What's in the Healthcare Bill for You?

I think we should all just bend over because here it comes again. I don't see any of those elected clowns having to use Medicare or Social Security.

I guess the new name for Medicare is Nocare. Or Obamacare.

Does anyone out there know whether sleep apnea is considered by health insurance companies a pre-existing condition that either precludes getting a new health insurance policy or results in higher premiums? Just one of many pieces of data that might make the question "what's in it for us" a bit easier to answer.

As a worker in the healthcare field I have been folllowing both of these bills fairly closely. Just this last week as the Senate bill was going through I ask a few of my friends who are supporting the bills (some Dem some Repub) just whats it is they like about the bills. There are things I like and dislike about both bills so I was interested in their views. Every single one of them mentioned that the bills would provide affordable healthcare to individuals with pre-existing conditions. I asked them what part of the bill guarantees that the coverage will be affordable, and none of them had an answer for me. So I put the question to those of you here who have stated a similar position, not trying to sound challenging, but merely as a question of clarity because I have read both bills and frankly I don't see anything that guarantees the coverage will be affordable.

Just so you understand where I'm coming from, for example if I lost my job tomorrow and OSA (which I have) is considered a pre-existing condition, what is preventing the insurance companies from saying "Sure we will insure you with your pre-existing condition, your monthly premium will be $2,500 a month for an individual policy".

Yes I am aware that there are rebates and such built into the bills, but that is not an answer. How much are the rebates, to whom do they apply, is there a qualifying income, can I drop my work coverage and get private insurance with the rebate if it's cheaper?

Again, I'm not trying to challenge anyone or shoot holes in the bill, I just want to understand what I'm supporting.


AKCPAPGUY

Jay K wrote:Does anyone out there know whether sleep apnea is considered by health insurance companies a pre-existing condition that either precludes getting a new health insurance policy or results in higher premiums? Just one of many pieces of data that might make the question "what's in it for us" a bit easier to answer.

I am losing my company-provided health insurance on January 1 due to bankruptcy of the company. I took out a private policy for myself, wife and daughter. I was given the lowest health rating due to sleep apnea and my wife got a medium rating due to hypertension. My daughter got a preferred rating. It is a high deductible policy with copays and my premiums are $15,000+ per year with BCBSNC.

According to an agent, I could have gotten a policy with another company at a little cheaper premium with a rider that excluded any coverage for sleep apnea. Had I been rejected altogether, there is a high risk insurance pool run by the state and the premiums would have been $16,000 per year.

My wife and I did not have much time to get a new policy, so we did not do as much research as we would have liked. Over the coming months we will research and I already have an inkling we will be changing policies.

My son's employer also filed bankruptcy and he took a high deductible BCBSNC policy for $54 per month. He is 24 and a 'preferred' health risk.

Everything will vary depending on your state and whether you have any preexisting conditions besides apnea.

If you think this new bill is going to make your situation better, you should go back and read in my OP what I reported the socialtists are saying about the bill:

- the Senate bill, which mirrors the central flaw of the House bill as well, is that it "cedes far too much power to the tyranny of a callous insurance industry,"

- the current bill may lock into place a dysfunctional and inhumane system that threatens to move beyond the reach of more comprehensive reform for generations to come.

- the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the health care industry lobbyists

- an individual mandate forcing the uninsured to buy private insurance or be criminalized and subject to fines, in fact symbolizes the power of the insurance industry.

- The likely outcome is that far too many people will still face health care insecurity or medical bankruptcy due to ever rising out-of-pocket costs, or continue to skip needed medical care because of the high prices.

- will push employers to further reduce benefits for workers, and shift more costs to employees

- weak price controls on insurance companies

- the inequity of the entire provision

- lining up millions of new customers for the insurance giants, while failing to stop their price gouging or significantly cracking down on denials of claims

- Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

- Allowing insurers to charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

- Insurers may continue to rescind policies for "fraud or intentional misrepresentation" - the main pretext insurance companies now use to cancel coverage.

