A public option delayed until 2013 is not a public option, period

[eridani]

What we get until then is being forced to buy private insurance. That would actually not be so bad, except they think it's OK to pay 11% of your income for premiums, and have as much as $10,000 of copays for 2 people. This is totally unacceptable, given that the mandated private insurance in the Netherlands costs 100 euros/month per adult.

The insurance companies still get to limit your choice of doctors, and they still get to rescind policies on the grounds of "fraud." We can complain to a federal regulator, but the insurer wins if you die before they get to your file.

If we can't get single payer, why not just make Medicare the public option, starting within a year of passing the law? Or at least add an amendment dropping the Medicare age to 55.

[HamdenRice]

1. A public option delayed until 2013 is a public option delayed until 2013

I don't get the language people use around here sometimes. What's the point of the exaggeration? I don't want the public option delayed until 2013, but it is simply false to say that delaying it means it doesn't exist.

As for your other points, no the insurance companies won't get to rescind your policies for alleged fraud. That is part of the set of new restrictions on private insurance behavior.

[eridani]

5. Yes, they do.

If you die while the regulators are reviewing your case, tough shit.

http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111NLXA5c:e70566:

SEC. 2746. OPPORTUNITY FOR INDEPENDENT, EXTERNAL THIRD PARTY REVIEW IN CASES OF RESCISSION.

`(a) Notice and Review Right- If a health insurance issuer determines to rescind health insurance coverage for an individual in the individual market, before such rescission may take effect the issuer shall provide the individual with notice of such proposed rescission and an opportunity for a review of such determination by an independent, external third party under procedures specified by the Secretary under section 2742(f).

`(b) Independent Determination- If the individual requests such review by an independent, external third party of a rescission of health insurance coverage, the coverage shall remain in effect until such third party determines that the coverage may be rescinded under the guidance issued by the Secretary under section 2742(f).'.

(d) Effective Date- The amendments made by this section shall apply on and after October 1, 2010, with respect to health insurance coverage issued before, on, or after such date.

[HamdenRice]

9. No, they don't, and the material you cite disproves your point

Right now the insurance companies can unilaterally cancel your policy just by alleging fraud. If they are wrong, you can sue them to get reinstated, but if, in the meantime, while they have stopped paying, you die, then you die. This reform says that they cannot unilaterally cancel your policy. They have to get third party review, and during that time they have to continue paying.

Your statement, "If you die while the regulators are reviewing your case, tough shit," is completely wrong; it's right there in the provision you cite that the insurance company has to keep paying while the regulators are reviewing your case."

It is possible, you know, that a little fraud exists, so they have to have a mechanism for finding out if it exists. But it mostly doesn't exist and so this provision will save lives. In fact, by making the insurance company "prove it," it reduces any incentive to cancel on false grounds like they do now.

Moreover, false or mistaken statements on initial insurance applications are no longer grounds for fraud, so these provisions taken together make it virtually impossible for an insurance company to cancel your policy unless you are actually engaged in some kind of criminal activity.

[eridani]

10. There should be no recission, period

If there is fraud, then the insurance companies can sue the individual the regular way. Criminal acttivity is for crimnal courts to deal with. Recission is not allowed in any other industrialized country.

[HamdenRice]

13. So will you admit you were wrong about one aspect of reform before changing the subject?

"If you die while the regulators are reviewing your case, tough shit."

Do you at least realize that one of your fears about reform was wrong? That's how everyone needs to proceed on this -- in a reality based fashion. If we can't get each other to agree on the facts, how do you suppose we are supposed to convince those who are listening to Fox?

[eridani]

25. OK, they need to pay until adjudication. There is still no reason for recission to exist at all.

There are standard remedies against fraud. No other developed country allows recission for any reason, but that's because no one is left out.

[Bluenorthwest]

15. What about the points about the cost? You do not mention that.

Congress members pay about 3% of their tax payer paid income for their far better Insurance. 3%. They should not expect others to pay a higher percentage than they do. But they do. Much higher.
And that part just sails right past your alleged fact checking. How much will it cost me? Will they count my family as a family, or as strangers who have lived together for decades? Are we the family we are, or stangers to please the Faith Based faction?
Show me a bill without discriminatory language, in which the American people pay no higher percentage than our servants in Congress pay, and we can go from there. I do not support discrimination, against me or anyone. Many here are fine with discrimination against other people, it seems, if it profits them.

[HamdenRice]

16. "sails right past your alleged fact checking" -- huh?

Where did I write anything about "fact checking" cost? I wrote that (1) saying that the delay of public option is the same as no public option is an exaggeration, and (2) that insurance companies will not be able to arbitrarily and unilaterally cancel policies.

Sadly, comparing what the public gets to what Congress gets is a non-starter. They have the power to allocate several trillion dollars of tax payer money, and it's no surprise that they voted themselves basically free health care. No one is ever going to get what Congress votes itself with our money.

There are 2 components of health care insurance/health care, and I think a lot of people don't realize this.

1. It is insurance against something bad and expensive happening to you -- like a car accident or a serious illness. This is sometimes called "pure insurance." The idea is to spread the cost among everyone who is paying in.

2. The other part, however, is a savings component. Health insurance functions kind of like a Christmas club savings account. You are putting away money for medical expenses that we all know you will definitely incur in any given year (assuming it's a rational humane system). That includes things like your annual checkup, your kids' shots, etc. (We also have to bring down the cost of these inevitable visits.)

