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"Mandatory end of life Counseling" and other Health Care Reform woes

Started by July 24, 2009 08:35 PM
863 comments, last by nobodynews 15 years, 1 month ago
Quote: Original post by laeuchli

None of the plans being discussed in the house or senate are single payer systems.


?

They are indeed, again from my understanding: If you are currently with private healthcare you can continue that, but you cannot newly join private healthcare. Which means if you lose your job or switch jobs, you lose it and have to go to government healthcare. This will eventually run private healthcare out of business.

And I would agree that a "fair" hybrid of public and private would be a much better choice, if it were possible.
Quote: Original post by Chris Reynolds
Quote: Original post by laeuchli

None of the plans being discussed in the house or senate are single payer systems.


?

They are indeed, again from my understanding: If you are currently with private healthcare you can continue that, but you cannot newly join private healthcare. Which means if you lose your job or switch jobs, you lose it and have to go to government healthcare. This will eventually run private healthcare out of business.

And I would agree that a "fair" hybrid of public and private would be a much better choice, if it were possible.


Thats not correct. You'll still be able to join private insurance. However private insurance is required to meet certain standards about what they cover. Plans you current posses and are happy with however, you will be able to keep, even if they do not meet the criteria, but if you go off the plan, and it does not meet the required standards you will not be able to repurchase it. Some people have misinterperted the bill to mean you will not be able to buy any private insurance, but this is not the case.
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Quote: Original post by laeuchli
Quote: Original post by Chris Reynolds
Quote: Original post by laeuchli

None of the plans being discussed in the house or senate are single payer systems.


?

They are indeed, again from my understanding: If you are currently with private healthcare you can continue that, but you cannot newly join private healthcare. Which means if you lose your job or switch jobs, you lose it and have to go to government healthcare. This will eventually run private healthcare out of business.

And I would agree that a "fair" hybrid of public and private would be a much better choice, if it were possible.


Thats not correct. You'll still be able to join private insurance. However private insurance is required to meet certain standards about what they cover. Plans you current posses and are happy with however, you will be able to keep, even if they do not meet the criteria, but if you go off the plan, and it does not meet the required standards you will not be able to repurchase it. Some people have misinterperted the bill to mean you will not be able to buy any private insurance, but this is not the case.


On page 16 of the bill, I will quote:

- Grandfathered health insurance coverage
- limitation of new enrollment

"Except as provided in this paragraph, the individual health issuer offering such coverage does not enroll any individual in such coverage if the effective date is on or after the first day of Y1"

On page 425-426 it describes the "mandatory end of life counseling", which is indeed in the bill.
Quote: Original post by Chris Reynolds
Quote: Original post by laeuchli
Quote: Original post by Chris Reynolds
Quote: Original post by laeuchli

None of the plans being discussed in the house or senate are single payer systems.


?

They are indeed, again from my understanding: If you are currently with private healthcare you can continue that, but you cannot newly join private healthcare. Which means if you lose your job or switch jobs, you lose it and have to go to government healthcare. This will eventually run private healthcare out of business.

And I would agree that a "fair" hybrid of public and private would be a much better choice, if it were possible.


Thats not correct. You'll still be able to join private insurance. However private insurance is required to meet certain standards about what they cover. Plans you current posses and are happy with however, you will be able to keep, even if they do not meet the criteria, but if you go off the plan, and it does not meet the required standards you will not be able to repurchase it. Some people have misinterperted the bill to mean you will not be able to buy any private insurance, but this is not the case.


On page 16 of the bill, I will quote:

- Grandfathered health insurance coverage
- limitation of new enrollment

"Except as provided in this paragraph, the individual health issuer offering such coverage does not enroll any individual in such coverage if the effective date is on or after the first day of Y1"

On page 425-426 it describes the "mandatory end of life counseling", which is indeed in the bill.


Re-read page 16-18, you will find it is as I describe above. You will be able to continue to purchase private insurance..as long as it meets certain criteria. If the plan you currently have does not meet that criteria, it is grandfathered in.

Good catch with the google-fu on the mandatory end of life stuff, but as I said above, you need to take steps somehow to decide how much care is appropriate. What they'll decide in the required counseling however, I am unsure.
Quote: Original post by CirdanValen
I don't want hospitals to end up being run like the DMV. Then there is the whole increasing our national deficit. Gov't control = BAD. VERY BAD.


The "DMV" is a state agency, not a federal one. YMMV from state to state.
Also, the things involved with the two are so different the comparison is ridiculous to even think about.

When you say "Gov't control = BAD. VERY BAD." are you referring to health care, or any system in general?
Government control may not be ideal, but private health insurance is a complete scam. They've got the best racket going short of Goldman Sachs and the other big finance firms. Public healthcare could be a huge cost, fail to improve anything, and it'd still be an improvement.

Besides, the really big companies and the Republicans are all very angry at the idea of a public option. This is a sure fire sign that it's probably a good idea.
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Quote: Original post by laeuchli

Re-read page 16-18, you will find it is as I describe above. You will be able to continue to purchase private insurance..as long as it meets certain criteria. If the plan you currently have does not meet that criteria, it is grandfathered in.


