One thing was established by the President's speech last night -

[grantcart]

How good will the health care reform be?

For those of us with pre-existing conditions we now will have a chance to get in.

For those who are in and get sick they cannot be kicked out.

Those two elements are important changes from the current system.

How good is the rest of it - very hard to say until we see what is in the health exchange. Even the public option will be of little value if it is overpriced.

It will also depend on how big the subsidy is for people who can't afford to buy it.



But putting all of that aside the most important thing that happened in that speech is that the question "Should the government be controlling and regulating health care in the US?" was settled.


The case for the federal government having that control was established and even the Republicans stood up and clapped when the President talked about pre existing conditions.


Once the government takes over that role it will mean that eventually people will become more and more aware that they are over paying and getting underserved and eventually demand a single payer system.


Right now the question whether it is the proper role for the government to control that industry has been answered.

[LynneSin]

1. People don't get how important those 2 concepts are

To me those are the dealbreakers in healthcare. If we allow the health insurance agency to 'pick & choose' who they give health care, then there is no hope for us not in perfect health.

[mmonk]

8. Very important concepts.

The problem lies in the fact this will be a expensive system and inevitably, some will still not be able to afford it without a hit to the taxpayer due to a lack of cost controls except reductions in benefits, probably in the most efficient system within our gobbly gook system, medicare. By giving the health insurance industry and pharmaceutical industry a corporate welfare bill, it creates or manifests a backwards approach just like the bank bailouts.

[LynneSin]

10. There is money to pay for healthcare if we clean out wasteful spending

Hopefully we can get this fricking war overwith soon and THAT can easily pay for healthcare right there!

[abluelady]

16. I've Head Your View Often Lately

Was sitting around with some physicians who would like to see single payer, but would accept the public option. Without the public option in place they felt the insurance companies were still going to be in control and costs would still be very high. You could have been sitting in my living room.

[Uben]

2. With a PC, (pre-existing condition)............

... you will be able to get insurance, but how much is it gonna cost you? The wife and I pay $1550/mo for a catastrophic policy. Are you willing to pay at least that for coverage?

[Donnachaidh]

5. that's the KEY question, isn't it?

Ours too.

Of course, we won't even see the PO for FOUR years, so we need to pray our family members don't get sick or injured in the mean time...

[grantcart]

14. If I understand it correctly

it will serve like an open season - people with a PC will be enrolled at the same rate.


We don't know what those rates are.

[Donnachaidh]

19. that was never spelled out, and the insurance companies KNOW that

They've had DECADES to learn how to game systems. Telling them to play nice with NO rules in place is asking for trouble. But of course, as long as politicians said they *did something*, even if it potentially makes matters worse for the consumer - hell, they figure they've *won*.

[grantcart]

21. Its not spelled out and there is a lot that is not spelled out

What has been said is that it will run in the same way as the OPM health exchange for federal employees.


I am familiar with this and it operates with an open season where you can purchase or change any of the plans - without discrimination - and then you have to stay in that plan for one year before changing.


That was spelled out.


In any case we won't know how much better it will be until we see the details of the plan that have been approved to be in the health exchange.


If they are similar to what federal employees get I will be satisfied until we can get single payer.

[Donnachaidh]

22. and if they aren't?

After watching that speech, I believe we can throw any *hope* of a single payer plan out the window.

[grantcart]

7. we don't know that

but my understanding is that getting into a health care plan will be equivalent to an "open season" enrollment.


The cost of the premium will be the same for everyone in that category (age) for example and will not be effected by any PC.

[Donnachaidh]

20. *open season* is the right term, but not in the way you think

Those with p-c may be in for a rude awakening. Insurance will be forced to give you coverage, but they have NO ceiling caps in place, so you're basically SCREWED both ways - forced to buy with the mandate, and forced to pay out the nose to the companies.

[laughingliberal]

24. Not true

There are ceiling caps in place. And there are requirements that the companies must maintain a certain medical loss ratio or rebate the differences back to their policy holders. HR3200 does let them charge more for age but no premium may be more than 2 times the lowest cost premium for the same policy. That said, it does not limit the amount they can charge for their lowest cost premium but if they get too out of hand with it a lot of the young, healthy people they want will just choose to pay their fine and not buy insurance.

[Donnachaidh]

27. dupe much? n/t

[laughingliberal]

25. Not true

There are ceiling caps in place. And there are requirements that the companies must maintain a certain medical loss ratio or rebate the differences back to their policy holders. HR3200 does let them charge more for age but no premium may be more than 2 times the lowest cost premium for the same policy. That said, it does not limit the amount they can charge for their lowest cost premium but if they get too out of hand with it a lot of the young, healthy people they want will just choose to pay their fine and not buy insurance.

