[SK in CV]

[quote=bearishgurl]
The second refers to the statement that was made that the (HCRA of 2010) “reduces Medicare payments for hospice programs that studies have shown to be very cost efficient.”

[/quote]

There are no absolute cuts in the act that specifically target hospice. There are (almost) across the board cuts in whats called the “market basket increase”. This isn’t technically a cut, but rather a reduction in possible increases in reimbursements. Additionally, there is a provision for some possible (maybe probable?) additional cuts related to revenue neutrality subject to negotiations of per diem rates with major hospice providers. But nothing that I’ve found that specifies any reduction in covered services. There are quite a few quality of care surveys specified in the plan. Some of these may ultimately set and/or reduce some limits for hospice coverage.

[SK in CV]

[quote=bearishgurl]
The second refers to the statement that was made that the (HCRA of 2010) “reduces Medicare payments for hospice programs that studies have shown to be very cost efficient.”

[/quote]

There are no absolute cuts in the act that specifically target hospice. There are (almost) across the board cuts in whats called the “market basket increase”. This isn’t technically a cut, but rather a reduction in possible increases in reimbursements. Additionally, there is a provision for some possible (maybe probable?) additional cuts related to revenue neutrality subject to negotiations of per diem rates with major hospice providers. But nothing that I’ve found that specifies any reduction in covered services. There are quite a few quality of care surveys specified in the plan. Some of these may ultimately set and/or reduce some limits for hospice coverage.

[SK in CV]

[quote=bearishgurl]
The second refers to the statement that was made that the (HCRA of 2010) “reduces Medicare payments for hospice programs that studies have shown to be very cost efficient.”

[/quote]

There are no absolute cuts in the act that specifically target hospice. There are (almost) across the board cuts in whats called the “market basket increase”. This isn’t technically a cut, but rather a reduction in possible increases in reimbursements. Additionally, there is a provision for some possible (maybe probable?) additional cuts related to revenue neutrality subject to negotiations of per diem rates with major hospice providers. But nothing that I’ve found that specifies any reduction in covered services. There are quite a few quality of care surveys specified in the plan. Some of these may ultimately set and/or reduce some limits for hospice coverage.

[SK in CV]

[quote=bearishgurl]
The second refers to the statement that was made that the (HCRA of 2010) “reduces Medicare payments for hospice programs that studies have shown to be very cost efficient.”

[/quote]

There are no absolute cuts in the act that specifically target hospice. There are (almost) across the board cuts in whats called the “market basket increase”. This isn’t technically a cut, but rather a reduction in possible increases in reimbursements. Additionally, there is a provision for some possible (maybe probable?) additional cuts related to revenue neutrality subject to negotiations of per diem rates with major hospice providers. But nothing that I’ve found that specifies any reduction in covered services. There are quite a few quality of care surveys specified in the plan. Some of these may ultimately set and/or reduce some limits for hospice coverage.

[SK in CV]

Great comment eavesdropper.

I remember going to a medical financing conference, probably in the late 80’s. There was some sort of legislation pending, have no recollection of what it was. But there was a session, attended mostly by physicians, assailing unions for destroying healthcare. While I certainly didn’t agree with that conclusion, the point was that growth of 1st dollar coverage and the demise of annual deductibles and 20% co-pays greatly reduced consumers motivation to carefully consider their use of medical services. $10 they could always afford. 20% not so much.

(Ironically, it was the physicians who were the greatest beneficiary of that particular shift. But they got it all and more taken away from them with they began accepting risk with capitated payments. But that’s a whole different story. Confirming your conclusion that the problem is extraordinarily complex. Indeed it is. And irreparably broken.)

[SK in CV]

Great comment eavesdropper.

I remember going to a medical financing conference, probably in the late 80’s. There was some sort of legislation pending, have no recollection of what it was. But there was a session, attended mostly by physicians, assailing unions for destroying healthcare. While I certainly didn’t agree with that conclusion, the point was that growth of 1st dollar coverage and the demise of annual deductibles and 20% co-pays greatly reduced consumers motivation to carefully consider their use of medical services. $10 they could always afford. 20% not so much.

(Ironically, it was the physicians who were the greatest beneficiary of that particular shift. But they got it all and more taken away from them with they began accepting risk with capitated payments. But that’s a whole different story. Confirming your conclusion that the problem is extraordinarily complex. Indeed it is. And irreparably broken.)

[SK in CV]

Great comment eavesdropper.

I remember going to a medical financing conference, probably in the late 80’s. There was some sort of legislation pending, have no recollection of what it was. But there was a session, attended mostly by physicians, assailing unions for destroying healthcare. While I certainly didn’t agree with that conclusion, the point was that growth of 1st dollar coverage and the demise of annual deductibles and 20% co-pays greatly reduced consumers motivation to carefully consider their use of medical services. $10 they could always afford. 20% not so much.

