Yesterday, the Democratic Caucus of the House listed the provisions of the health reform bill that will take effect “as soon as health care passes,”
The legislation would:
- Prohibit pre-existing condition exclusions for children in all new plans
- Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;
- Prohibit dropping people from coverage when they get sick in all individual plans
- Lower seniors prescription drug prices by beginning to close the donut hole
- Offer tax credits to small businesses to purchase coverage
- Eliminate lifetime limits and restrictive annual limits on benefits in all plans
- Require plans to cover an enrollee’s dependent children until age
- Require new plans to cover preventive services and immunization without cost-sharing
- Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions
- Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs.“By enacting these provisions right away, and others over time” the Caucus declares, “we will be able to lower costs for everyone and give all Americans and small businesses more control over their health care choice.”
Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.
no Peter, the cmpanies policy said dependets over 19 had to be full time students. Then the state passed a law saying carriers had to cover dependents that are unmarried until age 29.
When a sick over age dependent is added to the plan the groups rates go up to cover those claims. As I told Margalit there is a slight amount of pooling the claim over the carriers entire block but only after the group has been max rated.
Nate I find you quite entertaining, whether I agree with you or not, I like your posts.
“How many Africans, Latinos and ILLEGALS live in Switzerland? Only six percent — not nearly 50% in USA.”
Actually, Switzerland has one of the highest immigration rates in the world. One quarter of its population is foreign-born.
so hot swedish bikini models are 25% probobility not Swedish???? Does that make them just hot bikini models or is none of it real to start with?
Random thoughts (I forgot my tele-prompter) in response to the half wits list and subsequent comments:
1) WellPoint increase premiums 29%, Obamacare increases taxes on old people by 31%
2) Americans generally, (until recently) are not like the Swiss or the Germans or the Canadians. We are not rule followers (Slaughter House maneuver). Entrepreneurs are founding father, rugged, individualist’s types. Make me cover a 26 year old dependent (dependent being the operative word) on my company’s group policy, and I cancel dependent coverage for everybody. I promise not to tell all the other employees it was your dependent that encouraged me to cancel dependent coverage (at least not in a provable way).
3) America is not like Switzerland. We have let in a lot of fuzzy, ill smelling, penniless, foreigners…like most of our forefathers. Switzerland does not.
4) Pre-Existing Conditions of children are always covered under insurance policies in my state if you bother to buy the coverage before the child is born or gets sick.
5) Why limit dependents to age 26. Why not let the parents add their loser kids to their Medicare policy…oh yeah, that is what we are doing.
I’m learning to speak Costa Rican. Thanks for listening. LD
Why are democrats being told to avoid talking about the details of the CBO score?
Explicitly. From a Thursday memo on the subject:
“We cannot emphasize enough: do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reductions and number of Americans covered.”
Emphasis theirs, not mine. Also:
“The inclusion of a full SGR ['sustainable growth rate' - ML] repeal would undermine reform’s budget neutrality. So, again, do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reductions and number of Americans covered.”
“As most health staff knows, Leadership and the White House are working with the AMA to rally physicians support for a full SGR repeal later this spring. However, both health and communications staff should understand we do not want that policy discussion discussed at this time…”
I’d ask what they were so afraid of, but I already know the answer – and so do you. A rush job is never good for anyone and this bill is going to wreak havoc on the healthcare of this nation and the envy of the world.
DO NOT BELIEVE YOUR LYING EYES OR THAT LYING CALCULATOR
No. 1 STEAL-O-CRAT LIE — “we know more, so STFU.”
Bull.
START OVER — TOO MANY LIARS.
http://www.indexmundi.com/switzerland/ethnic_groups.html
+++++++++++++++
“How many Africans, Latinos and ILLEGALS live in Switzerland? Only six percent — not nearly 50% in USA.”
Actually, Switzerland has one of the highest immigration rates in the world. One quarter of its population is foreign-born.
“but only after the group has been max rated.”
Ok, what was the upcharge for the group?
when the dep married and came off the plan their rates dropped little over 30%
I’m not sure how I feel about this particular bill. It could be a start, but it has potential to be a problem. Personally, I think the focus should be on cost control first. According to a study done by PriceWaterhouseCoopers, over half of all money spent on healthcare is spent unecessarily. Then on top of those corrections, allow the sale of drugs manufactured in other countries to be sold here, retract the law that only allows 100,000 new doctors a year into the system (this was put into affect due to lobbying by the AMA), and create a single payer system that will give us buying/negotiating power. This will lower overall costs, lower individual costs, and cover everyone.
