ObamaCare - exchanges ,report your states options!

[Neoteny]

ffs

[PLAYER57832]

Here's a link to the bill - http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

The relevant language is under Section 102 (I highlighted the language I thought was particularly relevant), which states:

"(a) Grandfathered Health Insurance Coverage Defined - Subject to the succeeding provisions of this section, for purposes of esablishing acceptable coverage under this division, the term "grandfathered health insurance coverage" means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) Limitation of New Enrollment -
(A) In General - Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1"

There's some other stuff under limitation of new enrollment, but I think it's pretty clear that if you lose your Y1 private health insurance coverage post-Y1 you can't enroll in a new private health insurance plan. Perhaps I'm missing something?

I will look at your link more closely.

However, as I am sure you are aware, this is a pretty standard "grandfather clause". Its no different than building codes. If a new code is passed, then you usually don't have to knock down or cease using old buildings, but if you make significant improvements or build a new structure, you have to comply with current law.

Where does it say that no new policies at all can be offered?

Specifically, it says may not offer such policies -- that is, they cannot offer the old type of policy.

[thegreekdog]

I will look at your link more closely.

However, as I am sure you are aware, this is a pretty standard "grandfather clause". Its no different than building codes. If a new code is passed, then you usually don't have to knock down or cease using old buildings, but if you make significant improvements or build a new structure, you have to comply with current law.

Where does it say that no new policies at all can be offered?

Specifically, it says may not offer such policies -- that is, they cannot offer the old type of policy.

I agree, the grandfather clause is no different than one in a building code. However, three things:

(1) The grandfather clause doesn't modify the PERSON, it modifies the POLICY. Under a grandfathered PERSON plan, if thegreekdog had a private insurance plan, and lost it, he could still have a private insurance plan. Under a grandfathered POLICY plan, if thegreekdog had a private insurance plan, and lost it, he could not get a new private insurance plan.

(2) The word "such" does not refer to grandfathered policies, it refers to "new enrollment." It wouldn't matter in any event.

(3) The current administration and knowledgeable supporters of this bill are definitely making sure they aren't lying by saying "You can keep your current plan" and nothing more. You will not, however, hear from the president that the current bill permits choice among private health insurance and government health insurance, because, well, it doesn't.

[Neoteny]

It's the same one we talked about earlier. The Exchange is discussed on page 72 (Sec 201). What everyone's fixation is on the grandfather clause is beyond me. Insurance that you currently have can be kept if it meets the requirements placed upon it by submission to the National Insurance Exchange.

That is what you are missing. Private policies will still be offered through the exchange, both "old" and "new"...

I actually talked about this earlier in the thread ffs. Now I have an actual page number for you.

The question is about acceptable coverage. If your current insurance policy doesn't meet the standards set, then you can't keep it. If it does, you can.

[Neoteny]

Maybe this guy can explain it better than me.

http://allbleedingstops.blogspot.com/20 ... -lies.html

[Neoteny]

Let me throw this out there too, for the trolls like Phatscotty.



And neither of these are what is being proposed in this bill, though some individual politicians could want either of these.

[PLAYER57832]

I will look at your link more closely.

However, as I am sure you are aware, this is a pretty standard "grandfather clause". Its no different than building codes. If a new code is passed, then you usually don't have to knock down or cease using old buildings, but if you make significant improvements or build a new structure, you have to comply with current law.

Where does it say that no new policies at all can be offered?

Specifically, it says may not offer such policies -- that is, they cannot offer the old type of policy.

I agree, the grandfather clause is no different than one in a building code. However, three things:

(1) The grandfather clause doesn't modify the PERSON, it modifies the POLICY. Under a grandfathered PERSON plan, if thegreekdog had a private insurance plan, and lost it, he could still have a private insurance plan. Under a grandfathered POLICY plan, if thegreekdog had a private insurance plan, and lost it, he could not get a new private insurance plan.

(2) The word "such" does not refer to grandfathered policies, it refers to "new enrollment." It wouldn't matter in any event.

(3) The current administration and knowledgeable supporters of this bill are definitely making sure they aren't lying by saying "You can keep your current plan" and nothing more. You will not, however, hear from the president that the current bill permits choice among private health insurance and government health insurance, because, well, it doesn't.

