Another very strange Affordable Care Act rule

[gimmethesimplelife]

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?

I don't agree with the American model of health care in so so so many ways, Bae. The research that you so approve of leads to the highest prescription drug prices in the world in the US - don't believe me, do the research yourself. Certainly you must know that many people flee to Canada (or down my way to Mexico) for meds, Bae - there is a reason for this. Because America doesn't care if you get your meds or not - meds are priced accordingly here and as IL says, there are winners and losers now with the advent of ObamaCare. I am one of the winners for the moment as my meds are free. This does not mean I live under any illusion that things will remain that way for any length of time, though. But I digress. I see health care as a basic human right. To have insurance companies meddling in it does cause a lot of problems because when profit needs to be made, basic human rights go out the window and health care becomes constant feuding and fighting and wondering if you can sue and never work again. I have so much sympathy for those who don't qualify for Medicare or Medicaid and live far away from the border. I don't even think if I made more money, would I even want to buy insurance on the exchange? I guess maybe for life and death situations but for anything else, I'm going to cross the border going forward. It means more basic human rights for me if I choose to do so. And we all know by now for me human rights triumph above all else, that I have no loyalty whatsoever to any country or to any way of doing things, and that I'm able to think independently for myself and do what I believe is right with no regard for the opinion of others - at least as far as access to health care goes. Rob

[gimmethesimplelife]

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.

+1 Rob

[peggy]

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 I don't think you understand, or would rather gloss over, the history of insurance 'fraud' from the insurance companies themselves. If the insurance companies were a good honest industry, we wouldn't have needed the ACA in the first place. We still don't 'need' it in that we should just have universal health coverage instead of this.

I know what an insurance company is. And within that model, dishonesty was rampant. I'm talking about people paying years into what they thought was a good policy only to be denied coverage because they failed to 'report' acne as a teen. I'm talking about even considering acne a pre-existing condition (but only when you actually make a claim)
I'm talking about denying coverage for ridiculous reasons..."Oh, you had a baby 10 years ago? Well, we won't pay for your broken leg because of this pre-existing condition."

How about taking money for polices that don't really cover anything.
Yes, they are businesses who want to make money. All businesses want to make money. Almost all businesses are regulated in some way. The ACA is a set of regulations. And the gov bent over backwards to make sure insurance companies still make money. IN fact, the ACA is a windfall for them. They just want it both ways. They want the new business without the rules. Tough. If they can't make money then they should just quit and do something else. I'm guessing they won't.

Why do you Alan think this particular industry should be allowed to do business without any regulations? And why do you fight against everyone having basic health care?
You want to regulate voting (even though there aren't 10 cases of voter fraud in the country)
You want to regulate women's bodies and health care choices
You want to regulate who can marry who
But guns and insurance....not so much.

[Alan]

Why do you Alan think this particular industry should be allowed to do business without any regulations? And why do you fight against everyone having basic health care?
You want to regulate voting (even though there aren't 10 cases of voter fraud in the country)
You want to regulate women's bodies and health care choices
You want to regulate who can marry who
But guns and insurance....not so much.

Claims without merit designed to inflame low information types. If you want to debate me, you'll have to try harder.

[peggy]

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

Well that's just sad Rob. I'm sorry you can't feel loyalty to your home. I can't make fun of that.
I am an American. This is my home, and I think it's a pretty good one. In all my posts I have never once said it was perfect, or the best in the world. It's the best place for me, but I would hope everyone feels that way about their home. And if they don't, like you, then I think they should find that place that is best for them.

