House "Affordable Health Care for America Act"

[FinanceDude]

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Originally Posted by teejayevans As written, even if it passed tomorrow, it wouldn't take affect until 2013. TJ

Yeah, and based on the movie 2012,the earth is going to come to an end in 2012 anyway, so what's the big deal?

[teejayevans]

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Originally Posted by FinanceDude Yeah, and based on the movie 2012,the earth is going to come to an end in 2012 anyway, so what's the big deal?

Fortunately that's only a movie and is a complete fantasy. What's really is going to happen is the aliens who help the Egyptians and Mayans build their pyramids are coming back to visit (see note) and give us immortality, so get your lifetime annuities now!
TJ
Note: I believe this theory was first proposed by Carl Sagan

[HFWR]

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Originally Posted by ziggy29 I don't know how you can implement this without the individual mandate. It just doesn't seem possible to eliminate these without a universal coverage mandate because of the adverse selection problem.

Just wave the magic wand...

[dgoldenz]

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Originally Posted by ziggy29 I don't know how you can implement this without the individual mandate. It just doesn't seem possible to eliminate these without a universal coverage mandate because of the adverse selection problem.

You can implement it by tripling everyone's premiums. I sell health insurance....this is what will happen, even with a mandate. It's going to be nuts. Just wait until families who balk at paying $400/month find out that their great healthcare reform is going to cost them $1500 per month instead.

[samclem]

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Originally Posted by dgoldenz I sell health insurance....

IMO, your trade group, AHIP, is the most duplicitous, dishonorable group of incompetent jackals in existence. If your company is still a member, they should be ashamed.

AHIP is largely responsible for the mess we are now in--in so many ways. Their failed attempt to game the system, trying to make an extra nickel at the expense of both customers and health care providers, could very well end up causing your industry to fail to exist as a result of the legislation coming down the pike. They need to start the money flowing now to undo the damage they've already done and get on the right side of this fight. Idiots.

Not that I have a strong opinion on this.

[dgoldenz]

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Originally Posted by samclem IMO, your trade group, AHIP, is the most duplicitous, dishonorable group of incompetent jackals in existence. If your company is still a member, they should be ashamed. AHIP is largely responsible for the mess we are now in--in so many ways. Not that I have a strong opinion on this.

AHIP is a bunch of crooks that would sell agents down the river in a second if they could...

[M Paquette]

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Originally Posted by dgoldenz I sell health insurance.... their great healthcare reform is going to cost them $1500 per month instead.

So, my rates will go down, eh? Yaaaay for me.


Nothing personal, but I've never had particularly good luck relying on salespeople for unbiased product information and projections on future pricing.

[dgoldenz]

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Originally Posted by M Paquette So, my rates will go down, eh? Yaaaay for me. Nothing personal, but I've never had particularly good luck relying on salespeople for unbiased product information and projections on future pricing.

You probably haven't found a good salesperson then. That is why I am an independent agent - I don't have to sell anything for a particular company, I sell for all of the major ones in my state based on the client's needs and medical history. You can't jam a square peg in a round hole, but a lot of people love to take that approach....not me.

It is impossible for a salesperson to perfectly project future prices since there are so many variables in health insurance and things change rapidly. However, it has been proven time and time again that guaranteed-issue health insurance is incredibly expensive and rightly so based on the amount of claims for COBRA and HIPAA policies versus traditional underwritten coverage. All you have to do is go to https://www.mahealthconnector.org/po...ite/connector/ and run some numbers for yourself to see what you can expect. That is the Massachusetts "health exchange" - Mass. has guaranteed-issue policies with no pre-existing conditions. A family of 4 with two 55-year-old parents can expect $1200/month for a junk policy or $1500-3000 per month for a very good policy. A 60 year old husband/wife can expect $1000/month for a junk policy and $1500-2500/month for a good policy. If a husband/wife make over $46k per year, they get no subsidies. What kind of person making $50k (let's call it $40k after taxes) is going to shell out $15k of after-tax money on health insurance premiums? That's before you pay anything for deductible/copayments.

Take a look at the cost of health insurance in New York where they have community rating (everyone pays the same price regardless of age, sex, or health) - great deal for old people, horrible deal for young people. A 20 year old in perfect health in NY would pay $450/month for a junk policy, $1000/month for a good one. How many 20 year olds have $450, let alone $1000/month to spend on health insurance?

[FinanceDude]

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Originally Posted by clifp Also I'd like to give a shout out to all those nice folks making a $1 million+ who are helping to fund my Hawaii retirement, keep working hard we need you to pay the extra 5.4% on the income...

SO, we're going to punish the folks who create all the jobs in this country, and believe they won't find ways to reduce their income and such? Boy, I guess Joe Biden was right when he said: "It's patriotic to pay taxes".......

