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The Bomb Buried In Obamacare Explodes Today-Hallelujah!

45 posts
  1. McCallum David K
    McCallum David K avatar
    1/4/2012 7:01 AM
    A good read on this whole thing is "The Truth About Obamacare"........it spells it out clearly in language one can understand.



  2. David Stone
    David Stone avatar
    9 posts
    1/4/2012 7:01 AM
    If you have not already read it I suggest you read the book "Deadly Spin" by Wendell Potter. He is a former health insurance PR exec. who became disgusted with the misconception put out by him and the insurance industry. He went over to the other side. It may open your eyes as to what is true and what is PR to protect the insurance interest. You can also hear some of Wendell Potter's points when he appeared before a senate hearing committee. See what he has to say about insurance companies having to pay 80% of the premiums back for health care. He said they used to pay a higher % than that until the last few years.

    David Stone



  3. Melvin Waldron
    Melvin Waldron avatar
    43 posts
    1/4/2012 7:01 AM
    One thing I disagree with you John, although it is with limited knowledge, but when I was looking for work 8 years ago, (and of course things might have changed in that time) every job offer or interview I had if there was insurance there was a lifetime maximum, most were 1 million, here at the city it was 2 million. That did not change until the new health care act took affect, I sat in a supervisors meeting where they told us they were dropping the 2 million and it was now unlimited. I do remember some jobs had more of a health savings account type plans, or flexible spending plans, with our situation that was a no go for us. Also we checked about the pre-existing condition clauses, in the case here with the city, they did deny coverage for a year, despite when I asked the question, what about my high blood pressure or such, I was told that was fine, even if I had diabetes, once we got settled, they did not cover our son for a year and they changed their pitch on what they told employees, (after my wife told them off). Since they were a self insured plan from a governmental agency (as we were told) they didn't have to cover pre-existing conditions, but would cover at 12 months. Since the change I don't know if they changed that part of their plan, they did change the kids on coverage, even going beyond what the new plan called for in the phase -in, they made it to 26 for all.

    Mel

    Melvin H. Waldron III, CGCS, Horton Smith Golf Course, City of Springfield/Greene County MO

  4. Wahlin Scott B
    Wahlin Scott B avatar
    1/4/2012 8:01 AM
    David McCallum said: A good read on this whole thing is "The Truth About Obamacare"........it spells it out clearly in language one can understand.


    Pacific Research Institute for Public Policy - Language YOU would understand!



  5. Kauffman John M
    Kauffman John M avatar
    1/4/2012 9:01 AM
    Scott Wahlin, CGCS said:
    John Kauffman said: Sean was right. PPACA isn't about helping anyone. PPACA is about changing who pays for health care and how much they pay. Some will contribute, but everyone will pay more. Many will receive less.


    Sean is a very convincing guy, but he manages golf courses not health care systems. In my case I am completely locked into a system where if I should lose my job for some reason I am dead. Under the current system if I lose my job I get COBRA which I can afford for about 15 minutes. The hospitals will literally let you die on the sidewalk outside the ER. I have been there before. It sounds dramatic and it is, but I can remember hearing my wife crying and seeing the tears on the giant orderly's face as he carried me (all 250#) to our mini-van. My liver had completely failed and I was denied medical service by my HMO because my doctor assumed I was a drug addict. I was subsequently given a 5% chance of survival. We need a descent healthcare system in this country and unless you have the money or the hubris of a Republican you fully realize we do not have one.


    I think Sean's a great guy who offers a perspective that many of us haven't seen, as I think you are a great guy who offers a perspective that many of us haven't seen. But, medical insurance (or any other type of insurance, for that matter) is infinitely more complex than what I can understand. I think that nuclear physics would be a cake walk compared to insurance. Maybe this is why its hard to keep posts about insurance short and readable.

    Your situation was certainly unfortunate, but it wouldn't be any better under a single payer system. My mother-in-law's brother in Canada died outside the hospital in his hometown of Winnipeg (not really a small town), because it wasn't his turn to receive care. I don't think we want that type of situation here.

    But, we have to remember what health care is – a service and a product. If I believe in freedom for all, I can't demand that this service or product be delivered from someone else to me at a price not of the provider's choosing, unless I am willing to let others determine my compensation without my input. An insurer is taking risk by agreeing to pay medical claims for a member. We shelled out a little over $3,000 for our son's birth (normal, no complications), while insurance picked up the remaining $25,000. I had only paid about $2,000 in premiums from the time I joined this insurer until the birth.

    However, I think that using insurance for anything but catastrophic events is precisely the problem that has made health care in the US so expensive. When you go to the doctor, do you know what it actually costs to see the doctor? Most of us with insurance only look at our co-pay, but check out the EOB (Explanation of Benefits) you get after the visit. The first four columns are usually a service code, service date, then a billed charge and a contract adjustment. The insurance company doesn't pay what you would if you had no insurance – it costs them something different than it costs you. But, the patient usually doesn't know either one.

    Most of us wouldn't dare buy a pair of pants without knowing the cost, but we'll go to the doctor without knowing the cost – then be upset when it's expensive! Free market function depends on information. The more prices and quality of service are hidden, the more expensive the product becomes.

