House "Affordable Health Care for America Act"

In regards to govt run health care in Europe, how many of them have a huge illegal immigration problem like the US? Probably none........never heard of anyone willing to risk life and limb to go to France or Germany or Britain........:)
Of course they do. Illegal immigration is driven by economic opportunity.
 
There are many more low income citizens than illegal immigrants that overrun hospital emergency rooms. Many illegal immigrants pay cash for reasonably priced health care services in walk-in clinics around the country. Others would pay if the health care services weren’t so outrageously priced.

“Illegal immigrants” is (are?) a red herring – an easy way to distract. The core of health care reform is access and affordability for everyone. Any reform that enables more people to have better coverage should be encouraged.
 
I did not take into consideration the illegals when I typed my last post. When they are taken into consideration that leaves only about 19 million people this bill is supposed to cover. The question then becomes, is that going to bring down the cost of insurance for everyone? Since the amount of money an insurer makes is limited to an as of yet unspecified percentage of medical loss and there isn't a provision for a carryover of loss to future years, an insurer would be foolish to have the premiums set so low that they would not be giving a refund every year. Currently with the "cut throat" claims payouts and underwriting standards the insurers only make 8% profit The expectation is that the infusion of new people will bring the costs down further. My WAG is when the number of new people is balanced against those with preexisting conditions and having to cover everything, it is at best a wash.

Here is an article about what happens when the government gets to decide how much profit an insurance company can make. Blue Cross Blue Shield of Maine is the only carrier that sells individual policies in that state because fo the government decision to run other carriers out of business with guaranteed-issue and no pre-existing condition. Anthem agreed to cover all policyholders for a guaranteed profit of 3%, which was agreed to by the state.....and then the government decided to exercise its power once all the other carriers were gone. Just wait until this happens nationally:

AUGUSTA — More than 100 people stood in the pouring rain Wednesday to protest Anthem Blue Cross Blue Shield's lawsuit against the state.

The lawsuit seeks to overturn a decision by Maine's insurance superintendent denying the company a guaranteed 3 percent profit margin.

Protesters rallied on the lawn of Kennebec County Superior Court, where the lawsuit was filed Aug. 21. Oral arguments are expected to be heard next month.

Phil Bailey, state director for Change That Works, a grass-roots organization supporting health care reform, told the crowd that Anthem's rates in Maine have gone up 89 percent and profits have increased 79 percent in the past seven years.

"We're gathering here, asking them to drop the suit against taxpayers of Maine, who already can't afford their polices, and return the money – that they are using to lobby against health-care reform – to their ratepayers in the form of reduced premiums," Bailey said.

Anthem submitted a request last winter seeking an average 18 percent rate increase for its four individual health care insurance products, affecting about 12,000 of its 400,000 policy holders in Maine.

The request reflected the medical risks of doing business in Maine, company officials said. In its lawsuit, the company said Maine has high rates of asthma, heart disease, diabetes and other chronic illnesses, a high number of smokers and a restrictive regulatory environment.

"Unfortunately, the individual market premiums are merely the symptoms of a larger underlying problem in Maine's individual market: rising health care costs," said Anthem spokesman Chris Dugan.

After holding several public hearings, Insurance Superintendent Mila Kofman cut Anthem's rate increase request to 10.9 percent, which provided for a zero percent profit margin.

In a brief filed in Superior Court, Anthem called the zero-percent profit margin unfair and unprecedented.

In response to Anthem's lawsuit, Attorney General Janet Mills filed a 38-page brief two weeks ago detailing Anthem's revenues, profits and profit margins in Maine. Anthem, she said, can easily make a profit on the lower rate increase.


In these tough economic times, she said the average individual policy holder pays about $6,000 in premiums each year, with deductibles of $7,250.

"They want a guaranteed profit of a certain minimal amount on the backs of ratepayers who are carrying these health insurance plans, mainly small business owners, sole proprietors, restaurant owners, loggers, farmers – the backbone of our economy," Mills said Wednesday.

