ok: can someone tell me what good is left for the health care reform

[SK in CV]

[quote=bearishgurl]
flu, I have an HDHP individual policy (which I had to actually rigorously “qualify for”). My mo premium has gone up 3x since Obama signed the bill in March of 2010. I have only used the plan minimally since then so my ins co has made generous profits off me. It is clear to me that the reason for my 2x per year rate increases is due to my carrier having to accept a lot of people they didn’t want … for ANY price due to “Obamacare.” Even if many of these new “patients” are paying $1100 – $1500 mo for coverage for themselves only, I have no doubt that many of these newly-covered individuals are a “loss leader” for my carrier. Unfortunately, most of these “new insureds” are in my age group and a lot of the health problems they are suffering from now were self-inflicted due to past behavior.

My mo premium has risen 270% since 2006. Not only do they raise it on my birthday, they are allowed to raise it again six mos after my birthday.

Having insureds pick up the tab for the uninsured (who will not now have any incentive to cover themselves) will only raise the premiums of the insured more (who are trying to cover their a$$es and be responsible). That’s the way it’s always been. In my neck of the woods, these uninsureds are mostly illegal aliens availing themselves of emergency services at area hospitals.

If I wasn’t a current homeowner with actual “equity” (who fears a potential Medi-Cal, CMS or judgment lien for unexpected medical treatment/svcs), I too might be tempted to drop my coverage. It would certainly help me to be able to deploy this money elsewhere and pay all cash for my minimal dr visits. My “co-pays” are $40 – $50 visit, anyway, under my plan.

flu, just be grateful you have coverage and that there is now no lifetime cap on health coverage. I have put two relatives in the ground in my lifetime who HAD medical coverage that “maxed out” while they were still alive. On the one who had TWO policies which maxed out (a primary and secondary), it took us over four years to work out a deal with some of their providers to accept less than what was owed. Both were under the age of 65 at the time of their deaths.

Even if Obamacare ends up decimated due to piecemeal gutting by the courts, There are some good things about Obamacare and elimination of the annual and lifetime caps is one of them.[/quote]

The only new insureds that your company would have had to accept as a result of the ACA is children under the age of 27. I guarantee that hasn’t resulted in higher premiums for you, only higher profits for the insurance companies.

Your complaints seem mis-directed.

[SK in CV]

[quote=bearishgurl][quote=GH]….If and I am approved for insurance, make the legal assumption the insurer has run ALL needed background investigations and concluded I am qualified for their plan, rather than having them deny my claim later after finding out I tried a cigarette in High School…[/quote]

GH, this is the way individuals bought medical insurance for themselves before “Obamacare.” The pricing of the premiums was ALSO based largely upon the individual’s prior health-care usage, reasons for that prior usage and their daily habits, past habits, current weight and a barrage of medical tests before deciding to underwrite.

Now, under “Obamacare,” even fit and well individuals are charged “extra” in their monthly premium to “even out” premiums for high-usage policyholders in their age groups who formerly were “uninsurable” due to pre-existing conditions. A large percentage of those “pre-existing conditions” were directly caused by the behavior of the (formerly uninsurable) individual.

There is a point where a monthly health premium becomes exorbitant, even for a high-usage person. My understanding is that beginning in 2014, these high monthly premiums (> $1,000 month for one individual) will be regulated under Obamacare …. that is, the insurance companies will be regulated as to how much they can charge for premiums for different categories of high-usage individuals. This will only serve to raise EVERY policyholder’s monthly premiums in a particular age group even MORE.

The insurance companies aren’t going to lose money so the money to pay for the “high users” medical bills has to come from somewhere.[/quote]

Bearishgirl, you’re smarter than this. You know better than to believe political rhetoric, without doing your own research. I’ll leave my comment there.

Except with regards to the apparent discrepancy between your lauding both GINA and the elimination of annual/lifetime caps, and then criticizing the ACA for elimination of restrictions for pre-existing conditions. You both want it, and don’t want it. Can’t have it both ways. (There is, by the way, nothing within the ACA that requires insurance companies to charge the same premiums for those with pre-existing conditions. So those fat, out of shape, smokers you so disdain, can be charged higher premiums.)