    Insurance is precisely why things are so expensive now.



  6. Kauffman John M
    Kauffman John M avatar
    1/4/2012 9:01 AM
    And a word about COBRA -- COBRA is so expensive because you're paying the employee's portion AND the employer's portion of the insurance premium.

    So many on the political left advocate employers paying more for employee insurance or more employers offering insurance to employees. COBRA gives you a little insight into how much insurance costs employers and why making it more expensive will reduce the ability of employers to hire employees or will shift more of the insurance cost to employees.



  7. Wahlin Scott B
    Wahlin Scott B avatar
    1/4/2012 9:01 AM
    Police and Fire Protection are not Free Market. You can purchase your own if you have the means, but otherwise these are provided. I think Health Care should follow the same pattern.



  8. Kauffman John M
    Kauffman John M avatar
    1/4/2012 10:01 AM
    In wishing this, I would have to caution us to be careful what we wish for. I would suggest reading the following links:

    http://www.patientpowernow.org/2008/06/health-care-police-protection/

    http://www.patientpowernow.org/2008/06/health-care-fire-department/

    The purpose of police protection is to apprehend suspects after crimes have been committed (identify what went wrong, in medical terms). Beyond that, police have no duty to do anything else. I want my doctor to do more than tell my family why I died. The purpose of fire protection is to keep my house from burning to the ground. But, it does not help me to rebuild. I would like my doctor to keep me from dying AND I would like him to help me get better. So, I don't want my health care to look anything like police or fire protection!

    I don't know about where you live, but in each of the 8 towns I've lived in at different times of my life, the fire department and ambulance services sent you a bill for what they did – much like going to the doctor.

    I also look at my mother-in-law's family in Winnipeg, how her brother died outside of the hospital because it was not his turn for treatment that month, and how they drive to North Dakota or Minnesota for routine doctor visits, as well as larger procedures,. I wouldn't wish that kind of system on my worst enemy.



  9. Stephen Okula
    Stephen Okula avatar
    3 posts
    1/4/2012 11:01 AM
    John Kauffman] But, we have to remember what health care is – a service and a product. If I believe in freedom for all, I can't demand that this service or product be delivered from someone else to me at a price not of the provider's choosing, unless I am willing to let others determine my compensation without my input. An insurer is taking risk by agreeing to pay medical claims for a member. We shelled out a little over $3,000 for our son's birth (normal, no complications), while insurance picked up the remaining $25,000. I had only paid about $2,000 in premiums from the time I joined this insurer until the birth.


    Something is seriously wrong in the U.S. that a normal, uncomplicated birth costs $28,000. That's just crazy.

    My wife spent three days in an excellent private hospital in a private room for a normal, uncomplicated birth just outside of Paris, total cost the equivalent of $7,000, of which I paid around $100. The care she received was impeccable, absolutely no problems. In fact, she delivered two children three years apart and the experience was exactly the same both times.

    I refuse to believe that Obama is gouging the American public, rather there is something fundamentally corrupt about the entire U.S. healthcare and insurance system, since way before any of us heard of Obama.



  10. Wahlin Scott B
    Wahlin Scott B avatar
    1/4/2012 11:01 AM
    In my municipality the police are expected to prevent crimes. We are not too far from Miami and it can be a pretty rugged area. Between detectives, undercover, SWAT and uniformed officers they are hardcore, fast speed and do one heck of a job. I am sorry about your family member who died outside the hospital in Canada, but as I said that nearly happened to me here too. Your family member was waiting to be served, I was turned away with no hope whatsoever.



  11. Kauffman John M
    Kauffman John M avatar
    1/4/2012 11:01 AM
    Stephen, you're right -- it did cost entirely too much. But, I was a bit midleading. Those numbers were the Billed Charges on the EOB. The Contract Adjustment charges were les than half of that. Either way, it was too much. If insurance wasn't part of the system at all, information about costs and quality of competitors would be better known and competition could drive down price. Also, no one would pay the large bills if insurance didn't exist, so providers would be forced to drop their prices.

    I understand crime prevention, Scott, but read the links I provided -- it really explains what I'm talking about. Crime prevention can still only react -- you can't arrest someone before they do something bad. In fact, the supreme court (South v Maryland, 1865) ruled that police have no obligtion to protect one private person from another private person and the 7th Circuit court of appeals (Bowers v DeVito, 1982) that "there is no Constitutional right to be protected by the state against being murdered by criminals or madmen."

    Our policemen are great people and my brother-in-law is is one of them (as was my father). But, I don't want my health care to resemble their jobs or structure at all. I much prefer doctors and hospitals (as I've said before) WITHOUT insurance companies.



  12. Dennis Cook
    Dennis Cook avatar
    1 posts
    1/5/2012 8:01 AM
    Melvin Waldron, CGCS said: Dennis I disagree about the 26 year old staying on parents policy as being bad, but it might only be relevant to our situation but I see it good for others as well. Although it might become irrelevant as the Affordable Care Act kicks in, I'm not sure.

    I do know the pre-existing condition hurt us some the first year I worked for the city, luckily our prescriptions were covered that first year.