Harris, James, Peter, Barry, Nick, Paola, Nikc, Frustrated,
Harris– Yes, I totally agree about # 9–thanks for highlighting it.
James- Under the reconciliation bill the Federal govt is offering substantial help to all states — I believe (not entirely certain) that Washington is cover 100% of additional costs as well as extra money to states that were already covering childless adults.
Peter– Good point.
But brand name hospitals that overcharge are already being “outed” in Massachusetts– and these are essentially good brand-name hospitals . But they’re charging too much
I think you’re going to see more and more of this “outing”–even before reform rolls out. More and more people are calling for “transparency” in hospital pricing. It’s not just that some hospitals charge more than others, but the secrecy surrounding the deals they make with insurers is becoming better-known.
See my post on Maryland on “HealthBeat” (www.healthbeatblog.org) In Maryland, the state sets the rates for all hospital charges, adjusting for differences in local prices, how many Medicaid and uninsured patients the hospital sees (eating the losses on Medicaid and the charity care), whether it has extra expenses because it is a teaching hospital, etc.
All insurers pay hospitals the same amount–i.e. the rates that the state sets for that hospital. t. Medicare and Medicaid also pay these set fees–Medicare has agreed to do this as long as growth in its reimbursements for hospital care in Maryland remain below the national average–and it has. Meanwhile, non-profit hospitals have more stable revenues, and average a 2% to 3% surplus- which gives them v. good bond ratings. And when you look at insurance premiums as a percentage of income, Maryland is the lowest in the U.S. A win/win all around. Quality is also very good if you compare an academic med center like Hopkins to academic med centers in other states.
This system has been workign in Maryland for more than 30 years. (Many other states were doing the same thing–but in the 1980s, as Republicans took over state governments, they were anti-regulation and killed the programs. Democrats managed to hold onto Maryland.)
It was a pretty wonky post; I was surprised to see it re-posted . . . seems to be much interest in the idea.
Will it work everywhere? No. But I wouldn’t be surprised if some states try it. (It would be hard for Washington to do–you really need to know the hospitals, what patients they are seeing, etc.. Though states would need Federal oversight to avoid corruption, pay-offs, etc.
Finally, and most importantly, Medicare, which pays 40% of hospital bills, is going to get much, much tougher with hospitals–including brand name hospitals–refusing to pay for preventable readmissions, errors, and inefficiency.
Under the reconciliation bill, for the first time Medicare will have the power to roll out pilot projects that change what it pays for, and how it pays– nationwide– without needing to go through Congress.
This is HUGE. In the past, many pilot projects have been very successful–but Congress (and lobbyists ) killed them. This will no longer happen. Medicare will be able to turn these pilot projects into nationwide Medicare policy.
Meanwhile, will brand-name hospitals start telling Medicare patients– “we no longer do by-passes because Medicare doesn’t pay enough.” Not on your life. I can’t think of a hospital in the U.S. that could keep it’s doors open if it didn’t have Medicare patients.
And going forward, the number of Americans on Medicare/ Medicaid is only going to increase.
Barry– A very good question.
The answer, I think, lies in the fact that Zurich is a very expensive city (I’ve been there.) Probably very few people in Zurich qualify for a subsidy. And my guess is that premiums in Zurich are significantly higher than in other parts of Switzerland because the cost of labor and real estate are much higher.
I also thought premiums sounded high — particularly for families. Though the Swiss are nearly as over-medicated as we are, and pay a very high price for drugs (since Pharma is a big part of the economy.) And perhaps they make premiums lower for individuals because many of those singles are younger and healthier, while making premiums higher for families where mother or father are likely to be older than singles. This is just a guess.
But I did keep searching, and everything I found suggests that premiums for the “basic benefits” are high in Switzerland–and that the “basic benefits” are what you and I would want for our families.
And at least one source said that people are expected to spend 10% of gross income before getting a subsidy. Europeans are accustomed to spending more of their own money on healthcare (and taxes to provide healthhcare to others) than we are.
Finally, the NYT story that provided the numberswas a pretty recent, long story–and there’s no correction. I have to think that if it was way off-base, someone who lives in Switzerland, or has friends or relatives in Switzerland would have written in. . . The Times is not always accurate in its interpretations of things, but it doesn’t usually get numbers just totally wrong . . . (Or if it does, there is a correction.)