Andrew Twaddle of Boothbay, a retired University of Missouri professor who attended the rally, said medical costs are bankrupting our society.

-snip-
 
So what, exactly, will Maine do if Anthem decides to leave the state? They don't have any competitors to take up the slack. With how the state is treating Anthem, it has lost all credibility on any promises it makes to any other insurer who might want to take up the challenge. I would say Anthem has the state over the barrel not the other way around. If the state decides to cut the "guaranteed" profit, the company can always go out of business.
 
So what, exactly, will Maine do if Anthem decides to leave the state? They don't have any competitors to take up the slack. With how the state is treating Anthem, it has lost all credibility on any promises it makes to any other insurer who might want to take up the challenge. I would say Anthem has the state over the barrel not the other way around. If the state decides to cut the "guaranteed" profit, the company can always go out of business.

Exactly. What happens when this occurs on a national level? This is the exact reason everyone is concerned that a public option and regulation would force private insurers out of business, leaving behind only the government-run program. It's like playing a football game in which the referee is also the coach of the other team.

The article also doesn't mention that Maine's state-run health insurance program, DirigoChoice, has not taken on a new person in about two years and is bankrupting the state on the same promises of Obamacare. Very efficient.
 
The core of health care reform is access and affordability for everyone.

What do you mean by "access"? Everyone in America has access to health care. You've already said "affordablity" in the same sentence, so I'm sure this "access" has nothing to do with cost. What does it mean?

I see this claim a lot, that people are "denied access" to health care, and as far as I can tell it is just spin, an implication that there are bars to medical care in addition to cost.
 
In regards to govt run health care in Europe, how many of them have a huge illegal immigration problem like the US? Probably none........never heard of anyone willing to risk life and limb to go to France or Germany or Britain........:)

Actually they do have a problem... I was surprised to hear on the news about all the illegals that kept coming to Britain... there are still a lot of poor countries in Eastern Europe and Asia... the illegals go to Russia, France, Germany, and England... it is easier than getting to the US....

I was really surprised that England got as many as they were claiming, being an island and all... but they jump trains and boats to get there...
 
As I see it, one of the things that makes the current system so unsustainable is that the uninsured actually piggy-back on other people's insurance, but in the most expensive way possible. Because they have no coverage of their own they generally wait until they are VERY sick and then seek ER treatment. IMO, getting these people real coverage (even if it's through a public option, subsidized by my taxes) will result in somewhat lower costs because they'll no longer wait to seek treatment and can do it through a routine visit with the Dr. rather than the ER.

Sorry... but someone not thinking like the people we are discussing... it became quite clear to me that if you are poor, you do not spend money like 'we' do... as an example... and I have said this before, I saw a show about RAM... a group of people who go around the country to help out the poor... with free healthcare... one of the people they showed HAD insurance... but either did not have the money to pay the deductible or (IMO) thought booze and cigs were more important (plus driving a huge 4X4 and paying all the money for their gas)....

My insurance, which will cost over $1,000 per month this coming year if we do not get a rate decrease... had a $4,000 deductible... PER PERSON... so if all 4 of my family had a major problem... we would be out $12K premium plus $16K deductible...

Not something that most people can afford.... especially if they are in the poverty level....
 
Sorry... but someone not thinking like the people we are discussing... it became quite clear to me that if you are poor, you do not spend money like 'we' do... as an example... and I have said this before, I saw a show about RAM... a group of people who go around the country to help out the poor... with free healthcare... one of the people they showed HAD insurance... but either did not have the money to pay the deductible or (IMO) thought booze and cigs were more important (plus driving a huge 4X4 and paying all the money for their gas)....

My insurance, which will cost over $1,000 per month this coming year if we do not get a rate decrease... had a $4,000 deductible... PER PERSON... so if all 4 of my family had a major problem... we would be out $12K premium plus $16K deductible...