- the insurance companies stand to gain tens of millions of new customers and at least $447 billion in taxpayer subsidies

JohnBFisher wrote:
But don't just take my word for it:

Matthew 25:35-40 wrote: 35 ‘For I was hungry, and you gave Me something to eat; I was thirsty, and you gave Me something to drink; I was a stranger, and you invited Me in; 36 naked, and you clothed Me; I was sick, and you visited Me; I was in prison, and you came to Me.’

37 “Then the righteous will answer Him, ‘Lord, when did we see You hungry, and feed You, or thirsty, and give You something to drink? 38 ‘And when did we see You a stranger, and invite You in, or naked, and clothe You? 39 ‘When did we see You sick, or in prison, and come to You?’

40 “The King will answer and say to them, ‘Truly I say to you, to the extent that you did it to one of these brothers of Mine, even the least of them, you did it to Me.’

.

John,

About the message of Jesus, I assure you that there is absolutely nothing imploring us to organize governments to help others. I have talked to New Testament scholars often about this and they consistently say his message was about one-on-one love and charity and are surprised that I would even ask the question.

About organizing governments to help others, I will say the current effort is horribly disorganized and will harm many more than it will help. Plus according to what I read it will help the “hungry, the thirsty, the sick” much less than it will help the warm, well-fed, well-clothed insurance companies.

JohnBFisher wrote: By the way, does this bill REALLY address the need to help one another? Oh, it might help some. It certainly can help remove some problems. It certainly is not the entire answer. …… We must be concerned about one another. That is why I hope (foolish as it might be) the final legislation will help improve the lot of all citizens. Will it? I certainly don't know.

You offer very little hope in those words and we know that this very little hope comes at a huge cost to all of our society.

JohnBFisher wrote: But doing nothing is not acceptable as a responsible citizen of this country and as a person of faith.

Now we agree on something! Doing nothing is not acceptable. But doing the horribly wrong thing is also not acceptable.

Thank you, PST and JohnBFisher. Thank you.

rooster wrote:... About the message of Jesus, I assure you that there is absolutely nothing imploring us to organize governments to help others. ...

Rooster, I think you will find that we are closer in thought than you might believe.

There is no doubt that we are encouraged to care for one another - as individuals and as a community of believers. In fact I heard the Bible described as a lengthy answer to the very first question posed in the Bible: "Am I my brother's keeper?" As you know, the answer is a resounding "Yes!"

rooster wrote:... according to what I read it will help the “hungry, the thirsty, the sick” much less than it will help the warm, well-fed, well-clothed insurance companies. ...

I agree. That is why I want to see some stratagy or stratagies that increase competition. My preference is to encourage the companies to compete our business. That's the advantage of the approach used to provide healthcare for federal employees. It's not perfect, but the increased competition helps improve the service they provide.

Lacking that approach I would endorse a "public" option. But I tend to want to avoid that, since I think such government systems tend to lead to far more graft and mismanagement than a competitive insurance environment.

rooster wrote:

JohnBFisher wrote:... That is why I hope (foolish as it might be) the final legislation will help improve the lot of all citizens. Will it? I certainly don't know.

You offer very little hope in those words and we know that this very little hope comes at a huge cost to all of our society.

Again, I see a big picture. From what I can see, no action will eventually cost us more (individually and as a society) than this bill will cost. But I do not think it is the "be all and end all" to solve our healthcare problems. More on that later.

rooster wrote:

JohnBFisher wrote:But doing nothing is not acceptable as a responsible citizen of this country and as a person of faith.

Now we agree on something! Doing nothing is not acceptable. But doing the horribly wrong thing is also not acceptable.

Again, I think we are closer in thought than you might imagine.

