Thoughts on health insurance in America

[oldguystudent]

Actually I was addressing one single person. Notice the statement within his quote and also specifically referring to him.

Eh, I actually do ok. Did that whole go back to grad school at UNT and better myself and everything. I was pointing out a mathematical trend, and you chose to tell me that I'm under performing, because it's much, much easier for you to point fingers and tell people that they're lazy than to look at the underlying realities of the situation. Then you get called out by a teacher, and make sure to specifically keep your finger pointed at me because you completely just got called out on your inability to see past the soundbites of the AM dial.

Whether or not I choose to be so ambitious as to become a partner in my firm or a CEO of a corporation should have no bearing on whether or not I can access health care, and yes, to an earlier point, cost is synonymous with access.

But seriously, I've got to get my lazy under performing ass to mosque. There's a socialist sit-in this afternoon.

[Green Mean]

I won't pretend to be an expert in health insurance but the actual cost of healthcare cannot just be ignored and the astronomical cost of medicines are. I'm sorry but something is really wrong there and it should be addressed. I think we all focus on who is going to pay and what but why does everyone always ignore the actual cost of this which I believe is the root cause of most of the health care problems here.

[UNTflyer]

All I'll say is this...

I current pay $289 a month for what would be considered a "GOLD" plan. Here is what HealthCare.gov says I am eligible for:

[Harry]

All I'll say is this...

I current pay $289 a month for what would be considered a "GOLD" plan. Here is what HealthCare.gov says I am eligible for:

Do you have group or individual coverage currently? That would provide more insight in regards to the difference in price you speak to. If you happen to work with a bunch of young healthy males then yeah you probably have a deal that can't be beat. If you are a fairly young male and healthy then yeah you probably may have to pay more. The younger and healthy of the population are subsidizing this model without a doubt.

The biggest thing I have noticed is that age is playing a much bigger role in the pricing on my groups. They seem to want to encourage individuals in the Medicare range to get into Medicare. The other thing is the days of composite rates (ie 4 tiers employee only, employee spouse etc) are over. They use an age banded grid with 46 pricing levels. <21 is one rate and they go up in price by age year from 22 - 65+. The pricing isn't horrible and for individuals with health conditions it is a godsend compared to the options they had before. I would say for most of my groups it is a fairly breakeven proposition.

The pricing issue isn't the big issue. The biggest issue out there right now is the provider networks. There are big savings to be had when you choose the plan with more concentric (smaller) provider and hospital networks. I typically will steer my clients away from it because there is nothing worse than showing up to your doctor's office to find out he isn't participating in your "new" network. I work with a lot of doctor groups and many of them are telling me they do not want to participate in the "exchange". Now if you have your key doctors and hospitals in a "narrow" network it makes all the sense in the world to give that consideration.

My prediction is they will eventually get the website issues fixed. They just today extended the penalty deadline for the individual mandate for 6 weeks. The big issue is the doctors and their participation in these smaller networks that offer the most savings. If people sign up for lower cost plans with limited networks you won't hear the complaints until January through March. That could cause a contentious battle between the insurers and the providers.

[FirefightnRick]

NBC News: "Obama administration knew millions could not keep their health insurance."

http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance?lite

President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.

Four sources deeply involved in the Affordable Care Act tell NBC News that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a cancellation letter or the equivalent over the next year because their existing policies dont meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience sticker shock.

Rick

[UNTFan23]

Suddenly, employer provided health insurance, no matter how "bad" the coverage might be, may have become the one thing people will want the most when looking for a new job.

[The Fake Lonnie Finch]

It's a screwjob.

No, actually, it's really a push to single-payor/true socialism. If you buy your own insurance for your family, as we've done for years, it's nothing but a kick in the nuts. The middle class is always handed the bill.

Met with the owner of five pizza franchises this afternoon. In order to avoid the penalties of Obamacare, the owner of the five franchises is splitting the company into three separate companies so he won't have to fire anyone or cut back hours.

Stupid. The whole law is stupid. It will never fund itself. Ever. You can't have an insurance program - P&C, Health, any line - that isn't allowed to underwrite the risk and expect it to be fiscally viable.

This country needs more business owners as legislatures and far less lawyers. I'm afraid it will never happen. Our congress and the succession of Democratic presidents we are about to endure will legislate America into the type of social and economic morass into which Mexico and the Central and South American countries perpetually find themsleves.

