Profits Before Patients - A PBS Interview w/Bill Moyers

Heh. I need a Cliffs Notes version.

So far, I've found where they say current coverage will not change, and if one needs to add a family member to this coverage after the law takes effect, one can.

Everything looks cool so far. No pre-existing condition restrictions, no restrictions based on medical history, genetic information, past claims history, among other things.

Perhaps I just haven't read far enough into it yet. Plus I'm skipping all the (subsection Title XVII) paragraph (a) strike through blah, blah crap. :p It's probably in there!
 
Okay, apparently the section in question is Section 102:

Sec. 102 (a) (1) (A) - "IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

This dude explains it:

Section 102 is laying out the requirements for Grandfathered Health Care Coverage. This means that the text refers to what an Insurance Provider must comply with in order to keep current plans from falling under the Bill's requirements for Insurance.

Your current insurance will not be required to meet the Bill's policies as long as they don't enroll new people, start charging you a lot more or change any of its terms or conditions.

If for some reason you change insurance providers or re-work your insurance, the New Insurance Policy will have to comply with the policies and requirements of the Bill.

Again, "does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1." refers ONLY to keeping a policy's status as "Grandfathered" or Immune to the requirements of the Bill. It does NOT apply to New Policies."
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Now I feel better. :)
 
Thanks Lori. The "does not enroll new people" clause gives me pause though. I guess that means that if I like my friend's private insurance I can't leave mine and enroll in it because private insurance companies can't take new clients?

If I have that wrong someone please clarify. Thanks!
 
LaughingWater said:
Okay, apparently the section in question is Section 102:

Sec. 102 (a) (1) (A) - "IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

This dude explains it:


Now I feel better. :)
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So what happens when you have a kid and need to add them to your insurance? Or your husbands company goes belly up and you need to switch over to your company's insurance? Will that not be an option? Honestly, it sounds to me like we may be able to keep our insurance for now, but I don't see that lasting in the long run. Dorothy - interesting article. I do not have an educated opinion either way yet. I just hope they don't rush it and screw it up. I'd rather them make sure they do it RIGHT.
 
Exactly Liann, which is why I am sitting back and reading opinions on both sides, and trying to find out the facts. There IS a problem with health care and people not being covered, but how to fix it???

Also, don't full yourself in thinking that this billions of dollars will not fall on tax payers. France's plan is going belly up. It is sited as one of the best socialized systems, works very well for both doctors and patients, but it will be unable to continue, unless further massive funding from their tax payers happens.

Our congresspeople seem to think that money grows on trees. It only grows on my and your trees, and we are going to get plucked dry if this keeps up.
 
Sparrow, you can leave and go with your friend's insurer, but the plan you'll get will be one that falls under the restrictions of the new health care bill.

Liann, family members ~ like new babies ~ are exempt from this. They can be added to an old plan without opening that plan up to new restrictions under the health care bill.

If you lose your old health care plan, yes...you can get coverage again from anywhere you'd like, however the plan you get will fall under the restrictions of the new health care bill.

These restrictions include, among other stuff, no pre-exisiting restrictions, no denial of coverage based on past claims history, medical history, genetic info.
 
Those sections mean access to our accounts? That is scaring me.

Sec. 163, Pg. 58-59 beginning at line 5 - Government will have real-time access to individual’s finances & a National ID health care card will be issued!
Sec. 163, Pg. 59, Lines 21-24 - Government will have direct access to your bank accounts for electronic funds transfer.
 
cockateils said:
Sec. 163, Pg. 58-59 beginning at line 5 - Government will have real-time access to individual’s finances & a National ID health care card will be issued!
Sec. 163, Pg. 59, Lines 21-24 - Government will have direct access to your bank accounts for electronic funds transfer.
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EXACTLY > > > > I don't like that idea at all . . .

Just FWIW - The company my husband works for is small - probably 60 employees total and the CEO said that if this goes into effect then they will drop their insurance (which they pay $30000 a month for) and let everyone do on the government plan as it would be cheaper to pay the cost to do so. There will be many that go this and it won't be 45 million anymore but a much larger number.
 
cockateils said:
Sec. 163, Pg. 58-59 beginning at line 5 - Government will have real-time access to individual’s finances & a National ID health care card will be issued!
Sec. 163, Pg. 59, Lines 21-24 - Government will have direct access to your bank accounts for electronic funds transfer.
Click to expand...

That's not what it says, it talks about the financial responsibility (aka co-pay and deductible) of the patient to be determined in "real-time" - meaning right at the health care provider's office. It also lets you know if that specific provider is an in-network provider which comes in handy because for most insurance plans your copay for out of network providers is much higher. For that purpose a machine readable Healthcare ID card will be issued.

"(D) enable the real-time (or near real-time) determination of an individual's financial responsibility at the point of service, including whether the individual is eligible for a specific service with a specific physician at a specific facility which may include utilization of a machine-readable health plan beneficiary identification card.


The second part that you are referring to talks about enabling electronic funds transfers to allow for automated reconciliation. Right now we have a dinosaur system where payments are done by check
 
Hey Laura - When you get the copy, can you look up the Sections mentioned above and tell us what it really says? (typed this before seeing Carola's response)
 
baylian said:
Just FWIW - The company my husband works for is small - probably 60 employees total and the CEO said that if this goes into effect then they will drop their insurance (which they pay $30000 a month for) and let everyone do on the government plan as it would be cheaper to pay the cost to do so. There will be many that go this and it won't be 45 million anymore but a much larger number.
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And that is bad why? From what you say it sounds like they are dropping the expensive insurance and instead reimburse their employees for the cheaper government plan, or am I missing something? It saves the company money, their employees still have health insurance. How is that bad?

Isn't that one of the Republican talking points that employers can't be competitive because of the unreasonably high health insurance cost?
 
baylian said:
EXACTLY > > > > I don't like that idea at all . . .

Just FWIW - The company my husband works for is small - probably 60 employees total and the CEO said that if this goes into effect then they will drop their insurance (which they pay $30000 a month for) and let everyone do on the government plan as it would be cheaper to pay the cost to do so. There will be many that go this and it won't be 45 million anymore but a much larger number.
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The thing is your husband's employer can drop health coverage now. There is no law requiring employer's to provide health care insurance; they do it to attract and maintain good employees. The incentive for company's to provide health care insurance to its workers will still exist whether there is health care reform or not.
 
BuffyR said:
The thing is your husband's employer can drop health coverage now. There is no law requiring employer's to provide health care insurance; they do it to attract and maintain good employees. The incentive for company's to provide health care insurance to its workers will still exist whether there is health care reform or not.
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The point is that the amount of people going to government run program is going to swell beyond 45million . . .AND THERE IS NO MONEY TO DO THIS!!!!!

Do you really want the government that far up you arse???
 
BuffyR said:
So what's the point? You don't agree that end of life care should be decided by the patient and the patient's doctor?
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The fact that Obama is basically saying maybe a pill would have been the better idea. . .

Don't think for one minute that end of life issues are not going to be impacted by this.

Or the start of life either . . .
 
baylian said:
The point is that the amount of people going to government run program is going to swell beyond 45million . . .AND THERE IS NO MONEY TO DO THIS!!!!!

Do you really want the government that far up you arse???
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A government run health insurance plan is not "free", people have to pay insurance premiums into the government plan - just that with the government there are no $ 744 Mio in stock options for CEOs to pay. It may make for a little more competitive insurance premiums.
 
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