    If one has a child that has a genetic condition for him or her to go purchase a policy for themselves it could be quite expensive, so it helps keeping them on our policy. Now if he is lucky enough to have finished college and found a good paying job then that might be different, but at this time we see this issue with lots of people, not just those with a situation.

    Mel


    Mel, in the situation you described, with the genetic condition, we are a country that has always taken care of those who cant take care of themselves. Thats why we have disability programs and medicaid and medicare. The current law already allowed young adults to stay on there parents policy through age 24 if they were enrolled in school. If they choose not to go to school and are unable to work, they would get disability and have all there medical covered, by the taxpayer. If they are capable of working and get a job and dont go to school, then thats a life choice they make and they need to budget a portion of their earnings to buy a policy. It wont be expensive, because they are young. Why extend the age from 24 to 26, other than to increase dependency. A 24 year old who does not have a disability, is considered an adult, but we treat them like they can't get by because life is so difficult. So we take money from one person and give it to another person, in an effort to buy their vote in future elections. Health insurance for a 24 year old who is healthy and capable of working is very inexpensive. The problem is that we take that responsibility away from them so they can be irresponsible and spend that money on flat screen tv's, fancy cars, restaraunt tabs, and the like. We should be resisting things like this so that young people learn to be responsible and understand that the first thing you buy after food and shelter, is health insurance. Then whatever you have left, dictates the type of car you drive and all the comforts of life you can afford.
    Why is it that most people can figure out that when they have a family they need to buy life insurance, but they expect medical insurance to be given to them. They both serve the same purpose, to help in a catastrophic event, but we have stigmatized health insurance to mean health care. We have changed the definition of it so that we expect someone else to pay for everything that we do when it involves a doctor, including the office visit



  13. Sean Hoolehan
    Sean Hoolehan avatar
    0 posts
    1/5/2012 10:01 AM
    To Scotts, point I am not a health care manager, but I have spent the past 12 years as a member of a small committee that oversees a self-insured medical insurance plan for my employer insuring over 1600 people. In the course of serving on this committee I have had many hours of training/learning the ins and outs of health care. One thing I like to communicate to our employees is that the medical plan is money in and money out. To call a medical plan insurance these days is a misnomer, it is a program that must include education, preventive benefits and shared costs to be effective.

    If you know me I am a proponent of health care reform including insurance reform, but to reform health care in the USA you must reform Medicare/Medicaid. The Health Care industry in the USA is involved in a very expensive Shell Gam", the providers are guessing where the insurance companies are hiding the Pea. The Pea is actually coding, what codes pay well and what codes pay poorly is very important for providers to know. Medicare and Medicaid is adjudicated by insurance companies. Medicare rates are generally ½ of what is actually billed, but not always. Providers are adept in knowing what pays well and what does not. You might check out this group. http://madashelldoctors.com/ They are for single payer health insurance and strongly opposed to the PPACA on the grounds that it does little to correct the problems. I do not agree with everything they propose but they are on the right track. The PPACA is a political program that does little to fix the system, and will make health care more expensive for the average American not less. There are many other reasons for the rapid rise in health care cost which cause the rapid rise in insurance premiums. In bygone days people studied medicine and medical research to save/improve lives. One could argue that in more recent times with a more monetary motivation we have seen a more rapid rise in innovation and as a result improvement in quality of life. Why wait for your hip pain to reach the 9-10 pain scale. Fix it now while it is only a 6. I live in a small rural City of 16,000, we have a hospital and a private out-patient surgery center competing against each other. Trust me the surgeons who own the surgery center understand that they need to keep it busy. It is not immoral to fix a problem like sinus surgery, carpal tunnel, and other less evasive types of surgery to improve someone's life. With the present technology, medications, training of doctors, surgeons, our expectations of a healthy life have changed dramatically the past 30 years. We hear a lot of support for HSA's but in truth they can lead to bigger problems as people let things go to save money, catch things like cancer, diabetes, hypertension, and heart diseases early and you will save a ton of money. People need to see their physician as regularly as their age, and condition require. They should be rewarded not penalized. Mental health cannot be over looked as its importance to a person's overall health. A employer who provides medical insurance is wise to encourage employees to use the preventive part of their insurance regularly. If you think going to the doctor when you have the flu, or a cold (not that I would encourage either) is what is driving up cost you have it wrong. Large Claims are what really drives up premiums, 5% of all claims can account for 50% of costs. Preventing large claims is the present Key to maintaining (they are not going down) expenses and premiums in a health plan.



  14. Melvin Waldron
    Melvin Waldron avatar
    43 posts
    1/5/2012 8:01 PM
    Thanks for the insight Sean, too bad our politicians didn't have that insight.

    Mel

    Melvin H. Waldron III, CGCS, Horton Smith Golf Course, City of Springfield/Greene County MO

  15. McCallum David K
    McCallum David K avatar
    1/6/2012 6:01 AM
    Sean good post but going back to many of Scott's previous post.....serving on a committee probably does not (in his eyes) give you any more insight into this issue that the guy on the street........plus it was way to wordy. To post something that long one MUST have credentials.



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