Not something that most people can afford.... especially if they are in the poverty level....

Your maximum expense is probably 2x the single deductible. If you had two max claims during the year, a claim for the 3rd person would cost $0. Look into a high deductible policy with a single deductible for the whole family to bring down your premiums.
 
Your maximum expense is probably 2x the single deductible. If you had two max claims during the year, a claim for the 3rd person would cost $0. Look into a high deductible policy with a single deductible for the whole family to bring down your premiums.

You might be right... I have not checked... I have only been there a year and my wife was the only one who hit the limit...

I have looked at getting insurance on my own for the rest of the family and just take the companies for me... they pay 100% for the employee, but nothing for the family...

However, the 'savings' do not seem to be a lot... and the company helps with the deductible over a certain number... so I guess I will stay with the $1000 per month policy...
 
You might be right... I have not checked... I have only been there a year and my wife was the only one who hit the limit...

I have looked at getting insurance on my own for the rest of the family and just take the companies for me... they pay 100% for the employee, but nothing for the family...

However, the 'savings' do not seem to be a lot... and the company helps with the deductible over a certain number... so I guess I will stay with the $1000 per month policy...

It looks like you're in Texas judging by your board name.....how old are your wife/kid(s)?
 
I called the Missouri high risk pool and they said I would be accepted without question, without pre-existing limitations, but I had to exhaust COBRA first. They offer several plans of varying prices but they are very expensive. The woman I talked to said if I could get commercial insurance, she was sure it would be less expensive. However, at least I know I have a backup plan, expensive thought it is, to avoid bankruptcy. It's only going to be for 18 months and who knows, maybe some legislation will pass and be signed into law that will help me out.

The cheapest plan was over $800 a month with a high deductible ($5K, I think). That's for single female 60-<65.
 
What do you mean by "access"? Everyone in America has access to health care. You've already said "affordablity" in the same sentence, so I'm sure this "access" has nothing to do with cost.
The total cost for a lab test at labcorp is $114 for someone with a UHC policy. This cost is split between insured and insurer based on the policy. The same test costs $1400 for someone without insurance. This is not access, it is exploitation.

UHC (along with all other insurers) refuses to sell me a policy in Florida. They will sell policies to other with much worse health but who insure through their employer.

This is what I mean by access and affordability.
 
This is what I mean by access and affordability.

I agree the market for both health care insurance and actual health care is very fragmented and inefficient. IMO, just fixing that alone would solve a very big part of our problems. Price transparency (insurance and services), information on health care outcomes by procedure and facility, availability of individual policies across state lines, allowing non-employer groups to buy group coverage, etc. These reforms would help millions and would do a lot to drive down the cost of care without costing taxpayers a dime. That could be step 1, it is complementary to (not in conflict with) tackling the problems of insuring the poor and the already sick. We can do that, too.
 
Here's what the Dean of Harvard Medical School had to say today.

What he thinks about our national dialogue on the issue so far::

As the dean of Harvard Medical School I am frequently asked to comment on the health-reform debate. I'd give it a failing grade.

What he thinks of our health-care delivery in the US today:
Our health-care system suffers from problems of cost, access and quality, and needs major reform. Tax policy drives employment-based insurance; this begets overinsurance and drives costs upward while creating inequities for the unemployed and self-employed. A regulatory morass limits innovation. And deep flaws in Medicare and Medicaid drive spending without optimizing care.

And what he thinks of the present proposals:
Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that's not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform.

In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system.

. . . .
Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.
In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants.

I suspect my idea of a good solution is different from his, but I agree with his assessment of the present "system" and the proposals now on the table.
 
This quote from Samclean's post which he got from the article...


"Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that's not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform.

In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system.

. . . .
Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.


In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants. "





And how long have I been saying that the bills do not address costs:confused:

I had not considered that they would hamper real reform, but the Dr. seems to think so....
 
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