[SK in CV]

[quote=bearishgurl][quote=GH]….If and I am approved for insurance, make the legal assumption the insurer has run ALL needed background investigations and concluded I am qualified for their plan, rather than having them deny my claim later after finding out I tried a cigarette in High School…[/quote]

GH, this is the way individuals bought medical insurance for themselves before “Obamacare.” The pricing of the premiums was ALSO based largely upon the individual’s prior health-care usage, reasons for that prior usage and their daily habits, past habits, current weight and a barrage of medical tests before deciding to underwrite.

Now, under “Obamacare,” even fit and well individuals are charged “extra” in their monthly premium to “even out” premiums for high-usage policyholders in their age groups who formerly were “uninsurable” due to pre-existing conditions. A large percentage of those “pre-existing conditions” were directly caused by the behavior of the (formerly uninsurable) individual.

There is a point where a monthly health premium becomes exorbitant, even for a high-usage person. My understanding is that beginning in 2014, these high monthly premiums (> $1,000 month for one individual) will be regulated under Obamacare …. that is, the insurance companies will be regulated as to how much they can charge for premiums for different categories of high-usage individuals. This will only serve to raise EVERY policyholder’s monthly premiums in a particular age group even MORE.

The insurance companies aren’t going to lose money so the money to pay for the “high users” medical bills has to come from somewhere.[/quote]

Bearishgirl, you’re smarter than this. You know better than to believe political rhetoric, without doing your own research. I’ll leave my comment there.

Except with regards to the apparent discrepancy between your lauding both GINA and the elimination of annual/lifetime caps, and then criticizing the ACA for elimination of restrictions for pre-existing conditions. You both want it, and don’t want it. Can’t have it both ways. (There is, by the way, nothing within the ACA that requires insurance companies to charge the same premiums for those with pre-existing conditions. So those fat, out of shape, smokers you so disdain, can be charged higher premiums.)

[SK in CV]

[quote=bearishgurl][quote=GH]….If and I am approved for insurance, make the legal assumption the insurer has run ALL needed background investigations and concluded I am qualified for their plan, rather than having them deny my claim later after finding out I tried a cigarette in High School…[/quote]

GH, this is the way individuals bought medical insurance for themselves before “Obamacare.” The pricing of the premiums was ALSO based largely upon the individual’s prior health-care usage, reasons for that prior usage and their daily habits, past habits, current weight and a barrage of medical tests before deciding to underwrite.

Now, under “Obamacare,” even fit and well individuals are charged “extra” in their monthly premium to “even out” premiums for high-usage policyholders in their age groups who formerly were “uninsurable” due to pre-existing conditions. A large percentage of those “pre-existing conditions” were directly caused by the behavior of the (formerly uninsurable) individual.

There is a point where a monthly health premium becomes exorbitant, even for a high-usage person. My understanding is that beginning in 2014, these high monthly premiums (> $1,000 month for one individual) will be regulated under Obamacare …. that is, the insurance companies will be regulated as to how much they can charge for premiums for different categories of high-usage individuals. This will only serve to raise EVERY policyholder’s monthly premiums in a particular age group even MORE.

The insurance companies aren’t going to lose money so the money to pay for the “high users” medical bills has to come from somewhere.[/quote]

Bearishgirl, you’re smarter than this. You know better than to believe political rhetoric, without doing your own research. I’ll leave my comment there.

Except with regards to the apparent discrepancy between your lauding both GINA and the elimination of annual/lifetime caps, and then criticizing the ACA for elimination of restrictions for pre-existing conditions. You both want it, and don’t want it. Can’t have it both ways. (There is, by the way, nothing within the ACA that requires insurance companies to charge the same premiums for those with pre-existing conditions. So those fat, out of shape, smokers you so disdain, can be charged higher premiums.)

[SK in CV]

[quote=bearishgurl][quote=GH]….If and I am approved for insurance, make the legal assumption the insurer has run ALL needed background investigations and concluded I am qualified for their plan, rather than having them deny my claim later after finding out I tried a cigarette in High School…[/quote]

GH, this is the way individuals bought medical insurance for themselves before “Obamacare.” The pricing of the premiums was ALSO based largely upon the individual’s prior health-care usage, reasons for that prior usage and their daily habits, past habits, current weight and a barrage of medical tests before deciding to underwrite.

Now, under “Obamacare,” even fit and well individuals are charged “extra” in their monthly premium to “even out” premiums for high-usage policyholders in their age groups who formerly were “uninsurable” due to pre-existing conditions. A large percentage of those “pre-existing conditions” were directly caused by the behavior of the (formerly uninsurable) individual.