[Donnachaidh]

26. and if they REFUSED to give premiums to people in the FIRST place?

Got news for you -- it's open season on the insurance lepers we have in this country. Two times the lowest cost of a REFUSED policy is what?

The people in this country with pre-existing conditions and genetic disorders were pretty much thrown under the bus with this mess.

[Donnachaidh]

3. I'll get back to you when I find AFFORDABLE health insurance coverage for my hemophiliac son

The key is AFFORDABLE. He is an insurance leper - we've been laughed at by insurance company reps when we asked for quotes. His pre-existing condition is one of those that no one talks about in this mess. And thousands more have the same problem.

[Myrina]

9. Bingo!

n/t

[saltpoint]

4. A useful and insightful dialogue about where we go from here on this

issue should probably begin with this post.


:thumbsup: :hi:

[WeDidIt]

6. MEdicare was nowhere near as good on July 30, 1965 as it is today

But LBJ signing that bill was a start and lead us to the wonderful system we have today.

This is a start. We can go nowhere if we never start, and for the past century all that's been done is talking about starting.

[pinto]

15. Good point.

:thumbsup:

[goclark]

18. Excellent point nt

[eridani]

31. It began by being single payer for everyone over 65, though

Important difference.

[pinto]

11. Agree with you on those points. A federal role in health care is clear there. n/t

[Historic NY]

12. I'm hoping the exposure will drive the cost of Rx's drug down too.

[rbixby]

13. I have mixed feelings about the whole speech

I just hope that after this there can be a more open and honest dialogue with people on both sides of the aisle to hammer out a deal that works for everyone and ensures that nobody needs to die or go bankrupt because of health care costs. That's the real issue. Are we going to get exactly what we want (I'd prefer single payer, totally socialized medicine personally)? No, but I'm hoping that the end result of this is going to be adding a regulation and competition to the health insurance industry, and hopefully drive down costs. Of course its not exactly what I'd consider to be ideal, but I think that totally socializing the health care industry right now is unrealistic, the money is on the side of the industry, not on the side of the small guy who's being hurt by all of this, and unfortunately, money talks.
I think that in the end, we're going to get a system that works better than our current one, probably not an ideal system, but the idea is very similar to the way the health insurance industry works in Switzerland, and it works pretty well for them. I'm still sticking to my guns that a totally socialized single payer system is going to work best for all of us, but unfortunately its going to have to wait a bit, until a lot of the money and lobbying power is sucked out of the insurance and private health care industries.

[goclark]

17. I totally agree with you ~ last night was a giant step for America

Some people are looking for their idea of perfection and if all their TOYS are not on the table, they threaten to go home.

Where is home?

In their minds HOME is a magic kingdom where they will have Palin spearhead their efforts.

Some Democrats may even threaten to form their own party or give all their energy to finding a Man/Woman from La Mancha to run for President and get him/her to make their dream come true.

When all the moaning is over for a few ~ what I saw last night gave me hope for my country.

All those claps represented what America is feeling and to see the few that were sitting on their hands or saying "LIES" really put it all out there to show us they could care less about America.

Last night was a thing of beauty for me and I will be clapping for what ever the CLAPPERS believe will make our Health Care system work.

I was shocked, I mean shocked to see all those people on their feet and clapping their hands off last night.

The M$M sure is in the hands of the Insurance/Pharmas, what they have been reporting is not what the feeling was in that room last night!

It really showed how the "little grumpy people" were outnumbered.

:patriot:

[strategery blunder]

23. Massive Loophole: Denial of Claims

I applaud the President for talking about pre-existing conditions, and insurance companies not being allowed to drop you if you get sick. I give credit where credit is due.

However, NOTHING was said about insurance companies arbitrarily denying claims over individual treatments. We all know that the health insurance company death panels that decided whom to drop, will now just be shifted over to deciding which claims to deny. That's the way scum works.

The insurance company might not be able to cancel your policy, but they sure as hell can refuse payment on any and all claims you file. I have heard NO politician, Obama or anyone else, say otherwise.

It is one of the Great Big Elephants in the room that no politician has dared to address to date. Probably because they all receive campaign cash from the insurance industry and they've gotta leave them a loophole to preserve their profits while looking like they're actually doing something.

[grantcart]

28. Doesn't the cap on out of pocket expenses cover this?

[strategery blunder]

29. Not really.

Insurance Company Death Panel: "It's not medically necessary. Therefore we must deny payment."

So you go without. No out-of-pocket expense incurred.

I would LOVE for the President and/or Congress to explicitly stipulate otherwise, but when dealing which insurance, the most cynical prediction is probably the correct one. x(

[eridani]

30. If you have pre-existing conditions, you get in only if you pay through the nose

That could mean most of an average person's discretionary income.