Paola– Thanks for setting the record straight on diversity of the Swiss population.
Nick– Politco.com has announced that the memo who are referring to was a fake– circulated by the Republican party.
Frustrated– Unfortunately in places where there are more doctors, doctors’ fees are higher! Market competition just doesn’t work in healthcare the way it works in other markets. People assume that the more expensive doctor is better. And when you’re really sick, you’re not looking for a discount doctor. (80% of our healthcare dollars are spent when people are very sick.)
I’m willing to relax and see what happens when the bill passes. Can’t be any worse than the mess Bush left this country in a year ago.
DO NOT BELIEVE YOUR LYING EYES OR THAT LYING CALCULATOR
No. 1 STEAL-O-CRAT LIE — “we know more, so STFU.”
Bull.
START OVER — TOO MANY LIARS.
http://www.indexmundi.com/switzerland/ethnic_groups.html
+++++++++++++++
“How many Africans, Latinos and ILLEGALS live in Switzerland? Only six percent — not nearly 50% in USA.”
Actually, Switzerland has one of the highest immigration rates in the world. One quarter of its population is foreign-born.
+++++++++++++
SWITZERLAND:
Ethnic groups:
German 65%
French 18%
Italian 10%
Romansch 1%
other 6%
Definition: This entry provides an ordered listing of ethnic groups starting with the largest and normally includes the percent of total population.
Source: CIA World Factbook – Unless otherwise noted, information in this page is accurate as of September 17, 2009
WOW! What a lot of WHITE immigrants!
Facts — the tax-loving liberal’s worst enemy. Right after calculators.
Howl at the moon if you want, liberals. But 2+2 will still equal four. Duh.
MATTHEW HAS CONVINCED ME
Going on welfare. No need to excel now. Be just like the UK and France.
All you working slobs, have a nice time, supporting us welfare bums.
We don’t appreciate what you do, and if you try to stop working, we’re going to protest, like all the ILLEGALS in D.C. today.
Going for some beers now, and get some ‘rays. Keep working — Obama has created more welfare folks.
problem is the “puppy’s are dying so we must do something quickly” always leads to a knee jerk reaction that ends up (always in the governments case) to cause an enormous unintended problem as it tries to solve the existing one. case in point soc sec and medicare. these two programs, while they were deemed necessary to help those who could not help themselves have cost us dearly, medicare is 30+ trillion in debt and the soc sec trust fund is far beyond bankrupt and is loaded with IOU’s from mostly democratic but in truth both parties having raided it over the years… no doubt something needs to be done but this solution is a bad thing for the health care situation and the country’s economic outlook for decades to come… I have to blame the progressive takeover of the democratic party, they have wanted this for decades and now have the control they wanted, time for democrats to wake up and smell the coffee and kick that rats out of the barn… seriously is having the IRS and the federal health bureau, that will be created by mandate of the bill to manage your care, really what you want – or was it just some fair treatment by ins. companies you were after… this will effect us all badly, it will only take time to see that…
This will sound like a stupid question (maybe it is), but what does “as soon as health care passes” mean?
Also, for #1: I have insurance, which excludes my child’s pre-exisiting condition (which I have to pay for out of pocket). They told me today (3/23) that they will still exclude my child’s condition because it is an existing plan. So I have to drop my plan and purchase a new plan? Is that how this works?
We have unknowingly harming and even killing our children and pets. We are giving them cancer and other diseases they are unaware of.
Please review the sites below.
They will show you how.
Spring and Summer are upon us. Arcenic wood is a killer.
Help me to spread the word. There is a fix, however this healthcare problem is nation wide.
http://www.ewg.org/node/8700
http://www.ewg.org/reports/poisonwoodrivals
http://www.ewg.org/node/20370
http://www.ewg.org/reports/poisonedplaygrounds
http://www.ewg.org/node/15160
do the idiot right wingers really believe they have more weapons and more soldiers than us? they better think again before we eat them and piss on the soles of their families, excuse my french. we can do it and we intend to do it if necessary. they should leave well enough alone, or else.
To help cover the sick and the poor is a FASC Concept that states that to build a Health Care Forum within our Government Institution is a Peoples right to do so and this is Protect Under the Constitution as a Human and Civil Right. So in plan words if the poor and the sick could only afford to pay $5.00 to $10.00 per month this would to bring a balance toward the broken tax system, to add up this number 32 million to 100 million sick and poor people x $5.00 per month. This will place back into the system $116 million $to 500 million dollars per month. The cause and effect of this will reduce the purposed Health Care Tax Forum, to bring about a reduced effect so not to a over burden system. Take my faith in this and almost all the poor and sick would be happy to pay in and help rebuild the United States failed tax system. Also To bring about a balance of trust lost between the people and Officials.