Edited October 29, 2013 by The Fake Lonnie Finch

[The Fake Lonnie Finch]

Do you have group or individual coverage currently? That would provide more insight in regards to the difference in price you speak to. If you happen to work with a bunch of young healthy males then yeah you probably have a deal that can't be beat. If you are a fairly young male and healthy then yeah you probably may have to pay more. The younger and healthy of the population are subsidizing this model without a doubt.

The biggest thing I have noticed is that age is playing a much bigger role in the pricing on my groups. They seem to want to encourage individuals in the Medicare range to get into Medicare. The other thing is the days of composite rates (ie 4 tiers employee only, employee spouse etc) are over. They use an age banded grid with 46 pricing levels. <21 is one rate and they go up in price by age year from 22 - 65+. The pricing isn't horrible and for individuals with health conditions it is a godsend compared to the options they had before. I would say for most of my groups it is a fairly breakeven proposition.

The pricing issue isn't the big issue. The biggest issue out there right now is the provider networks. There are big savings to be had when you choose the plan with more concentric (smaller) provider and hospital networks. I typically will steer my clients away from it because there is nothing worse than showing up to your doctor's office to find out he isn't participating in your "new" network. I work with a lot of doctor groups and many of them are telling me they do not want to participate in the "exchange". Now if you have your key doctors and hospitals in a "narrow" network it makes all the sense in the world to give that consideration.

My prediction is they will eventually get the website issues fixed. They just today extended the penalty deadline for the individual mandate for 6 weeks. The big issue is the doctors and their participation in these smaller networks that offer the most savings. If people sign up for lower cost plans with limited networks you won't hear the complaints until January through March. That could cause a contentious battle between the insurers and the providers.

[EagleGreen]

I think the reason Obamacare is and will continue to be problematic is that it's a half-assed attempt to do what works for pretty much everybody else. Because of political infighting (which basically boils down to wanting to keep relationships and money rolling in from pharma companies and such), they kept the issue nice and political and overcomplicated it. So by trying to do something that would be pretty reasonable, Obama may have inadvertently made it a bigger and weirder mess than before.

Yes, this is the problem. The dems had an idea for healthcare reform, republicans didn't want to be a part of it so Obama would fail, dems pushed it through, and now we are all stuck with it. It would help to have a 2 party system, but we have a 1 party system on many matters because the opposition party doesn't want to lose money or votes. It's time for a sensibility party.

[The Fake Lonnie Finch]

Why would the Republican Party want to be a part of putting the the country one step closer to complete socialism?

So which is it:

(1) Democratic Party stop fighting for programs that lead the country toward socialism?

or

(2) Republican Party stop fighting programs that lead the country toward socialism?

Why do you think Democrats are elected in their districts? Their constituents believe in those things they espouse.

Why do you think Republicans are elected in their districts? Their constituents believe in those things they espouse.

You think a chuck of politicians from either party are going to suddenly stop believing in and championing their causes and politial philosophies?

Nationalized health care is not, "Hey, we need a traffic light at this intersection" type of legislation. Democrats are right to champion it if they support. And, Republicans are right to fight it if they oppose it.

Why would you want it any other way? Without opposition, you have what they have in China, North Korea, Cuba, etc. Is that what you want?

Edited October 29, 2013 by The Fake Lonnie Finch

[Green Mean]

Why would the Republican Party want to be a part of putting the the country one step closer to complete socialism?

I think regardless of party there needs to be serious look at reform. For the most part I think most average people from both parties agree. For me my big thing is the continuing rise of cost of healthcare. It's not even a slight right but the rise is astronomical. That needs to be addressed. I'm particularly not a huge fan of the ACA as the issue of cost is still ignored in this whole thing.

[The Fake Lonnie Finch]

I think regardless of party there needs to be serious look at reform. For the most part I think most average people from both parties agree. For me my big thing is the continuing rise of cost of healthcare. It's not even a slight right but the rise is astronomical. That needs to be addressed. I'm particularly not a huge fan of the ACA as the issue of cost is still ignored in this whole thing.

I agree. But, recall, cost controls were promised by the party which pushed it through.

What we are talking about is insurance. Insurance involves underwriting risk. If something is too risky, the insurance is going to be more costly; or, not offered at all.

The problem is that "insurance" and "guarantee" are not interchangable terms or ideas. What one party hoped to do was provide a guaranteed level of coverage for all without allowing underwriting to occur. It's not possible. Without underwriting, the "insurance" is "guaranteed" to go up in price.

The numbers are already projecting to raise only about of quarter of the money needed to make this thing - as put together - work. So, where do you think the money for the other 3/4th is going to come from?