I am a moderate Republican, which the current Republican Party seems to dispise. I want to find reasonable, workable solutions. No action (as the Republican party appears to have proposed) is unacceptable to me. It is unacceptable as a citizen who SHOULD care about other citizens. The Republican party was not founded on the principles of Big Business and "Me First". (Nor am I saying you embrace that view. If anything, I see you as someone who cares deeply about others and worries about the consequence of this bill.)

The Republican Party was built shortly before the Civil War when we were concerned about the concequences of failing to meet the obligations we have to one another. We should remain united. ALL members of the society should have an equal opportunity. Not have it handed too them on a plate. But all should have the chance to reach for the stars!

I also firmly believe we as individuals are called to care for one another. But how many people really do that? This is not a new problem. I do not endorse a "nanny" state, but we can not rely on the good will of individuals. Several years ago, UnitedHeath Care proved we can not do that. They gave a bonus to their outgoing CEO at the same time they started to deny coverage to people they insured. Suddenly none of the hospitals or doctors in my county were covered. My wife was undergoing medical treatments at the time. I had to eat thousands of dollars of cost. But their CEO walked away with a retirement bonus of almost $1,000,000,000. No, that's not a typo. He got almost one BILLION dollars. We can not rely on the good will of individuals, because people can be very evil.

Regardless of all the politics, none of this will get better unless we as individuals and as a society change how we approach healthcare. Right now the system only works by trying to treat a disease. If we encourage doctors to only test and only pay them by the number of tests they request, then costs will continue to escalate.

We (as individuals and a society) must assume responsibility for ourselves. My doctors do not manage my healthcare. I do. I challenge tests that are requested. If they don't make sense, I say "NO!". Let me provide two recent examples:

My neurologist / sleep specialist wanted to run lots of test to rule out causes of my neurological condition. I asked "Will it change anything in how we manage it?" The answer: No. So, why do more testing? No, thank you.

My neurologist / sleep specialist wanted me to redo my BiPAP titration sleep study. I asked "Since I had a horrible time falling asleep and staying asleep due to central apneas, what would the second test prove?" The answer: Oh, nothing. So why repeat that test? Ah, we started to address some of the fundamental problems. A new sleep test was ordered with an ASV unit. It was another expensive test, but had a higher chance of helping.

My doctors either accept that they act as a consultant to help me manage my health, or I find another doctor. DME's either act as my agent to help me manage my health, or I find another DME. I have very high standards and I expect them to adhere to MY approach. My approach does not violate any laws, but puts me squarely in charge of my health. And I fear few will accept that level of responsibility, because it means each of us are responsible for what happens to our health (good or bad). And all too often, people just want someone else to blame.

Okay. Sorry for pulling out the soapbox. I will put it away and try to stay away from these posts for a while.

PST wrote:

Gerryk wrote:I can answer that too not just Rooster. I have taken small pay hikes so that I could get benefits where I work such as healthcare. I saw this coming well over 20 years ago. The Me generation with the immediate gratification sure haven't helped this country much. I do feel sorry for people who don't have insurance, but I have given up pay increases so I can have insurance, and I find it discusting that I should be taxed on my benefits so the people who didn't have the foresight to get insurance through work benefits can now have coverage via my back pocket.

And that could all be lost instantly if the company fails. You could lose everything you worked for if that job goes away and you can't replace the coverage because you are already sick. I've had the same experience you've had -- taken less in pay to have first-class health insurance. I can tell you from the heart that the second thought that went through my brain six years ago when I was diagnosed with cancer was that if I lose this job, my family and I are completely screwed. I may have the skills to find another one, but I can't be sure of insurance coverage ever again. This is not just a problem for the imprudent. Everyone faces risk they can't guard against today that they many not be able to get health insurance in the future. That's what this bill changes, and that's why it is essential even if we all can find things to criticize in it. Finally, I don't believe that the bill taxes any recipients on their benefits. There is a proposed tax on employers for certain plans that are much more costly than normal.