(Ironically, it was the physicians who were the greatest beneficiary of that particular shift. But they got it all and more taken away from them with they began accepting risk with capitated payments. But that’s a whole different story. Confirming your conclusion that the problem is extraordinarily complex. Indeed it is. And irreparably broken.)

[SK in CV]

Great comment eavesdropper.

I remember going to a medical financing conference, probably in the late 80’s. There was some sort of legislation pending, have no recollection of what it was. But there was a session, attended mostly by physicians, assailing unions for destroying healthcare. While I certainly didn’t agree with that conclusion, the point was that growth of 1st dollar coverage and the demise of annual deductibles and 20% co-pays greatly reduced consumers motivation to carefully consider their use of medical services. $10 they could always afford. 20% not so much.

(Ironically, it was the physicians who were the greatest beneficiary of that particular shift. But they got it all and more taken away from them with they began accepting risk with capitated payments. But that’s a whole different story. Confirming your conclusion that the problem is extraordinarily complex. Indeed it is. And irreparably broken.)

[SK in CV]

Great comment eavesdropper.

I remember going to a medical financing conference, probably in the late 80’s. There was some sort of legislation pending, have no recollection of what it was. But there was a session, attended mostly by physicians, assailing unions for destroying healthcare. While I certainly didn’t agree with that conclusion, the point was that growth of 1st dollar coverage and the demise of annual deductibles and 20% co-pays greatly reduced consumers motivation to carefully consider their use of medical services. $10 they could always afford. 20% not so much.

(Ironically, it was the physicians who were the greatest beneficiary of that particular shift. But they got it all and more taken away from them with they began accepting risk with capitated payments. But that’s a whole different story. Confirming your conclusion that the problem is extraordinarily complex. Indeed it is. And irreparably broken.)

[SK in CV]

[quote=flu]Also, I wasn’t thinking of the the case in which someone is self-insured and is simply adding the grownup kid to his/her policy…. I believe the original article indicated that the young lady was being added to her parent’s employer plan (not her parent’s self-paid insurance). What the article didn’t mention is who pays for dependent care in her parent’s plan and how much.

Eh, never mind….[/quote]

The first part of your comment makes perfect sense to me. But I’ll tell you, the current trend in benefits is to pay for less, with fewer and fewer employers paying for any part of dependent coverage.

I guess my confusion is where you put in the part about rationing of health care. I don’t see how this particular situation fits.

As a side note, there is a loophole (or as the insurance companies see it, a feature, not a flaw) on the effective date of this portion of the law. For group policies, the part that requires allowing coverage of children through age 26 applies on the plan anniversary date first following September 23. I know that Aetna is strictly enforcing that on their small group plans. I tried to get my 24 year old son onto my policy (the marginal cost would have been zero, since I already was paying for family coverage) at the July 1 open enrollment date and was told that they won’t allow it until NEXT July 1. I didn’t watch the video, but it’s possible that this woman might be out of luck for the moment if she hasn’t already confirmed eligibility.

Another feature of this provision, which I don’t think has been mentioned yet, is that children are only eligible for tagging along on their parents policies if they are not eligible for group coverage through their own employers. So employed children under age 27 who are eligible for company plans can’t opt to get added on to their parents policy.

[SK in CV]

[quote=flu]Also, I wasn’t thinking of the the case in which someone is self-insured and is simply adding the grownup kid to his/her policy…. I believe the original article indicated that the young lady was being added to her parent’s employer plan (not her parent’s self-paid insurance). What the article didn’t mention is who pays for dependent care in her parent’s plan and how much.

Eh, never mind….[/quote]

The first part of your comment makes perfect sense to me. But I’ll tell you, the current trend in benefits is to pay for less, with fewer and fewer employers paying for any part of dependent coverage.

I guess my confusion is where you put in the part about rationing of health care. I don’t see how this particular situation fits.

As a side note, there is a loophole (or as the insurance companies see it, a feature, not a flaw) on the effective date of this portion of the law. For group policies, the part that requires allowing coverage of children through age 26 applies on the plan anniversary date first following September 23. I know that Aetna is strictly enforcing that on their small group plans. I tried to get my 24 year old son onto my policy (the marginal cost would have been zero, since I already was paying for family coverage) at the July 1 open enrollment date and was told that they won’t allow it until NEXT July 1. I didn’t watch the video, but it’s possible that this woman might be out of luck for the moment if she hasn’t already confirmed eligibility.

Another feature of this provision, which I don’t think has been mentioned yet, is that children are only eligible for tagging along on their parents policies if they are not eligible for group coverage through their own employers. So employed children under age 27 who are eligible for company plans can’t opt to get added on to their parents policy.