Whether it is the person or the policy is irrelevant. The point is that insurers will be able to offer new policies, but the way they do it and the rules under which they operate will differ.

The relevant sections are not the "grandfather" sections, it is beyond that when it talks about rules and restrictions, etc. My computer is balking at downloading that thing, but I will try to read it again.

[Night Strike]

The question is about acceptable coverage. If your current insurance policy doesn't meet the standards set, then you can't keep it. If it does, you can.

Which is 100% contrary to the democratic talking points. They are saying that if you like your policy you'll get to keep it. But what I'm gathering that the bill actually says is that if your policy meets our minimum guidelines, you'll get to keep it. Those are very different qualifiers. And I would listen to those who read from the bill, not from the talking points.


On a slightly different subject, the president referenced the postal/shipping arena as a place where the private sector competes with the government. That was a horrible example since everyone knows the postal service is broke. Great analogy.


On a third note, it is inherently an uneven playing field when the government enters against the private sector because the government can take money from the private business through corporate taxes. When private companies take money directly from their competitors, it's calling theft. But when the government takes money from their private sector competition, it's called a tax. If the government wishes to offer a public insurance plan, then it's only fair to eliminate all corporate taxes on the insurance providers. Then you will have a more even playing field.

[Neoteny]

I was wondering if I was going to have to make cricket noises.

The question is about acceptable coverage. If your current insurance policy doesn't meet the standards set, then you can't keep it. If it does, you can.

Which is 100% contrary to the democratic talking points. They are saying that if you like your policy you'll get to keep it. But what I'm gathering that the bill actually says is that if your policy meets our minimum guidelines, you'll get to keep it. Those are very different qualifiers. And I would listen to those who read from the bill, not from the talking points.

This is where I imagine the most successful criticisms of the current bill will stem from. People who think competing against the government is bad in the insurance forum have some beefs that are infinitely more valid than railing against the grandfather clause or socializing (to whatever degree) health care as far as this bill goes. I can't, for the life of me, figure out why the latter is occurring more than the former.

Having said that, I don't know the specifics of how the standards are going to be set, because my knowledge of current health insurance standards is rather minimal. Logically, if they are slight changes, then you probably will be able to keep your current policy. If the changes are larger, the chances you'll be able to keep your current policy will, I imagine, go down. But those are just my thoughts, and I can't really back them up with anything.

For the record, I like the USPS.

[PLAYER57832]

The question is about acceptable coverage. If your current insurance policy doesn't meet the standards set, then you can't keep it. If it does, you can.

Which is 100% contrary to the democratic talking points. They are saying that if you like your policy you'll get to keep it. But what I'm gathering that the bill actually says is that if your policy meets our minimum guidelines, you'll get to keep it. Those are very different qualifiers. And I would listen to those who read from the bill, not from the talking points.

No. If you like your current policy, you get to keep it. If you lose that policy (lose your job, etc.), then you need to choose one of the new policies.

Minimum standards are absolutely necessary, because else insurance companies can offer policies with $10,000 deductibles and $80 co-pays and claim they are "offering coverage". Also, a key point here is that once you are in the open market, you no longer will be stuck with paying only the highest premiums offered. Everyone will be offered the same basic policies. The bottom level of coverage will be set by the government and then people may elect better coverage, at higher cost, if they wish.

[thegreekdog]

Yeah, the "Exchange" is a rather different issue, one that I have not looked into closely, mostly because I take the cynical view that the government is going to try its hardest to eventually be a single payor.

To be completely honest, I just want a measured, well-thought out healthcare bill, not one that was put together seemingly on a whim without the input of anyone from the other side of the aisle. I know this is a lot to ask (seriously), but healthcare is an important enough issue that it bears some more discussion. I understand the political ramifications of not passing the thing as soon as possible, but I'd still like to see some kind of compromise on this.

[Neoteny]

Firstly, who gives a f*ck if it's bipartisan? If it gets passed, great. But if it does, I don't want to see it watered down by people who are then going to continue voting against it. Whatever effectiveness may have been intended would be handicapped. And we still wouldn't even be sure, if it fails, whose fault it is.