There is a point where a monthly health premium becomes exorbitant, even for a high-usage person. My understanding is that beginning in 2014, these high monthly premiums (> $1,000 month for one individual) will be regulated under Obamacare …. that is, the insurance companies will be regulated as to how much they can charge for premiums for different categories of high-usage individuals. This will only serve to raise EVERY policyholder’s monthly premiums in a particular age group even MORE.

The insurance companies aren’t going to lose money so the money to pay for the “high users” medical bills has to come from somewhere.[/quote]

Bearishgirl, you’re smarter than this. You know better than to believe political rhetoric, without doing your own research. I’ll leave my comment there.

Except with regards to the apparent discrepancy between your lauding both GINA and the elimination of annual/lifetime caps, and then criticizing the ACA for elimination of restrictions for pre-existing conditions. You both want it, and don’t want it. Can’t have it both ways. (There is, by the way, nothing within the ACA that requires insurance companies to charge the same premiums for those with pre-existing conditions. So those fat, out of shape, smokers you so disdain, can be charged higher premiums.)

[SK in CV]

[quote=bearishgurl][quote=GH]….If and I am approved for insurance, make the legal assumption the insurer has run ALL needed background investigations and concluded I am qualified for their plan, rather than having them deny my claim later after finding out I tried a cigarette in High School…[/quote]

GH, this is the way individuals bought medical insurance for themselves before “Obamacare.” The pricing of the premiums was ALSO based largely upon the individual’s prior health-care usage, reasons for that prior usage and their daily habits, past habits, current weight and a barrage of medical tests before deciding to underwrite.

Now, under “Obamacare,” even fit and well individuals are charged “extra” in their monthly premium to “even out” premiums for high-usage policyholders in their age groups who formerly were “uninsurable” due to pre-existing conditions. A large percentage of those “pre-existing conditions” were directly caused by the behavior of the (formerly uninsurable) individual.

There is a point where a monthly health premium becomes exorbitant, even for a high-usage person. My understanding is that beginning in 2014, these high monthly premiums (> $1,000 month for one individual) will be regulated under Obamacare …. that is, the insurance companies will be regulated as to how much they can charge for premiums for different categories of high-usage individuals. This will only serve to raise EVERY policyholder’s monthly premiums in a particular age group even MORE.

The insurance companies aren’t going to lose money so the money to pay for the “high users” medical bills has to come from somewhere.[/quote]

Bearishgirl, you’re smarter than this. You know better than to believe political rhetoric, without doing your own research. I’ll leave my comment there.

Except with regards to the apparent discrepancy between your lauding both GINA and the elimination of annual/lifetime caps, and then criticizing the ACA for elimination of restrictions for pre-existing conditions. You both want it, and don’t want it. Can’t have it both ways. (There is, by the way, nothing within the ACA that requires insurance companies to charge the same premiums for those with pre-existing conditions. So those fat, out of shape, smokers you so disdain, can be charged higher premiums.)

[ifyousayso]

It will make it illegal for insurance companies to claim ER care is out of network. This is very important and I was surprised to find it’s not illegal already.

[ifyousayso]

It will make it illegal for insurance companies to claim ER care is out of network. This is very important and I was surprised to find it’s not illegal already.

[ifyousayso]

It will make it illegal for insurance companies to claim ER care is out of network. This is very important and I was surprised to find it’s not illegal already.

[ifyousayso]

It will make it illegal for insurance companies to claim ER care is out of network. This is very important and I was surprised to find it’s not illegal already.

[ifyousayso]

It will make it illegal for insurance companies to claim ER care is out of network. This is very important and I was surprised to find it’s not illegal already.

[Anonymous]

[quote=SK in CV]There is no evidence that more competition will decrease costs.[/quote]

True. The economy here in California is plenty big enough to allow competition. Allowing companies from other states to peddle their products here isn’t going to change the market dynamics enough to influence prices.

The “interstate competition” argument is just a Republican red herring. An absurdly ironic one considering that we hear phrases like “let the states decide” on many other issues. The Republicans wanted the heatchcare bill to fail because they wanted Obama to fail – it is that simple. So they contrived a few half-hearted arguments to make it appear that they were actually involved in the debate. Some folks are so obedient to their master’s talking points that they are still repeating them years later.