"grandfathered healthinsurance coverage’’ means individual health insurance
coverage that is offered and in force and effect before the
first day of Y1 if the following conditions are met"

I'm not sure how I'm misreading this. Grandfathered health insurance cannot offer new coverage. Are you talking about the grace period?
Quote: Original post by Chris Reynolds
Quote: Original post by laeuchli

Re-read page 16-18, you will find it is as I describe above. You will be able to continue to purchase private insurance..as long as it meets certain criteria. If the plan you currently have does not meet that criteria, it is grandfathered in.


"grandfathered healthinsurance coverage’’ means individual health insurance
coverage that is offered and in force and effect before the
first day of Y1 if the following conditions are met"

I'm not sure how I'm misreading this. Grandfathered health insurance cannot offer new coverage. Are you talking about the grace period?


Yes plans that don't meet the minimum requirements will be grandfathered in, but will not be allowed to enroll new people. Private insurance that does meet these requirements will be able to however. Not all private insurance needs to be grandfathered, since some(lots?) meets the minimum requirements laid out in the bill.
Quote: Original post by Promit
Government control may not be ideal, but private health insurance is a complete scam. They've got the best racket going short of Goldman Sachs and the other big finance firms. Public healthcare could be a huge cost, fail to improve anything, and it'd still be an improvement.

Besides, the really big companies and the Republicans are all very angry at the idea of a public option. This is a sure fire sign that it's probably a good idea.


Best racket short of? They have what amounts to a monopoly on life. And free reign to decide when they no longer want to support yours. Its a shame more people don't realize it.

Quote: Original post by laeuchli
Yes plans that don't meet the minimum requirements will be grandfathered in, but will not be allowed to enroll new people. Private insurance that does meet these requirements will be able to however. Not all private insurance needs to be grandfathered, since some(lots?) meets the minimum requirements laid out in the bill.


He's reading with tunnel-vision. He's going to have to read from the beginning of Title 1 on page 14 to understand that grandfathering is an exception to the rule, not the rule itself.
Quote: Original post by Chris Reynolds
Here is just one of the bill's many problems that I see:

"Mandatory end of life counseling" - If you are over the age of 60 you will be required to attend a counseling to determine whether or not prescriptions or procedures are worth the government's money.

Denying treatment based on age?
Do any of you really think that this bill can be paid for by "efficiencies"? And are these efficiencies really just cutting corners with the elderly?

How much are you willing to pay for your health? Let's say you have a medical condition and a curative treatment costs $1 million, but accepting that treatment will increase your current monthly health insurance premiums by 50%. The condition is not fatal; if you elect not to accept the treatment you will be forced to manage it via medication and intermittent doctor visits, but your premiums will not change. Will you accept the treatment?

Now, let's say the situation is terminal and you have 6 months to live but the treatment will save you life. Problem is the cost is now $2 million, and your premiums will rise by 75%. Will you accept the treatment?

Let's now say the disease is terminal and you have 6 months to live. There is a medication available that will probably extend your life by another 3 months, but you'll be dead within a year no matter what. The medication is extremely new and must be administered surgically, so the costs for it total $1 million. Whether your premiums would go up is obviously irrelevant, since you'll be dead in a year. Will you accept the treatment?

Finally, let's say someone else has the disease, the treatment will only extend their life by 3 months, but your treatments will go up because of it (because the treatment is so expensive and rare, and that cost has to be recouped by your insurer). Are you willing to pay a 5% higher premium so someone else can live for an extra 3 months? 10%? 50% higher? How much of an increase of the cost burden on you is too much for someone else's health?


Insurance companies already do this. Insurance premiums have been rising four times as fast as incomes, and despite having paid on time for a protracted period the insurer can still refuse you coverage or deny access to a procedure it doesn't deem cost effective.

The current health proposals are actually too conservative and ineffective, because the "leftist" Democrats are actually scared centrists and the "right-leaning" Republicans are actually far-right reactionaries. Fixing our health care system requires layers of changes. It won't be enough to simply shift the bill around; we have to focus more on prevention than emergency treatment, because emergency treatment is far more expensive - keeping people out of emergency rooms in the first place is much cheaper. We will have to quantify publicly and unambiguously what treatments and procedures are not cost-effective for a tax-funded system; individual wealth and charities will have to pick up the slack in the case of extremely expensive operations for rare cases. We will have to put pressure on pharmaceutical companies via the collective bargaining power of a public health option bloc - "Wal-Mart 'em," so to speak - to lower costs for drugs.

Many of the criticisms being leveled at the idea of public health care ring particularly hollow considering that we already experience those same problems now. "You'll have to wait weeks to see your doctor!" Have you tried to book an appointment with your doctor recently? The receptionist tells you when there's an opening, which can be over a month away. Et cetera.

My only criticism is that we need real, balls-to-the-wall reform. This half-ass pablum is not what I voted and paid taxes for.

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