I think, for me and I'm thinking for many here, what we object to is your constant harping and trashing based on clearly distorted views of reality. Those things you criticize the US for do not exist anywhere else. Sure, most modern countries have universal health care, but none of them are a 'lay on your couch and get free stuff' society. They require things of you to ensure everyone gets that health care. To be honest Rob, there probably isn't a one of those countries that would accept you as a citizen. And here is something else you may not realize. Many of those countries don't take too kindly to constant criticism as well as the US.
Now I'm not trying to sell you on the US. Trust me when I say you should move to Mexico, or wherever as soon as you can. Live somewhere else for a while, then see how they take your constant trashing. Frankly I don't think you will ever find a place that is all you think it should be, nor a society that is going to give you all you think you are entitled to, and that's sad. That's what I think is sad. No place is perfect. Certainly not the perfection you envision, and you will never be satisfied.
But that's your own fault. Not this country's or any country's really. You so desperately want confirmation of these perceived faults that when something happens you go see! see! what did I tell you!
Even when things don't go wrong, and good stuff happens, like you getting health care coverage, you still piss and moan and say...well, I got lucky, but just wait. This other bad thing that I can imagine just might happen, and..and this is a crappy country and I should move to Mexico.

So move Rob. Move to Mexico. And leave my country alone. Cause I like my country, warts and all. I love it. No it isn't perfect, but I'm mature enough to not let the perfect get in the way of the good. I have lived in other countries, as it turns out. And they were pretty good countries. I enjoyed them. But I loved coming home, because this is my home. This is where I grew up and this is where my family is.
Do I love that people get passionate about things and fight to make it better? Hell yeah! I get very passionate myself about ideas and policies (couldn't guess could you!)
Do I like petulant 'children' who only complain and piss and moan because they haven't been given everything they think they deserve without any effort? No. Hell no.

America is completely unique in the world. In the way we look, act, and function. We are freer than most, and harder than most. You have the freedom to be wildly successful, and the freedom to fail spectacularly. This is citizenship 101
Please don't mistake the liberal/democratic ideology as one of disdain/dislike for this country. Or a pass to freeload for handouts without effort. We may not have our Sarah Palin wrapped in a flag shooting guns and screaming the national anthem, but we love our country with a passion. We believe in the dignity of all work (living wage), giving a hand up when needed, and 'community organizing'. (had to throw that one in )

I guess this is a long (and ridiculously wrapped in flag-ish) way of saying I'm really sorry you can never love your home.
It's a failing I can never criticize, only pity.

[peggy]

Claims without merit designed to inflame low information types. If you want to debate me, you'll have to try harder.

no I don't want, or need to debate you Alan. You are an excellent conservative. A credit to your party. I know where you stand on every issue.

[Alan]

no I don't want, or need to debate you Alan. You are an excellent conservative. A credit to your party. I know where you stand on every issue.

LOL, Peggy. You mis-represent where I stand on some issues and imagine others. But, that's what makes you an entertaining poster.

[iris lilies]

Well that's just sad Rob. I'm sorry you can't feel loyalty to your home. I can't make fun of that.
I am an American. This is my home, and I think it's a pretty good one. In all my posts I have never once said it was perfect, or the best in the world. It's the best place for me, but I would hope everyone feels that way about their home. ...

I can just hear Sean Hannity saying "peggy, you are a True American!" I don't mean this in a snarky way.

[Lainey]

I think Rob specifically said, Loyalty "as far as access to health care goes."

So I disagree with those saying Rob should leave the U.S. - it smacks pretty close to the dismissive "love it or leave it" that was hurled at those protesting the Vietnam War. Is our democracy so fragile that we cannot tolerate any dissent?

Stay here Rob and continue to give your opinion and vote for more access to health care - that is your right, and we should be applauding you for your exercising your rights, not trying to shut you down.

[iris lilies]

I think Rob specifically said, Loyalty "as far as access to health care goes."

No, you are wrong. Rob is desperately unhappy with these United States on many fronts and has made at least 50 posts over past several weeks on these things that make him unhappy:

1) class structure and hypocrisy about same
2) his own low social caste (although there are things he likes about that)
3) inability to get a good job in the U.S.
4) his East Coast extended family's greed and consumerist expectations
5) his high school classmates' attitudes toward him and treatment of him
4) corporate greed in the U.S.
5) police (individuals) and policing (policy & practices)
6) gun culture in the U.S.
7) he can't push home a grocery cart any more

...to name a few

and I am leaving out the many, many issues he raised on healthcare in the U.S.

I've got nothing against the philosophy "stay here and address these problems, use your voice to change it."

I do have something against crying wolf again and again.