Here is one excerpt from that article:
"Once people had insurance, the state reasoned, they would flee emergency rooms for neighborhood doctors and drug stores. As a result, state funds intended to pay safety-net hospitals and community health centers for serving the uninsured have been reduced by $660 million.

But if anything, demand has increased as the newly insured seek more medical attention. "The funding levels are not keeping pace with the volume that we're seeing," says William Halpin, CEO of South Boston Community Health Center. "There's been a little bit of robbing Peter to pay Paul."

Boston Medical Center, the state's largest provider to the poor, filed a lawsuit against the state last week charging that it's getting only 64 cents on the dollar to care for low-income patients.

"We kept the patients, but we didn't keep the money," says Thomas Traylor, vice president for federal, state and local programs."

I'm am not against healthcare reform, however I do believe it is a very serious issue that is going to require a huge amount of money. I would like to see lawmakers take their time to come up with a sustainable plan, not something crafted in a few weeks by a select few. As my mother always says "Act in haste, repent in leisure."

[Anonymous]

As a physician married to a physician, the AMA does not speak for me or for any physician I know.
It is a dying organization that represents maybe 10% of practicing physicians, primarily surgeons.

[Anonymous]

"Why are so many of you opposed to people having affordable access to healthcare? I just don't understand it. "

Maybe its wishful blindness. The health care system and the risks that people face today are hidden from many americans who when they are healthy think their insurance is just fine. Many people have no idea that they are underinsured until they develop a serious condition or have an accident. More people may not realize how incredibly expensive private insurance is and how it will not cover pre-existing conditions until they lose their job. The employed may complain when they see their premiums rise but they do not see the full increase and are usually not aware that their employer's portion is also escalating. They don't see that this leads to lay offs and less coverage.

[Anonymous]

Anonymous wrote:Repealing ERISA

Obama health plan would repeal Erisa

One by one, President Obama’s health-care promises are being exposed by the details of the actual legislation: Costs will explode, not fall; taxes will have to soar to pay for it; and now we are learning that you won’t be able to “keep your health-care plan” either.

The reality is that the House health bill, which the Administration praised to the rafters, will force drastic changes in almost all insurance coverage, including the employer plans that currently work best. About 177 million people—or 62% of those under age 65—get insurance today through their jobs, and while rising costs are a problem, according to every survey most employees are happy with the coverage. A major reason for this relative success is a 1974 federal law known by the acronym Erisa, or the Employee Retirement Income Security Act.

For the full article:

http://online.wsj.com/article/SB10001424052970203946904574298661486528186.html

Wow, I didn't know Harry and Louise post on DCUM. Cool.

[Anonymous]

ERISA is evil. It means individual states can't regulate the insurance companies operating in their own state. Since federal insurance regulation is notoriously difficult to enact, the insurers are getting away with murder. I'm all for individual mandates, though not for a public plan- we do NOT need medicare for all- but removing ERISA so that we can have a more tightly regulated industry is not a bad thing.

[Anonymous]

Anonymous wrote:Interesting provision to note. Apparently if you leave your job and thus your private insurer, you have to go to the public plan.

What is your complaint? What is the alternative to the public plan? No health insurance? So you show up sick at the hospital and they have to treat you even though you don't participate in the public program?

[Anonymous]

Another new nugget found out. In today's world if say your dad had colon cancer and you want to go for an early screening you can. In the new plan--the "coordinated" care that Obama is talking about is in fact rationing..it's just a marketing term..but I digress..in the new plan you can go for your screen at a designated time regardless of maybe your family has such an early history of colon cancer that maybe you want to go before 40..this plan not only can you not go early but you couldn't even pay for it with your own money. Beware of Obama's words remember he asked the question of maybe some people should receive drugs instead of surgery for certain cancers etc..that is rationing. If I or a family member and even grandma have cancer and want to go for it with surgery..it should be our choice and not some government board deciding a la England.

Other interesting thing to note is that a lot of this doesn't go into effect until 2013 hmmm right after the next election so that this could go through and Obama could rah rah rah this is great but we don't see the effects until after he gets safely in his next term.

[Anonymous]

Oh thought of something else. If you are one of the 85% of this country who likes their insurance-why would you want to give that up?? There are a lot of us who buy the best because it's what we prioritize..another term now is the "gold plated" plan. Yes I pay more because that is what is important to me. It's more important than a new car in fact and that is my choice. Many many people who don't prioritize could at least get a catashtropic plan with a high deductable so that they are not ruined forever if they get sick and the country doesn't have to pay if are not able to pay the deductable..ex. the country would be in the hock for 10K instead of millions.

The first step we need in reform is to not tank the entire system.

First step should be-no denial of prexisting conditions--that makes sense and seems fair

Same tax deductions for individuals as for companies-that makes sense and seems fair

Tax penalties for the 10 million people who are offered care and do not take it

Let's go from there..