[DeborahB]

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Originally Posted by dgoldenz You probably haven't found a good salesperson then. That is why I am an independent agent - I don't have to sell anything for a particular company, I sell for all of the major ones in my state based on the client's needs and medical history. You can't jam a square peg in a round hole, but a lot of people love to take that approach....not me.

I'm curious - since you are an agent (and not in my state), how hard is it for someone like me to get insurance and what type is the most likely to be underwritten? Is it easier for me to be accepted for a high deductible plan?

I'm female, looking for individual coverage, 61, with a recent history of recurrent asthmatic bronchitis. I haven't been hospitalized for it - just on prednisone and antibiotics. I also had low grade ("borderline") ovarian cancer almost 14 years ago with no chemo, no recurrence. No hospitalizations in 40+ years except the cancer surgery in 1996.

Right now I'm covered at work but hoping to stop in June at 62. I can afford COBRA but it's the 18 months after it runs out that I'm worried about. I can also afford to cover the expenses a high deductible policy wouldn't cover.

I've had no luck getting a hint of whether I'm likely to be denied coverage! I won't hold you to it, just would like an opinion. Thanks.

[antmary]

This conversation is interesting...Which is why we need a public option. I fault the cartels such as Anthem Blue Cross. The insurance sales people are just trying to make a living. Our insurance guy could not afford his and his wife's own health insurance, so he decided to skip a few months until he could get Medicare. Well, he had a major stroke. He is in a wheel chair, and cannot eat or talk. He will be disabled for the rest of his life. Advanced rehabilitation is not available for him. He is a prisoner in his own body. He and his wife need to file for bankruptcy. Nice retirement, huh.

I am a nice person. I am trustworthy, honest and loyal. I am not Democratic or Republican - I'm independent, and I love this country. But, I am angry to see health insurance premiums being the biggest expense we have. As I have said before, I would be glad to pay higher taxes if there would be a community clinic to go to. At least I could see my tax dollars at work. I know that my current doctor would drop me like a hot potato if we were unable to afford (in two years) Medicare supplement insurance. Yea, as a matter of fact, how about my tax dollars going to fund the kind of health insurance our illustrious elected officials now receive?

Maybe I am so grumpy because I have not had a vacation for a long time; we are saving for retirement, and private health insurance premiums are astronomical. Where is free enterprise and a sense of fairness? If the health insurance companies are so altruistic and caring about my well-being, and they are doing such a good job, then why not a public option?

[DeborahB]

AntMary - I too would be glad to pay some more taxes and see everyone have health care, just as most other industrialized nations have. Your stroke/bankruptcy story is all too common. Even if he had health insurance it could have happened.

[dgoldenz]

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Originally Posted by antmary This conversation is interesting...Which is why we need a public option. I fault the cartels such as Anthem Blue Cross. The insurance sales people are just trying to make a living. Our insurance guy could not afford his and his wife's own health insurance, so he decided to skip a few months until he could get Medicare. Well, he had a major stroke. He is in a wheel chair, and cannot eat or talk. He will be disabled for the rest of his life. Advanced rehabilitation is not available for him. He is a prisoner in his own body. He and his wife need to file for bankruptcy. Nice retirement, huh. I am a nice person. I am trustworthy, honest and loyal. I am not Democratic or Republican - I'm independent, and I love this country. But, I am angry to see health insurance premiums being the biggest expense we have. As I have said before, I would be glad to pay higher taxes if there would be a community clinic to go to. At least I could see my tax dollars at work. I know that my current doctor would drop me like a hot potato if we were unable to afford (in two years) Medicare supplement insurance. Yea, as a matter of fact, how about my tax dollars going to fund the kind of health insurance our illustrious elected officials now receive? Maybe I am so grumpy because I have not had a vacation for a long time; we are saving for retirement, and private health insurance premiums are astronomical. Where is free enterprise and a sense of fairness? If the health insurance companies are so altruistic and caring about my well-being, and they are doing such a good job, then why not a public option?

What makes you think he would be able to afford the premiums on a guaranteed-issue basis if he couldn't afford them as it was? A public option would not change that. People seem to think a public option will wave its magic fairy dust and lower premiums by 50%, except they have it completely backwards.

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Originally Posted by thinker25 I'm curious - since you are an agent (and not in my state), how hard is it for someone like me to get insurance and what type is the most likely to be underwritten? Is it easier for me to be accepted for a high deductible plan? I'm female, looking for individual coverage, 61, with a recent history of recurrent asthmatic bronchitis. I haven't been hospitalized for it - just on prednisone and antibiotics. I also had low grade ("borderline") ovarian cancer almost 14 years ago with no chemo, no recurrence. No hospitalizations in 40+ years except the cancer surgery in 1996. Right now I'm covered at work but hoping to stop in June at 62. I can afford COBRA but it's the 18 months after it runs out that I'm worried about. I can also afford to cover the expenses a high deductible policy wouldn't cover. I've had no luck getting a hint of whether I'm likely to be denied coverage! I won't hold you to it, just would like an opinion. Thanks.

