Another very strange Affordable Care Act rule

[peggy]

Why would you expect the purveyors of Obamacare to admit that all may not be rosy with it?

From our President of the United States:
Let me be exactly clear about what health care reform means to you…if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you.”

In the spirit of fairness, this quote may be slightly out of context in that the Prez was talking about plans (if you've got it you can keep it) but unfortunately, that wasn't true, either.

It was true, actually. By the rules of the ACA you could keep your plan, unless you bought a new plan or your INSURANCE COMPANY changed/cancelled your plan.
DING DING DING! Enter the greedy insurance companies. They saw a way to get more money, especially those young, healthy people who hardly ever use their insurance anyway. Funny, the grandma who paid and paid but whose insurance didn't actually cover anything when it was really needed got to 'keep her plan'.
Do you think the insurance company just might have gone through their plans and 'upgraded' those who didn't really use it much, yet 'allowed' those who really could have used better coverage to keep their old useless plan? Naw, of course not. They are way too helpful and honest to do that.

Sure didn't get a lot of press when several of those companies who lied to their policy holders telling them the ACA said they couldn't continue with their old plans, had to reissue those plans to many.

[peggy]

... I understand there is economic pressure on this doctor to behave this way -

No Rob, this guy was an a**hole. Trust me.



OK, I'm going to stop posting. All I can say is, this thread just amazes me how accommodating we are to being screwed.
We have been jerked around for so long by this largely unregulated industry that we trip over ourselves making excuses for them.
Aww, gee, so the unregulated consumer screwing has come to an end. Don't you just feel sorry for the insurance companies? They actually have to follow rules! And Regulations! They can't just take your money for 20 years then deny you service!
What next? Fracking? These people have been in business for years, yet NOW some want to regulate them? Stop them even? Imagine, the audacity of some wanting accountability from an industry! It's unheard of. Why, if some have their way, fracking companies will go the way of asbestos companies. All those poor people out of a job. I mean, it's their water too, right? So they should be able to do what they want, where they want. It's the Libertarian way!

[gimmethesimplelife]

No Rob, this guy was an a**hole. Trust me.



OK, I'm going to stop posting. All I can say is, this thread just amazes me how accommodating we are to being screwed.
We have been jerked around for so long by this largely unregulated industry that we trip over ourselves making excuses for them.
Aww, gee, so the unregulated consumer screwing has come to an end. Don't you just feel sorry for the insurance companies? They actually have to follow rules! And Regulations! They can't just take your money for 20 years then deny you service!
What next? Fracking? These people have been in business for years, yet NOW some want to regulate them? Stop them even? Imagine, the audacity of some wanting accountability from an industry! It's unheard of. Why, if some have their way, fracking companies will go the way of asbestos companies. All those poor people out of a job. I mean, it's their water too, right? So they should be able to do what they want, where they want. It's the Libertarian way!

Hi Peggy! Good to see your spirited posts here on this topic. Question for you, if I may? You don't see my going to Mexico for health care as fighting back against being screwed? I didn't want to post that here as there's been enough inflammation on the police brutality thread and I don't mean to stir the pot here, this is just an honest question and and honest observation. I really feel that by crossing that border and voting with my feet it's also a middle finger salute to US health care in general. This is by far not the only reason I cross the border and not even one of the major ones. Just curious as to your take on offshoring health care in general as a way to get around the issues in your post? And I'd respond to more of your posts here but I'm off to Cheesecake Factory to mystery shop their lunch service so I will do so later. Rob

[peggy]

Going across the border for health care, or to Thailand, is fine, if you can. That's your choice and I would never judge you on that. Some go to other countries to shop, vacation, whatever. Actually, my post wasn't directed at you alone. I hope you didn't read it like that. I meant it for all of us..out there (waves hand over the land)
I just wonder at the backlash at this attempt at regulating an industry that has a well documented history of screwing the customer. Of course I understand it..the black democratic President and all. To be honest ANY democratic president would get backlash, but it wouldn't be with such viciousness. You and I and the Pope know if Romney (or other republican president) had put this in place, every anti-ACA poster on this site would be falling over each other to nominate him to sainthood.
(Look how the good people of this site talked about community organizers simply because...well, I digress)

Actually, fracking is a good analogy. Or drones, although the anti-gov libertarian folks have become strangely quiet on the subject since it has become apparent that it isn't the evil government but rather your neighbor who is more likely to spy on you with drones. I guess that's OK.
We want to regulate fracking because of the obvious harm it is doing. Well, we needed to regulate the insurance industry because of the obvious harm they were doing. And by harm I mean misleading practices, along with denial of service and clearly taking advantage of folks who were confused or easily mislead.