[SK in CV]

[quote=flu]Also, I wasn’t thinking of the the case in which someone is self-insured and is simply adding the grownup kid to his/her policy…. I believe the original article indicated that the young lady was being added to her parent’s employer plan (not her parent’s self-paid insurance). What the article didn’t mention is who pays for dependent care in her parent’s plan and how much.

Eh, never mind….[/quote]

The first part of your comment makes perfect sense to me. But I’ll tell you, the current trend in benefits is to pay for less, with fewer and fewer employers paying for any part of dependent coverage.

I guess my confusion is where you put in the part about rationing of health care. I don’t see how this particular situation fits.

As a side note, there is a loophole (or as the insurance companies see it, a feature, not a flaw) on the effective date of this portion of the law. For group policies, the part that requires allowing coverage of children through age 26 applies on the plan anniversary date first following September 23. I know that Aetna is strictly enforcing that on their small group plans. I tried to get my 24 year old son onto my policy (the marginal cost would have been zero, since I already was paying for family coverage) at the July 1 open enrollment date and was told that they won’t allow it until NEXT July 1. I didn’t watch the video, but it’s possible that this woman might be out of luck for the moment if she hasn’t already confirmed eligibility.

Another feature of this provision, which I don’t think has been mentioned yet, is that children are only eligible for tagging along on their parents policies if they are not eligible for group coverage through their own employers. So employed children under age 27 who are eligible for company plans can’t opt to get added on to their parents policy.

[SK in CV]

[quote=flu]Also, I wasn’t thinking of the the case in which someone is self-insured and is simply adding the grownup kid to his/her policy…. I believe the original article indicated that the young lady was being added to her parent’s employer plan (not her parent’s self-paid insurance). What the article didn’t mention is who pays for dependent care in her parent’s plan and how much.

Eh, never mind….[/quote]

The first part of your comment makes perfect sense to me. But I’ll tell you, the current trend in benefits is to pay for less, with fewer and fewer employers paying for any part of dependent coverage.

I guess my confusion is where you put in the part about rationing of health care. I don’t see how this particular situation fits.

As a side note, there is a loophole (or as the insurance companies see it, a feature, not a flaw) on the effective date of this portion of the law. For group policies, the part that requires allowing coverage of children through age 26 applies on the plan anniversary date first following September 23. I know that Aetna is strictly enforcing that on their small group plans. I tried to get my 24 year old son onto my policy (the marginal cost would have been zero, since I already was paying for family coverage) at the July 1 open enrollment date and was told that they won’t allow it until NEXT July 1. I didn’t watch the video, but it’s possible that this woman might be out of luck for the moment if she hasn’t already confirmed eligibility.

Another feature of this provision, which I don’t think has been mentioned yet, is that children are only eligible for tagging along on their parents policies if they are not eligible for group coverage through their own employers. So employed children under age 27 who are eligible for company plans can’t opt to get added on to their parents policy.

[SK in CV]

[quote=flu]Also, I wasn’t thinking of the the case in which someone is self-insured and is simply adding the grownup kid to his/her policy…. I believe the original article indicated that the young lady was being added to her parent’s employer plan (not her parent’s self-paid insurance). What the article didn’t mention is who pays for dependent care in her parent’s plan and how much.

Eh, never mind….[/quote]

The first part of your comment makes perfect sense to me. But I’ll tell you, the current trend in benefits is to pay for less, with fewer and fewer employers paying for any part of dependent coverage.

I guess my confusion is where you put in the part about rationing of health care. I don’t see how this particular situation fits.

As a side note, there is a loophole (or as the insurance companies see it, a feature, not a flaw) on the effective date of this portion of the law. For group policies, the part that requires allowing coverage of children through age 26 applies on the plan anniversary date first following September 23. I know that Aetna is strictly enforcing that on their small group plans. I tried to get my 24 year old son onto my policy (the marginal cost would have been zero, since I already was paying for family coverage) at the July 1 open enrollment date and was told that they won’t allow it until NEXT July 1. I didn’t watch the video, but it’s possible that this woman might be out of luck for the moment if she hasn’t already confirmed eligibility.

Another feature of this provision, which I don’t think has been mentioned yet, is that children are only eligible for tagging along on their parents policies if they are not eligible for group coverage through their own employers. So employed children under age 27 who are eligible for company plans can’t opt to get added on to their parents policy.

[SK in CV]

[quote=flu]
I look at it another way… Health care needs to be (or is going to need to be rationed)…Folks like this I think are taking away resources from other folks who really need it.[/quote]

I’m confused by your logic here. How does insuring someone take resources away from other folks who really need it? Indeed, the claim begs the question. You’re assuming that this person, by having insurance (paid in full, presumably by her parents) will consume health care services that are less necessary than health care services someone else could consume, who is, for some reason, more deserving of those services. The assumption makes no sense.

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