The government simply priting money to cover it, as has been so popular in Mexico, Central America, and Latin America? Ready to see the dollar fall to the value of the peso?

Raising taxes across the board? A tax that would have to lnclude the middle class? During a molasses-like "recovery"?

Hmmm. Can they just borrow money from Social Security as they've done before for other social engineering bits?

The politicians who pushed this have painted the country into a corner. It really is pathetic.

Edited October 30, 2013 by The Fake Lonnie Finch

[FirefightnRick]

"WH Intimidates Insurance Companies Not to Publicly Criticize Obamacare"

http://m.weeklystandard.com/blogs/wh-intimidates-insurance-companies-not-publicly-criticize-obamacare_765582.html

"What is going on is, behind the scenes attempt by the White House to at least keep insurerers from publicly criticizing what is happening on this Affordable Care Act rollout. Basically, if you speak out, if you are quoted, you're going to get a call from the White House, pressure to be quiet," reports CNN.

Another step closer to fundamental change towards the U.S.S.R. of A.

Rick

[EagleGreen]

Why would the Republican Party want to be a part of putting the the country one step closer to complete socialism?

So which is it:

(1) Democratic Party stop fighting for programs that lead the country toward socialism?

or

(2) Republican Party stop fighting programs that lead the country toward socialism?

Why do you think Democrats are elected in their districts? Their constituents believe in those things they espouse.

Why do you think Republicans are elected in their districts? Their constituents believe in those things they espouse.

You think a chuck of politicians from either party are going to suddenly stop believing in and championing their causes and politial philosophies?

Nationalized health care is not, "Hey, we need a traffic light at this intersection" type of legislation. Democrats are right to champion it if they support. And, Republicans are right to fight it if they oppose it.

Why would you want it any other way? Without opposition, you have what they have in China, North Korea, Cuba, etc. Is that what you want?

I think that folks should stand by their political philosophies. However, when talking healthcare reform, one party presented a plan and the other party said "We will not help reform". They didn't want to be a part of the process of which they were elected to be a part of. They simply wanted opposition to the plan and didn't want to help fix the plan or present a plan of their own. They wanted failure on the part of the president so they could get re-elected.

[The Fake Lonnie Finch]

That's not true. GOP legislators did offer amendments/changes to the bill. But, remember, Pelosi wouldn't let them to the floor on the House, saying, "we have to pass a bill so we can see so that we can show you what it is and what it isn't."

The votes went on party lines because the Democrats would not allow debate on it.

[JesseMartin]

This is kind of a chicken or egg argument, because quite a few GOP officeholders went on record as saying their primary focus was to see Obama fail. Not all of them, but enough to raise a red flag. And they knew this was a big Dem project for a long time. So did Pelosi do that BECAUSE of their attitude, or did the attitude worsen because of Pelosi? Either way, I think most of them are ridiculous. I understand the need to fulfill party obligations and the obligation to the voters that brought you in, but playing the constant opposition game is annoying as hell no matter where it comes from. Sadly, we have a two-party system with two parties that like to play that game a lot.

[The Fake Lonnie Finch]

So, what is better? Mexico's three party system? Italy's dozens of party system?

Name a country whose system is better than two parties.

By the way, I've already predicted that America will split into a three parties within the next four election cycles. Democratic Party will stay the same as "minorities" continue as the majority in enough urban cities to win the electoral college. Republican Party will split between moderates and conservatives.

Unknown what the conservatives will call their party, but it matters little. America will destory itself over a 70 year or so period, the same as Mexico did when it had one party win the presidency for seven consecutive decades.

By then, it won't matter. Countries like China will have passed America in global importance by then. America will be mired in the same type of economic and social malaise that plagues Central and South American countries, and Mexico.

If you have children, just make sure they know enough math/finance/science to get well paying jobs either here or abroad. Also, knowing one or two other foriegn languages will be a strength for them. I suggest Spanish and Chinese. Hindu wouldn't hurt.

[forevereagle]

[Green Mean]

So, what is better? Mexico's three party system? Italy's dozens of party system?

Name a country whose system is better than two parties.

By the way, I've already predicted that America will split into a three parties within the next four election cycles. Democratic Party will stay the same as "minorities" continue as the majority in enough urban cities to win the electoral college. Republican Party will split between moderates and conservatives.

Unknown what the conservatives will call their party, but it matters little. America will destory itself over a 70 year or so period, the same as Mexico did when it had one party win the presidency for seven consecutive decades.