No system can avoid charging each person for 1 + 2, unless the person is poor, which which case his costs will be spread to others or the taxpayer. Someone (the covered person or the taxpayer or the other insured people) has to pay both 1 and 2 for each person. Congress critters obviously do not pay the full cost of either 1 or 2 for themselves, but pay for it on our dime. You cannot compare what we are going to get from Congress to what Congress gives itself. I would hope that Congress is forced to pay its fair share, but it's not likely. If they raised their premiums to 1+2 you can guarantee they would just raise their own salaries to offset it. The bigger point is that what Congress has is in no way feasible for everyone, because what Congress pays is far less than 1 + 2.

We have to take out of the cost of insurance: profit, CEO and executive salaries, advertising, insane administrative costs from different claim forms and procedures, etc. But the cost for most working class and middle class people (and richer) is still going to be 1 + 2. The closer we can get to insurance premiums being 1 + 2 and nothing more, then the closer we get to a rational system.

[Bluenorthwest]

17. You claimed to have addressed the posters 'other points'

when you had not. So you say Congress gets to screw us and we should just accept that. Sorry. You spend much time on what you think other do not understand, but you rush right past the points that others make such as that Congress pays less than they are asking the people to pay. That is wrong.

Will the plan, I ask again, be treating all Americans equally, or will it in fact discriminate against those families that your Faith Based Office does not like? Which is it. It should take about 5 words to answer that, if answering is the point.

[HamdenRice]

18. It will not treat "us" like it treats Congress.

Never happen. Does that answer your question?

[Bluenorthwest]

20. But you are again avoiding answering the question I have asked

twice now. Will it treat all families equally, or will it discriminate against GLBT families? Will my family be counted as a family or as the legal strangers your tax code insists that we are?
You have been asked twice now. As I read what they have so far, it is highly discriminatory against n against my community. My family. Not, to my knowledge, yours.

[HamdenRice]

23. You didn't ask about GLBT families

You asked about cost and then some bizarre question about faith based factions vetoing coverage (whatever that meant), so this is the first time you are asking the question.

Here is the subject line of your first post:

"What about the points about the cost? You do not mention that." Then you asked about Congress. Then you asked cryptically, "Are we the family we are, or stangers to please the Faith Based faction?"

That said, you may be aware that certain constituencies have asked that certain posters not express opinions on certain topic or face being banned -- even if those certain posters are supportive of certain topics or disagree slightly from the consensus on certain tactics and strategies regarding certain topics. So no, I won't directly address your question, because I've been asked not to. If you were part of the constituency that asked that certain posters not be allowed to address certain topics, then it's somewhat disingenuous for you to ask my opinion.

That said, I can make some general economic observations. Much of the various discrimination under the current system has to do with how insurers "pool" risk. There are, unfortunately different risk pools for different insured persons. That's why insurers exclude people with previously existing conditions who apply for individual insurance, but often accept them for groups insurance purchased by large insurers. Many of the abuses of the system have to do with how risk is pooled.

As the bills are evolving, much of the reform efforts seems to be focused on eliminating various risk pools and creating one common risk pool. If everyone is in the same risk pool, then various kinds of groupings -- like who you are employed by and whether you are part of a legally recognized family -- simply go away, and everyone is treated as an individual for insurance purposes. Getting coverage from your spouse's plan becomes increasingly irrelevant. It isn't clear whether the insurance exchanges will or won't offer discounts for families or family coverage.

Lastly, as a general matter, family law is generally state law (subject to the full faith and credit clause), so I wouldn't expect this to be at all addressed in the health insurance reform bill.

[snot]

2. K&R'd

[scheming daemons]

3. No hyperbole there.

:eyes:

If something doesn't happen until 2013, that's the same as it never happening at all!


Why? Because the Mayan calendar ends in December of 2012... and with it, the world.

:sarcasm:

[eridani]

6. People need help NOW, not in 2013

Give me one good reason why people shouldn't be able to enroll in Medicare as their public option.

[alc]

4. a 2013 public option is a 2010 republican campaign

"THEY passed the biggest ever increase in government. Where's YOUR insurance?" Those who bother to look at the issue further will get the response "It's coming in 3 years". It's even worse if any medicare cuts, pharm deals, or other pro-business items take affect sooner.

[andym]

22. 2012 electoral problem as well.

Not good political startegy! Leaves room for fear mongering.

[pampango]

7. And Medicare delayed until 1968 is no Medicare. n/t

[eridani]

8. It was established within 11 months of being passed.

And that was way before eomputing power was cheap.

[pampango]

14. Indeed it was. And Medicare would still be Medicare if its implementation had been delayed to 1968,

Obviously, any delay is not preferable, but a delay does not mean a program will not do a lot of good in the long run.

[nashville_brook]

21. health care delayed is health care denied

[eridani]

24. That it was not delayed says a great deal about its tru purpose

That the public option is being unnecessarily delayed says that the purpose of the bill is to force us to enrich private insurers without any real choice for four years. The public option could be administered by Medicare next yeara. Why is that not the case?

[tj2001]

11. Cancer does not wait for 2013

[depakid]

12. By 2013, the US could transition to single payer without much "disruption"

[truedelphi]

19. My personal solution is to see to it that

Our household gets another chunk of change from Random House Europe and then leave for Europe.

Now that you mention it, Amsterdam might be the perfect place to go.

This nation is mad crazy and it apparently isn't gonna get any better in my lifetime. And if I don't get decent medical attention soon, I won't have a long lifetime.