I took less in pay because I wanted better benefits. I don't worry about my job going away. If my job goes away, this will not be a world I would want to live in. I have over 20 years on my job and only have a few guys more senior than I am. If something were to happen that I got layed off or my job was gone this country would not exist. People will always need help when they are sick, will always do stupid things and get hurt and will always do stupid things and start their house on fire. If it weren't for people doing stupid things, I wouldn't have a job.

Now that may be selfish on my part but too bad, that is what we negotiated years ago and some jerk on the east coast should not be taxing me for that.

rooster wrote:I know many of the Democrat members here are happy that the health care bill continues to move toward enactment. It is quite puzzling to me why you are happy. The bill seems to offer none of what you have stated here that you want.

It would be interesting to have you tell us what you think you are getting out of this bill. Just one or two items would be very enlightening, because I just don't get it.

I went over to my enemy's site (the Socialists) and here is some of what they say about the bill:

- the Senate bill, which mirrors the central flaw of the House bill as well, is that it "cedes far too much power to the tyranny of a callous insurance industry,"

- the current bill may lock into place a dysfunctional and inhumane system that threatens to move beyond the reach of more comprehensive reform for generations to come.

- the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the health care industry lobbyists

- an individual mandate forcing the uninsured to buy private insurance or be criminalized and subject to fines, in fact symbolizes the power of the insurance industry.

- The likely outcome is that far too many people will still face health care insecurity or medical bankruptcy due to ever rising out-of-pocket costs, or continue to skip needed medical care because of the high prices.

- will push employers to further reduce benefits for workers, and shift more costs to employees

- weak price controls on insurance companies

- the inequity of the entire provision

- lining up millions of new customers for the insurance giants, while failing to stop their price gouging or significantly cracking down on denials of claims

- Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

- Allowing insurers to charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

- Insurers may continue to rescind policies for "fraud or intentional misrepresentation" - the main pretext insurance companies now use to cancel coverage.

- the insurance companies stand to gain tens of millions of new customers and at least $447 billion in taxpayer subsidies

So, please, what do you think you and our fellow citizens are getting out of this bill?

Smoke and mirrors used to hide the true cost of the bill. This is legislation at it's worst. Revenue starts immediately benefits several years later. Higher taxes both direct and indirect. Additional revenue for insurance companies with minimal additional risk. The bill is not health care reform - It is an awkward attempt at insurance reform. To truly reform health care all medical providers and insurance companies should be treated similar to utilities with regulated costs and a given return on investment allowed. Essentially the bill provides a blank check for the insurance industry while ignoring cost containment. Ever wondered why, if one is insured, the cost of a hospital visit, etc. is roughly half of that one without insurance would pay. The amount allowed by insurance is essentially the true cost of care while those with no insurance are charged full price. I have always been thankful I have had good insurance coverage through my employer, but as I look at the bill that will likely become law I am horrified, as most that voted for or against the bill have not even read it. Then, of course there are the bribes to states such as Nebraska to get their senator to vote for it - What was it our fearless leader in Washington said about change before he was elected? Looks like more of the same if not worse than before. All one need review to consider how our current legislation will be in the end is prescription drug care - The correct route would have been to provide prescription drug coverage for anyone with medicare rather than introducing another layer of coverage through private insurance - Could have saved substantial money by eliminating the middle man. There was a reason the insurance industry supported the prescription drug bill, and that reason is the same as their support for the health care bill, which is that they stand to reap substantial benefits. Read some of the articles on insurance company's considering IPOs in the future - Do you think there could be a reason they are considering that type of action? The bill will make health care worse, not better. For those that think they will get a better deal you are in for a very rude awakening. The current legislation is nothing more than socialism at its' finest.