Actually, a high deductible policy covers just as much as any other higher-priced policy. You just pay more out of your own pocket in expenses before the insurance company pays anything. I'm not sure about the laws in your state or whether you have a state risk pool, but after COBRA runs out you would still be able to get guaranteed-issue coverage with no pre-existing conditions under the HIPAA law. The premiums would be very expensive but everything would be covered in full. If I was in your position and you work for a company that offers severance packages or retiree benefits, I would strongly consider exploring the option of continuing your health coverage through the company instead of going on COBRA and HIPAA. Maybe they can work something out with you to provide coverage until you are eligible for Medicare.

If the recurrent bronchitis is still effecting you, you would either be declined or may be able to get an exclusion rider for the condition (probably your best option). The prior cancer surgery would be subject to underwriting from each carrier - it is really difficult to know whether you would be accepted based on the information provided. An underwriter would want to review the medical records to see exactly what is in the doctor's notes and get follow-up testing/exam information to see how the condition has improved over the last 13 years.

[antmary]

The insurance companies are very busy - creating a moat around their own self-interests. Regarding our insurance agent, I am convinced that they (at Anthem Blue Cross) would search around for a pre-existing condition - so they would have to pay as little as possible.

The only good thing about this situation is that I really focus on taking care of myself - eating well, exercising, social contacts, etc.

I don't think I'm alone. People are getting so fed up...I have never, in my life, seen so much financial distress in our community. And, our community is considered to be pretty affluent. I'm distressed - and, we are considered to be better off than 99% of our neighbors!

[samclem]

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Originally Posted by thinker25 AntMary - I too would be glad to pay some more taxes and see everyone have health care, just as most other industrialized nations have.

If all the people who want to pay more taxes would just donate that money to a charity which would pay for health care, I guess there'd be enough money to do it, right?

Talking about guaranteed issue without talking about an individual mandate at the same time doesn't make much sense. The only other way to do it without an individual mandate is to put huge govt cost sharing into place (i.e. the other taxpayers match your premium payment up to XX dollars) to help offset the higher cost that most people pay due to the government's policy of guaranteed issue. I guess that sidesteps the issue of the constitutionality of an individual mandate. Apparently it may be unconstitutional to force a person to buy insurance, but no one blinks if we take that same amount of money from a person in order to buy insurance for others. Kinda funny.

[antmary]

"What makes you think he would be able to afford the premiums on a guaranteed-issue basis if he couldn't afford them as it was? A public option would not change that. People seem to think a public option will wave its magic fairy dust and lower premiums by 50%, except they have it completely backwards."

I agree with you re: being unable to afford the premiums. All these years, he was promoting products that were in essence: breathtakingly unethical, well organized in their ability to bilk citizens out of millions of dollars, and manipulating the primal fear that we all have of losing everything we have worked so hard to enjoy.

My advocacy for a public option arises because I am fed up with business as usual. I see no argument that favors the insurance companies. I think many who work for those companies are self-serving people who have lived a lifetime dedicated to the feathering of their own nests - at the expense of others.

[huusom]

Can we get civilized and provide insurance for everyone just like other industrialized countries in the world? They pay only 10 percent of their GDP and everyone is covered while we paid 16.5 of our GDP and 46 millions are uninsured?

[ziggy29]

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Originally Posted by huusom Can we get civilized and provide insurance for everyone just like other industrialized countries in the world? They pay only 10 percent of their GDP and everyone is covered while we paid 16.5 of our GDP and 46 millions are uninsured?

If we can find a way to wring 6.5% of GDP out of the cost of care while insuring everyone and not hurting quality or availability, sure.

And here's a hint: insurance company profits are a LOT less than 6.5% of GDP, so putting all (or even most of) the blame there doesn't hunt.

[antmary]

Husuum,
I totally agree with you. We simply need to agree upon a system wherein our neighbors are covered. The other issue that I mentioned on another thread:

I don't want to go to the grocery store and be exposed to who knows what (flu, or drug-resistant TB) just because the person in front of me can't get health insurance.

I believe that a healthy population is an asset to us all. I'm also not interested in living in a metaphorical mega-gated community of just the "insured."

[antmary]

Ziggy,
Yes, the problem is multi-faceted; for me, though, the negative experiences have been with the insurance companies. It is hard to feel sorry for Blue Cross. I agree with you in that I think there is plenty of blame to go around - e.g. hospitals, clinics, etc.