[quote]Medical insurers gouge consumers. It’s what they do.[/quote]

It’s what all companies will try to do. But medical insurers can actually get away with it because their product is:

1) Mandatory (we all have unpredictable health needs)
2) So incredibly complicated that nobody really understands what they are buying.

Heathcare is the biggest real-world example of a market skewed by information asymmetry. There’s no way an individual consumer can even begin understand what they need, what it should cost, and what their alternatives are. How many people actually read the contract between them and their insurance company, let alone understand it?

If there is any industry where government must be involved to prevent market failures, it is health care (which includes health insurance.) Funny how some economics professors fail to acknowledge this basic Econ 101 concept.

[Anonymous]

[quote=SK in CV]There is no evidence that more competition will decrease costs.[/quote]

True. The economy here in California is plenty big enough to allow competition. Allowing companies from other states to peddle their products here isn’t going to change the market dynamics enough to influence prices.

The “interstate competition” argument is just a Republican red herring. An absurdly ironic one considering that we hear phrases like “let the states decide” on many other issues. The Republicans wanted the heatchcare bill to fail because they wanted Obama to fail – it is that simple. So they contrived a few half-hearted arguments to make it appear that they were actually involved in the debate. Some folks are so obedient to their master’s talking points that they are still repeating them years later.

[quote]Medical insurers gouge consumers. It’s what they do.[/quote]

It’s what all companies will try to do. But medical insurers can actually get away with it because their product is:

1) Mandatory (we all have unpredictable health needs)
2) So incredibly complicated that nobody really understands what they are buying.

Heathcare is the biggest real-world example of a market skewed by information asymmetry. There’s no way an individual consumer can even begin understand what they need, what it should cost, and what their alternatives are. How many people actually read the contract between them and their insurance company, let alone understand it?

If there is any industry where government must be involved to prevent market failures, it is health care (which includes health insurance.) Funny how some economics professors fail to acknowledge this basic Econ 101 concept.

[Anonymous]

[quote=SK in CV]There is no evidence that more competition will decrease costs.[/quote]

True. The economy here in California is plenty big enough to allow competition. Allowing companies from other states to peddle their products here isn’t going to change the market dynamics enough to influence prices.

The “interstate competition” argument is just a Republican red herring. An absurdly ironic one considering that we hear phrases like “let the states decide” on many other issues. The Republicans wanted the heatchcare bill to fail because they wanted Obama to fail – it is that simple. So they contrived a few half-hearted arguments to make it appear that they were actually involved in the debate. Some folks are so obedient to their master’s talking points that they are still repeating them years later.

[quote]Medical insurers gouge consumers. It’s what they do.[/quote]

It’s what all companies will try to do. But medical insurers can actually get away with it because their product is:

1) Mandatory (we all have unpredictable health needs)
2) So incredibly complicated that nobody really understands what they are buying.

Heathcare is the biggest real-world example of a market skewed by information asymmetry. There’s no way an individual consumer can even begin understand what they need, what it should cost, and what their alternatives are. How many people actually read the contract between them and their insurance company, let alone understand it?

If there is any industry where government must be involved to prevent market failures, it is health care (which includes health insurance.) Funny how some economics professors fail to acknowledge this basic Econ 101 concept.

[Anonymous]

[quote=SK in CV]There is no evidence that more competition will decrease costs.[/quote]

True. The economy here in California is plenty big enough to allow competition. Allowing companies from other states to peddle their products here isn’t going to change the market dynamics enough to influence prices.

The “interstate competition” argument is just a Republican red herring. An absurdly ironic one considering that we hear phrases like “let the states decide” on many other issues. The Republicans wanted the heatchcare bill to fail because they wanted Obama to fail – it is that simple. So they contrived a few half-hearted arguments to make it appear that they were actually involved in the debate. Some folks are so obedient to their master’s talking points that they are still repeating them years later.

[quote]Medical insurers gouge consumers. It’s what they do.[/quote]

It’s what all companies will try to do. But medical insurers can actually get away with it because their product is:

1) Mandatory (we all have unpredictable health needs)
2) So incredibly complicated that nobody really understands what they are buying.

Heathcare is the biggest real-world example of a market skewed by information asymmetry. There’s no way an individual consumer can even begin understand what they need, what it should cost, and what their alternatives are. How many people actually read the contract between them and their insurance company, let alone understand it?

If there is any industry where government must be involved to prevent market failures, it is health care (which includes health insurance.) Funny how some economics professors fail to acknowledge this basic Econ 101 concept.

[Author]

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