[Anonymous]

Anonymous wrote:Another new nugget found out. In today's world if say your dad had colon cancer and you want to go for an early screening you can. In the new plan--the "coordinated" care that Obama is talking about is in fact rationing..it's just a marketing term..but I digress..in the new plan you can go for your screen at a designated time regardless of maybe your family has such an early history of colon cancer that maybe you want to go before 40..this plan not only can you not go early but you couldn't even pay for it with your own money. Beware of Obama's words remember he asked the question of maybe some people should receive drugs instead of surgery for certain cancers etc..that is rationing. If I or a family member and even grandma have cancer and want to go for it with surgery..it should be our choice and not some government board deciding a la England.

Other interesting thing to note is that a lot of this doesn't go into effect until 2013 hmmm right after the next election so that this could go through and Obama could rah rah rah this is great but we don't see the effects until after he gets safely in his next term.

Please prove to me that it would be, what, illegal? For me to use my own money to pay for an early colonoscopy or other procedure if I choose to do so.

[Anonymous]

Anonymous wrote:ERISA is evil. It means individual states can't regulate the insurance companies operating in their own state. Since federal insurance regulation is notoriously difficult to enact, the insurers are getting away with murder. I'm all for individual mandates, though not for a public plan- we do NOT need medicare for all- but removing ERISA so that we can have a more tightly regulated industry is not a bad thing.

Not exactly... The actual law of ERISA clearly states that nothing in ERISA "shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities." So individual states can and do regulate insurance companies operating in their state. ERISA does not mandate that employer's provide health insurance coverage, but rather sets certain standards if employers do provide health insurance. For example, ERISA came into play when Maryland passed a law that required very large employers to provide health insurance coverage or pay the state a tax. ERISA prevented Maryland from mandating that large employers provide health coverage in that state.

[Anonymous]

10:29, I am pretty sure it means unless the ration committee says you can have your procedure, you aren't allowed to have an appointment and the doctors aren't allowed to provide you one.

Let's look at why everyone says the system is broken:

Some people don't have any health insurance - by choice or by circumstance (can't afford it).

Most primary care doctors (first line of defense) don't get paid enough, driven by insurance companies and Medicare driving reimbursement to only a small percentage of billed fees.

Billed fees have to be jacked up to allow the doctor to make enough money to stay in practice and pay for the staff that needs to process all the insurance forms.

Non primary care - specialists - get paid to do procedures and tests. So what do they do? procedures and tests, again, at jacked up fees to compensate for what they don't get reimbursed by the insurance companies and the governement.

Anyone who doesn't have insurance is stuck paying the jacked up fees.

So, what's been happening, even with "good" insurance coverage? Doctors don't take ANY insurance, and then the financial difference between reimbursement and customary fees is absorbed by the patient.

Does anyone else see a problem here? How does public option stop this except mandate insurance for all? That just puts us purely in the above described model. Can doctors NOt accept the public insurance, and force the fees back on the patients?

And I go back to who is going to pay for all of this?

[jsteele]

Anonymous wrote:10:29, I am pretty sure it means unless the ration committee says you can have your procedure, you aren't allowed to have an appointment and the doctors aren't allowed to provide you one.

There is no "ration committee". If you are going to make this type of sensationalistic charge, the least that you should do is post a link providing some sort of evidence. This type of statement is purely meant to scare the crap out of less informed readers.

At the moment, the health reform plans are works in progress. The Senate Health Committee has not even released a draft yet. But, somehow, every right winger knows exactly what the plan will or won't do. The plans under discussion have a number of goals -- primary of which is cost control. All the issues you listed are being considered. One reason this issue is so complex is that there are so many interrelated factors. It has to be dealt with holistically or else it's simply like pulling a single card out of a house of cards.

[Anonymous]

Anonymous wrote:10:29, I am pretty sure it means unless the ration committee says you can have your procedure, you aren't allowed to have an appointment and the doctors aren't allowed to provide you one.

You're "pretty sure"?? Gee thanks.

Look, this is still America, despite your terror of socialized medicine. And even doctors and patients will be free to buy and sell services to one another that do NOT go through regulated insurance companies or the government's public plan. Nobody is talking about outlawing fee-for-services.

You should stop posting. Aven though you are anonymous you are making yourself and more importantly, your position and argument, look idiotic.

[Anonymous]

10:29, I am pretty sure it means unless the ration committee says you can have your procedure, you aren't allowed to have an appointment and the doctors aren't allowed to provide you one.

That's ridiculous - the whole point is to real in government and insurance spending since it's spiraling out of control - not to forbid people from spending their own money on things.

On a separate note - it is political suicide to say it so no one says the truth, but we DO need some degree of rationing. It's simply not possible to affordably cover every single thing that any patient/doctor wants to try no matter how slim the odds of success are or how low cost other alternatives might be. That's why costs are shooting off the charts and Medicaid/Medicare are going to bankrupt us if we don't do some drastic changes fast.