The real problem is we tried to overhaul the healthcare practices while using the same old insurance industry.
Previously unchecked greed ran smack into desire to have everyone covered for even the basics. Then you throw in the republicans, who are always looking for opportunity to obstruct this President, no matter how much it harms their constituents, and it is a mess.

But here's the kicker. It works. And it's working. As messy as it is, and as hard as the republicans try to make it, and the country fail, it's working. And, it's working so well, even some of the obstructionist Republican Governors are singing a different tune. They discovered something I predicted a long time ago. Even their reddest, most anti-Obama, liberal hating lowest informed constituent has realized that they are getting the short end of the stick. Their healthcare sucks, (or is even non existent) and they are slowly but surely figuring out who is to blame. Oh sure many still fall for the Obama-death-panels-government-takeover misdirects, but even the thickest brick will eventually figure it out.

But back to your original question. The main problem is most don't have the option to hop over the border. They have to take the system we have.
Look, republicans will never admit it's a good thing. Just see how they talk about SS! And medicare. And a minimum wage for heavens sake. They don't want ANY minimum wage! So, just like always, they are on the wrong side of history. Again.
Just stop listening to them Rob. Make up your own mind. ..And for gods sake, move to Mexico, cause I think it's pretty clear that's where your heart is. That is where you belong and I believe your constant trashing of the US is because you know it and are just frustrated. So, stop picking on my country and start making plans to move to your country. I believe once you do, the US will not look so bad after all.

[awakenedsoul]

I've had a catastrophic plan from Blue Cross and Blue Shield, and now I have Health Net. I found them on Ehealthinsurance.com. I chose them because they were affordable. I'm currently on the Silver Plan, and I receive a subsidy. I haven't been to the doctor in fifteen years, I view what I have the same way I viewed having a catastrophic plan.

Regarding the girl in the above post who was humiliated by her doctor. What about those Urgent Care places? If you have something like an ear infection couldn't you go there and pay cash? (That's what I used to do...)

[Alan]

Well, we needed to regulate the insurance industry because of the obvious harm they were doing. And by harm I mean misleading practices, along with denial of service and clearly taking advantage of folks who were confused or easily mislead.

I don't think you understand the concept of insurance. It is a determination of risk, including the limits of that risk, and then the determination of a cost to mitigate or eliminate it.

What you seem to be talking about is a cost sharing scheme or a universal healthcare blanket. Neither are insurance.

Your last line sums up a lot of the problems people have with insurance products. They don't seem to know what they've signed up for and yet hold the insurance companies responsible for their confusion.

[gimmethesimplelife]

I don't think you understand the concept of insurance. It is a determination of risk, including the limits of that risk, and then the determination of a cost to mitigate or eliminate it.

What you seem to be talking about is a cost sharing scheme or a universal healthcare blanket. Neither are insurance.

Your last line sums up a lot of the problems people have with insurance products. They don't seem to know what they've signed up for and yet hold the insurance companies responsible for their confusion.

And herein lies a huge problem with US healthcare for me, anyway. It should not be done at a profit. In my book not only is that insane, it should be criminal. Obviously, not many here are going to agree with this and that's fine but one this one, I don't know that I am ever going to change my mind. Maybe the problem is that the insurance companies have their hands all over it to begin with? Rob

[gimmethesimplelife]

Going across the border for health care, or to Thailand, is fine, if you can. That's your choice and I would never judge you on that. Some go to other countries to shop, vacation, whatever. Actually, my post wasn't directed at you alone. I hope you didn't read it like that. I meant it for all of us..out there (waves hand over the land)
I just wonder at the backlash at this attempt at regulating an industry that has a well documented history of screwing the customer. Of course I understand it..the black democratic President and all. To be honest ANY democratic president would get backlash, but it wouldn't be with such viciousness. You and I and the Pope know if Romney (or other republican president) had put this in place, every anti-ACA poster on this site would be falling over each other to nominate him to sainthood.
(Look how the good people of this site talked about community organizers simply because...well, I digress)