What we really need is a "bipartisan" health-reform bill -- and if Democrats act properly, they could get one.

The myth that "bipartisan" legislation works better than partisan legislation is widespread, but virtually no real evidence supports it. For every successful program passed with support from both parties, you can find another one that failed. There are also plenty of popular programs that enjoyed the support of only one side. Republicans aren't afraid to attack Medicare because some party members voted for it in 1965; they're afraid to attack Medicare because it has been hugely successful at achieving its goal of providing quality, affordable health care to seniors. The future popularity of the current health-care reform will be a function of whether the program works, not how many Republicans voted for it.

More important, Republicans are not going to vote for this health-care reform, no matter what the final bill looks like. Chances are it will get zero Republican votes in the House and maybe two Republican votes in the Senate, tops. Anyone who thinks more optimistically has been partaking of too many free samples from pharmaceutical lobbyists.

Secondly, the current legislation wasn't put together on a whim. The ideas encompassed in the plan reflect those that have been around for quite awhile. The implication that the bill won't be well-thought out just because Republicans can't find anything they want in there is absurd.

f*ck compromise. The Pubs, as a majority, will do nothing but dig in their heels when it comes to this health care reform. Two or three Republicans does not a bipartisan bill make.

Please, correct me if I'm wrong. Show me a few Republicans who have suggested doable changes that they will then vote for other than "scrap the whole thing and start over" (which is ridiculous, because they won't agree with any Dem-backed plan [or vice versa for that matter]).

So, I say again, f*ck a bipartisan health reform plan. Let's actually try to get a bill through Congress that will actually have some weight to it.

[thegreekdog]

Okay, maybe "bipartisan" isn't the word. What I want is a healthcare plan that does not put control of healthcare in the hands of the federal government. The current bill, I theorize, will do that. But yeah, I haven't heard anything substantial from the other side of the aisle either. To be fair, I don't belong to the other side of the aisle, I just don't like this current plan.

In terms of whether the bill was put together on a whim, I didn't mean to imply that it wasn't well-thought out. What I was trying (and failing) to imply was that the bill was put together by a few people in consultation with none. I think the people that write such an important piece of legislation need to account for differences of opinion on what can solve the problems.

[Neoteny]

Ok. I still disagree, but less vehemently.

[PLAYER57832]

Yeah, the "Exchange" is a rather different issue, one that I have not looked into closely, mostly because I take the cynical view that the government is going to try its hardest to eventually be a single payor.

To be completely honest, I just want a measured, well-thought out healthcare bill, not one that was put together seemingly on a whim without the input of anyone from the other side of the aisle. I know this is a lot to ask (seriously), but healthcare is an important enough issue that it bears some more discussion. I understand the political ramifications of not passing the thing as soon as possible, but I'd still like to see some kind of compromise on this.

I do not believe this bill was put together on a whim at all. It has been modified to try and appease some opposition.

I have said all along that I prefer a single payor system for many, many reasons, for basic coverage. Th eproblem is that too many people want to use health care as leverage to their own personal issues. This talk of "limiting" care for seniors is a good example.

Talk to any doctor who deals with elder care and you hear a resounding complaint. They are just not given the time to talk to patients about their options in a reasonable and caring way, unless they take upaid time out of their day. No one is saying that elderly people aren't important and don't deserve care. However, most people, when they find out of the options available like being able to make some kind of plans. At the age of 90, do most people really want to go through the pain and difficulty of having a heart transplant? Or even (sometimes) a knee replacement? How many 90 year olds are really and truly healthy enough to endure? Some are, but many are just not. A lot of the anger that comes with "end of life" decisions comes from just plain lack of clarity and understanding. Its only fairly recently that the whole concept of DNRs, etc have become accepted in hospitals. In many cases, if the doctor does not either know the patient or have loved ones there willing to agree, they will STILL be ignored! Why? Not because it will do anything at all for the patient, but because it may save the doctor some headaches.