By then, it won't matter. Countries like China will have passed America in global importance by then. America will be mired in the same type of economic and social malaise that plagues Central and South American countries, and Mexico.

If you have children, just make sure they know enough math/finance/science to get well paying jobs either here or abroad. Also, knowing one or two other foriegn languages will be a strength for them. I suggest Spanish and Chinese. Hindu wouldn't hurt.

I think you mean Hindi. That said I'm not sure that language is all that beneficial. Sure if you speak Hindi, then you can speak Urdu pretty well but there's so many languages within India and Pakistan (India especially) that the common ground language spoken in the corporate world and even government is English.

Spanish, Chinese, Arabic, Portuguese, and French are probably the ones you will get the most benefit from IMO.

[The Fake Lonnie Finch]

Okay. Let's play this.

Explain to me how the Republican Party is going to get Tea Party voters and Christian Right voters to support any old moderate candidate they throw up there, i.e., John McCain/Mitt Romney.

Also, show me an electoral map in Florida, Colorado, Ohio, or Pennslyvania, where there is enough white/suburban vote to overcome "minority" voting in each state's big cities.

You have be real realistic about what people believe, and where the demographics of the country are headed. Texas is in the final throes of being a Republican stronghold.

There is no path to the White House any longer for the Republican Party. And, here is where the water is even muddier for the Republicans: without the Executive Branch, all federal judicial appointments will be made by Democratic presidents.

So, laws passed by states that may be conservative and to the liking of the state's voting base, have little chance of surviving federal appeals court challenges.

Once you understand how demographics plays into the eletoral college, this stuff isn't difficult to discern. There is a reason presidential candidates of either party do not waste their time in any but a handful of states.

[JesseMartin]

TFLF, I was definitely not disagreeing with you, I just referred to the problem that comes from playing partisan games versus actually working on legislation and progress. I've said things very similar to about half of what you've been talking about. I'd like to think that a new paradigm could come into play before we find ourselves dangling over the precipice you're referring to, but I have no idea what it might be. There is a fine line between trying to ensure the survival of voters and neighbors versus putting the overall welfare of the country at risk to do so. Too much power consolidated within one party over a long period of time is a very dangerous thing, no matter how much you might like that party before they may choose to start playing God.

[The Fake Lonnie Finch]

TFLF, I was definitely not disagreeing with you, I just referred to the problem that comes from playing partisan games versus actually working on legislation and progress. I've said things very similar to about half of what you've been talking about. I'd like to think that a new paradigm could come into play before we find ourselves dangling over the precipice you're referring to, but I have no idea what it might be. There is a fine line between trying to ensure the survival of voters and neighbors versus putting the overall welfare of the country at risk to do so. Too much power consolidated within one party over a long period of time is a very dangerous thing, no matter how much you might like that party before they may choose to start playing God.

Hello? The new paradigm is already here. It's been here since about 2006.

There is no longer a majority race in America. The conglomeration of the former "minorities" is now the majority. And, they will continue to be the majority.

This country isn't,and never was, a pure democracy. The electoral college will continue to tip for the Democrats. The decline into socialism will be difficult for many to face. And, those who believe they want it will be like most in this hemisphere who believe(d) they want(ed) it - disappointed that they are still poor, or getting poorer.

The health care plan is just an example of what is to come.

[oldguystudent]

So just a little PSA for anyone who may need it. Recent personal events forced me to seek obamacare coverage for my kid. 39 days, and I still can't get through the healthcare.gov website.

A happy little accident this morning. If you go directly to the Blue Cross/Blue Shield website, they will sell you the obamacare approved plans directly. No federal website nonsense necessary.

[UNTFan23]

So just a little PSA for anyone who may need it. Recent personal events forced me to seek obamacare coverage for my kid. 39 days, and I still can't get through the healthcare.gov website.

A happy little accident this morning. If you go directly to the Blue Cross/Blue Shield website, they will sell you the obamacare approved plans directly. No federal website nonsense necessary.

I have found through various news media reports that the healthcare.gov website is really only good for finding out if you qualify for premium subsidies. If you don't, best to go to a insurance agent and find the best qualifying plan that fits your needs.

[oldguystudent]

I have found through various news media reports that the healthcare.gov website is really only good for finding out if you qualify for premium subsidies. If you don't, best to go to a insurance agent and find the best qualifying plan that fits your needs.

That seems to be the case. So if they're gonna do a mandate, it really should be a simple thing like car insurance.

Law: Go buy insurance. If you think you can't afford it, here's this crappy exchange to see if you can get subsidies. Otherwise, just go buy insurance.