Actually, fracking is a good analogy. Or drones, although the anti-gov libertarian folks have become strangely quiet on the subject since it has become apparent that it isn't the evil government but rather your neighbor who is more likely to spy on you with drones. I guess that's OK.
We want to regulate fracking because of the obvious harm it is doing. Well, we needed to regulate the insurance industry because of the obvious harm they were doing. And by harm I mean misleading practices, along with denial of service and clearly taking advantage of folks who were confused or easily mislead.

The real problem is we tried to overhaul the healthcare practices while using the same old insurance industry.
Previously unchecked greed ran smack into desire to have everyone covered for even the basics. Then you throw in the republicans, who are always looking for opportunity to obstruct this President, no matter how much it harms their constituents, and it is a mess.

But here's the kicker. It works. And it's working. As messy as it is, and as hard as the republicans try to make it, and the country fail, it's working. And, it's working so well, even some of the obstructionist Republican Governors are singing a different tune. They discovered something I predicted a long time ago. Even their reddest, most anti-Obama, liberal hating lowest informed constituent has realized that they are getting the short end of the stick. Their healthcare sucks, (or is even non existent) and they are slowly but surely figuring out who is to blame. Oh sure many still fall for the Obama-death-panels-government-takeover misdirects, but even the thickest brick will eventually figure it out.

But back to your original question. The main problem is most don't have the option to hop over the border. They have to take the system we have.
Look, republicans will never admit it's a good thing. Just see how they talk about SS! And medicare. And a minimum wage for heavens sake. They don't want ANY minimum wage! So, just like always, they are on the wrong side of history. Again.
Just stop listening to them Rob. Make up your own mind. ..And for gods sake, move to Mexico, cause I think it's pretty clear that's where your heart is. That is where you belong and I believe your constant trashing of the US is because you know it and are just frustrated. So, stop picking on my country and start making plans to move to your country. I believe once you do, the US will not look so bad after all.

Peggy, you are not being judged in what I am about to say. I just want to be upfront and clear about that much. I find it fascinating that anyone can be so attached to a country that they would stand up for it - and I mean any country, not just the US - with such vigor as you do. When they were passing that quality out, I must have slept in late that day as I am incapable of mustering that up. Please understand this is not just for the US, I mean for any country. So I have always wondered what exactly it is in our socialization process I missed out on as I incapable of this? I'm a total introvert and not much of a joiner at all unless you consider my social activism as joining - but I think it goes much deeper than that. Hmmm.....interesting. Rob

[bae]

And herein lies a huge problem with US healthcare for me, anyway. It should not be done at a profit.

What does that even mean? Are doctors allowed to be paid for their time? At what rate? Are companies that research new technologies and drugs allowed to be paid for their research efforts, and compensated for their risk? Are people who own buildings that are leased out to health care providers allowed to collect rent?

What does "profit" mean, in Rob's World?

[jp1]

I don't think you understand the concept of insurance. It is a determination of risk, including the limits of that risk, and then the determination of a cost to mitigate or eliminate it.

What you seem to be talking about is a cost sharing scheme or a universal healthcare blanket. Neither are insurance.

Your last line sums up a lot of the problems people have with insurance products. They don't seem to know what they've signed up for and yet hold the insurance companies responsible for their confusion.

Actually the very early history of insurance was marine insurance pools where ship owners joined together in cost sharing schemes so that if any one of them had their boat sink all would pay to cover that loss.

and Peggy is right. Insurance needs to be regulated to prevent the 'evil insurance companies' from selling policies that don't cover anything. This has been going on for a long long time. The Standard Fire Policy, still law in 37 states, was the Ny legislature's reaction to property policies that insurers had written which didn't cover much of anything. Part of the actuary's job is to determine what the cost of the policy should be while taking into account the regulations that the policy will be subject to. Sure an auto insurance company could price policies with $1000 liability limits and offer them dirt cheap. But they don't. They price them with at least the minimum regulated limit as required in the state where the policyholder resides. Health insurers having to take into account the coverage and limit requirements of the ACA is really no different.