IN many cases, its not even a matter of whether its wise to provide extensive tests and such to an older patient. Often times, elderly patients just respond differently. Many elderly problems, for example, are due to simple dehydration because their bodies do not absorb water as effciently, they often don't drink like they ought, etc. So, while it may be a good idea to put a younger patient with certain symptoms through all sorts of aggressive tests, the best course for an older patient might be to give fluids and wait an hour or two to see what happens. (note, I am almost exactly quoting a well known hospice doctor on this).

I have had to make some serious decisions for family members, have just this past winter gone through the slow death of my father-in-law and will be, it turns out, facing something similar with my mother-in-law soon, too. So believe me, these are not hypthetical issues for me.

Hospice is NOT about ending people's lives early. It is not about killing people. It is about recognizing that even the best doctor and medicine can only do so much, and, at some point, most people would rather spend their time "making peace" (which can include being very, very, VERY angry at times!), connecting with loved ones, etc than listening to the drone of machines in uncomfortable surroundings. At some point, people just die. Fighting that end tooth and nail is not the best way for everyone to go.

So, this bill has included provisions that will give doctors time to discuss all of these options with people. Is that idea scary? Well, death is scary. Most of us like to pretend it does not exist until we must face the facts. However, for those of us who have had to deal with that ..either for ourselves or loved ones, most of us know that a reasoned understanding and acceptance makes things go much, much better for all concerned.

[Night Strike]

Please, correct me if I'm wrong. Show me a few Republicans who have suggested doable changes that they will then vote for other than "scrap the whole thing and start over" (which is ridiculous, because they won't agree with any Dem-backed plan [or vice versa for that matter]).

I know there are many free market plans out there that involve no federal government take over. These involve health savings accounts, removing the employer based insurance (which solves the losing job = losing coverage) in favor of person based insurance, allow individuals to shop from the policies offered in other states, and cap medical malpractice suits. All of those increase competition via the free market, which will naturally force prices down. There ARE free market solutions, but the democrats want the government control.

[Neoteny]

But the Dems want the government option. Taking it out voids the whole plan, really. That's why the Reps and the Dems are not going to agree on this thing.

[Night Strike]

But the Dems want the government option. Taking it out voids the whole plan, really. That's why the Reps and the Dems are not going to agree on this thing.

Which is definitely why the politicians should listen to the people. Those people now oppose the plan 42%-53%, with the support dropping 5% in just a couple weeks. The people are saying to remove the government from the plan, so listen to them.

[PLAYER57832]

Please, correct me if I'm wrong. Show me a few Republicans who have suggested doable changes that they will then vote for other than "scrap the whole thing and start over" (which is ridiculous, because they won't agree with any Dem-backed plan [or vice versa for that matter]).

I know there are many free market plans out there that involve no federal government take over. These involve health savings accounts, removing the employer based insurance (which solves the losing job = losing coverage) in favor of person based insurance, allow individuals to shop from the policies offered in other states, and cap medical malpractice suits. All of those increase competition via the free market, which will naturally force prices down. There ARE free market solutions, but the democrats want the government control.

Well, the current plan does not involve a "federal government takeover", either.

Those things will not drive healthcare costs down, because as long as Insurers can decide they will make more money insuring health people, that is exactly what they will do.

Until they are forced to provide coverage for everyone, we, the taxpayers will continue to pay for the care of the truly sick. That is what happens now, only after the person has lost their home, their job and most potential for being a taxpayer again.

[Neoteny]

But the Dems want to try the government option, and the people voted them in, so I suspect we're going to see it somehow. I don't know the numbers, but if there's some semblance of support, they're going to go through with it.

[PLAYER57832]

But the Dems want the government option. Taking it out voids the whole plan, really. That's why the Reps and the Dems are not going to agree on this thing.

Which is definitely why the politicians should listen to the people. Those people now oppose the plan 42%-53%, with the support dropping 5% in just a couple weeks. The people are saying to remove the government from the plan, so listen to them.

Here is the REAL question:

Are you sure you will have your coverage in three years? Are you positive? Most people who have insurance say "no". Many of those who don't have never really read their policies (lifetime limits, reasons for denying claims, reasons policies can be cancelled, etc.).