Kilopy wrote:Smoke and mirrors used to hide the true cost of the bill. This is legislation at it's worst. Revenue starts immediately benefits several years later. Higher taxes both direct and indirect. Additional revenue for insurance companies with minimal additional risk. The bill is not health care reform - It is an awkward attempt at insurance reform. To truly reform health care all medical providers and insurance companies should be treated similar to utilities with regulated costs and a given return on investment allowed. Essentially the bill provides a blank check for the insurance industry while ignoring cost containment. Ever wondered why, if one is insured, the cost of a hospital visit, etc. is roughly half of that one without insurance would pay. The amount allowed by insurance is essentially the true cost of care while those with no insurance are charged full price. I have always been thankful I have had good insurance coverage through my employer, but as I look at the bill that will likely become law I am horrified, as most that voted for or against the bill have not even read it. Then, of course there are the bribes to states such as Nebraska to get their senator to vote for it - What was it our fearless leader in Washington said about change before he was elected? Looks like more of the same if not worse than before. All one need review to consider how our current legislation will be in the end is prescription drug care - The correct route would have been to provide prescription drug coverage for anyone with medicare rather than introducing another layer of coverage through private insurance - Could have saved substantial money by eliminating the middle man. There was a reason the insurance industry supported the prescription drug bill, and that reason is the same as their support for the health care bill, which is that they stand to reap substantial benefits. Read some of the articles on insurance company's considering IPOs in the future - Do you think there could be a reason they are considering that type of action? The bill will make health care worse, not better. For those that think they will get a better deal you are in for a very rude awakening. The current legislation is nothing more than socialism at its' finest.

What are you? ... some parrot that broke free from FOX NOISE.

I don't agree with or support the bill either but the least you can do is think for yourself. Geeze ....

Actually I can think for myself. Looks like my thoughts are as close to original as it gets, particularly yours. I can actually read and think for myself, unlike most. Also, I am one of the people that will be footing the bill for this fiasco. I see it as the way people that work hard and are successful get rewarded by our government.

Ref. Democracy, if we have 85% of people happy or just fine with thier insurance, and 15% that don"t have or just don't care about insurance. Why are we having this Obama Care (Obamanacion) shoved down our throats, wouldn't make sense and be cost effective just to buy health insurance for the ones that don't have it or just don't care about it. Wait what am I saying, this make sense and in Washington it wouldn't work. For those out there who say not caring about the uninsured is wrong what about them caring themselve, or that just so wrong. Our expectation of government is way too much, when we give them so much power you can expect control over what you do with your life. For example: tax on softdrinks, fast foods, liquior. Some of us do have selfcontrol and don't want government control. If you want healthcare, there are way of getting it. Serve your country is one, the military has great medical plans, once you finish your time honoralbly the VA has excellent health care. There are many others in the private sector that offer insurance plans. The dilema is that no one wants to pay for them. They would rather spend thier money on vices. So now we have to pay for them anyway. What is in the Government health, Insurance plan. Does any really know? Ried knows but he's not telling. Oh, one big mistake that is going to happen, we will pay for it and not get any benefit from until four years have passed. Is there anyone out there who would like to buy a car and make payments for four years and not get until it's paid for. Just some thoughts to think about.

"What are you? ... some parrot that broke free from FOX NOISE.

I don't agree with or support the bill either but the least you can do is think for yourself. Geeze"

The above is the typical response of a liberal - I am entitled to my misguided opinion but you can't have yours.

Kilopy wrote:... The above is the typical response of a liberal - I am entitled to my misguided opinion but you can't have yours.

And that's a typical response from both sides. "Not only are you wrong, you are evil."

Hogwash! Somewhere between each of us is an answer that will help everyone. It's not a perfect answer. We don't live in a perfect world. But it's something we as a society badly lack. It is called a compromise. It starts with the assumption that each of us have valuable experience and insight. It it assumes we want to work together to make the situation better for everyone.

You are right! You do have a right your your opinion. And so do I. We do not need to be offensive to one another.

Can we at least not behave better than the politicians? How hard can that be? After all we are united in our efforts to gain better sleep. Let's at least find what unites us and and work together!