If you do, continuing on COBRA coverage costs, at a minimum $700 a month. IN many cases, to continue the policy you have now would costs you well over a thousand, close to two thousand dollars.

Do you know what your lifetime limit is? In many cases its around 2,000,000. Sometimes its 10,000,000 or much higher. But, compare that to the cost for treating just one bout of cancer. Doesn't seem like such a high number, then!

[comic boy]

But the Dems want the government option. Taking it out voids the whole plan, really. That's why the Reps and the Dems are not going to agree on this thing.

Which is definitely why the politicians should listen to the people. Those people now oppose the plan 42%-53%, with the support dropping 5% in just a couple weeks. The people are saying to remove the government from the plan, so listen to them.

Duplicate post, sorry Folks!

[comic boy]

But the Dems want the government option. Taking it out voids the whole plan, really. That's why the Reps and the Dems are not going to agree on this thing.

Which is definitely why the politicians should listen to the people. Those people now oppose the plan 42%-53%, with the support dropping 5% in just a couple weeks. The people are saying to remove the government from the plan, so listen to them.

As I remember the American people voted for change, well thats exactly what they are getting.
You cannot have a referendum every 5 minutes, if the President on balance doesn't give the electorate what they want then they can vote him out, its called democracy.

[stahrgazer]

Out of curiosity, what lies, specifically, are you referring to? I find it difficult to believe that you have had enough exposure to hold an informed opinion regarding the things of which you speak. It is impossible for you to hold a rational opinion on Rush Limbaugh for example, without having ever listened to his show. Sadly, I suspect you form your opinions based on filtered sources, not unlike most people within the United States.

Obviously Universal Health Care would be a great thing, but such a thing can not be achieved without paying a price. Many of us believe that the price being asked (for some it is the money, for others the invasion of privacy, and most importantly to me the infringement on personal liberty) is not worth it. In addition, the idea that it is, or should be the role of government to care for all citizens is contested in and of itself.

I'm curious, what underlying principle causes you to think that this is the case?

"Infringement on personal liberty" is one lie I can think of. "Invasion of privacy" is another. Under this plan, no one will be forced into a specific type of healthcare, if he or she can afford something else. For me, who has no healthcare through work, I can hardly consider it an invasion of my privacy for the government to realize that even those people who no longer benefit from employer-provided health care, might require a doctor's care. How does it infringe my personal liberty to have some sort of insurance against injury or illness? How does it infringe YOUR personal liberty to have medicaid/medicare type plans extended?

The only leftover is "money". Will it cost more in the long run, or will it cost less? Depending on which side of the issue you favor, you may say yes or you may say no, but the point is, that's debatable. Some economists, even economists who are not pro-Democrat, indicate that our current healthcare system requires Americans to pay too much for far too little. The weblinks I provided below show how in international ratings, we spend the most of our gross national product for healthcare, by dollars AND by percentage; to achieve only the 37th greatest benefit, less than some third world countries.

Given that gross overexpenditure for little return, "No change" is foolish.

Capitalism is based on competition. Currently, the insurance companies band together to establish their own rates. It's a grand old "buddy-buddy" system that, left uncheck as it has been, has resulted in Americans paying far too much and getting far too little in exchange, with quite a chunk of our population getting nothing at all in exchange. In that perspective, Obama's plan isn't "socialist" it's government-aided capitalism; the government will step in to provide insurance companies some competition so that they will be required, by the laws of supply and demand that Capitalism works with, to lower their rates in order to keep clients.

There is even an indirect precedence. Launching of satellites is now a combination of government and private business. Government influence keeps competition honestly working to reduce costs, while the private sector still profits.

[Titanic]

Great article on the BBC, comparing the stuff that US bloggers have been saying about the NHS - http://news.bbc.co.uk/1/hi/world/americas/8198084.stm

Amazing how since the bloggers started attacking the NHS, on Twitter #welovethenhs has been one of the fastest growing links for a few days on the trot. Kinda shows what British people really think about it. Btw, the IBD comment about Stephen Hawking, rofl, what idiots!

Oh and just to British people, [sarcasm]here's a conservative MEP who we should be really proud of [/sarcasm]

http://www.foxnews.com/search-results/m ... warned.htm