Under a Federal Health Care Group built by my friends and I. {You see the poor, as you see them}, as for them they see them self not poor, but of a different race of people and environment and have faith it that which was in the past that so many do not have a clue of what God and Country is all about.
Will be up dated today 3/25/2010
Issue 1.
FASC tax and pay in Forum, A Concept to help the Poor and Sick.
FASC Concepts of a guideline of income and a fair payment for the poor to the rich.
CLASS INCOME MONTHLY PAYMENTS
{A} formatt for people making up to $29000.00 per year, EST of monthly cost up to $40.00 per month
{B} up to $19000.00 per year, EST of monthly cost up to $30.00 per month
{C} up to $12000.00 per year, EST of monthly cost up to $20.00 per month
{D} from 0.00 income to $9000.00 per year / cost up to 0.00 to $10.00 per month
MIDDLE CLASS TO THE POOR
{A} {B} {C} {D} classification based on one person If married policy can be devided or stayed. These are concept numbers to open the mind…………..
Submitted by Marh Hidabrand,asked would it not be better to build on , instead of droping off of the {A}{B}{C}
{E} up to $49000.00 per year,EST of monthly cost up to $50.00 per month
{F} up to $59000.00 per year,EST of monthly cost up to $60.00 per month
{G} up to $69000.00 per year,EST of monthly cost up to $70.00 per month
{H} up to $79000.00 per year,EST of monthly cost up to $80.00 per month
{I} up to $89000.00 per year,EST of monthly cost up to $90.00 per month
To balance a payment plan to fit within the bills, within a home……….{J} {K} {L} {M} exc………………….
Need to balance to stay around $200.00 for above income and below $300.00 for the rich ?
The same incentives apply if husband and wife wish to pay separate.
The same incentives apply for the poor, even if all they can pay is $3.95 per month. No one is cut out of the rebuilding of the inter structure of Health care and the USA.
The money is a investment into our further and is to be tax free, just the money paid in.
You may ask: what about Medicare ? {is it not possible to merge Medicare into this concept ?}
With in this movement the {A} {B} {C} {D} will remove health care from a company so that a company can see into the building of other projects and put people back to work.
With the formatted goal of the use of this new concept, to form a more perfect Union within the design of the Health Care program offered, we submitted the up to 2 Trillion dollars per year. This will build a safety net / a buffer to maintain balance.
The billion dollars per year is at a high EST. based at $10.00 x 250 million people. As you can see the numbers above suggest a very high in pack of funds, we can not project a high in pack because dollars are not a constant.
at 100 000 000 million people x 10= $1 000 000 000 billion low ball figures
1 billion x 4 weeks = $4 billion dollars
4 billion x 12 months = $48 billion dollars
so at 100 000 00 the numbers would have to increase to $40.00/per month x $40.00
$40.00 x 48 000 000 000 = $1 220 000 000 000 per year at 100 000 000 people
In the US the progression is:
Hundred – 100
Thousand – 1,000
Million – 1,000,000
Billion – 1,000,000,000
Trillion – 1,000,000,000,000
Quadrillion – 1,000,000,000,000,000
and the interfacing of the FASC Card http://www.federalactsecuritycard.mysite.com
We need to see into the inter structure of the Presidents concept,without this right we can not help,no matter how much we wish to. It would seem that if you do not play follow the leader on just one concept ,that the door is not really open.
We offer the following concepts and we believe that it will be one that all can respect.
FASC Concepts of a guideline of income and a fair payment for the poor to the rich.
This is a concept to build on…….a idea, a way to bring life to hope where there is none.
CLASS INCOME MONTHLY PAYMENTS
{A} format for people making up to $29000.00 per year, EST of monthly cost up to $40.00 per month
{B} up to $19000.00 per year, EST of monthly cost up to $30.00 per month
{C} up to $12000.00 per year, EST of monthly cost up to $20.00 per month
{D} from 0.00 income to $9000.00 per year / cost up to 0.00 to $10.00 per month
MIDDLE CLASS TO THE POOR
{A} {B} {C} {D} classification based on one person If married policy can be divided or stayed. These are concept numbers to open the mind…………..
Submitted by Marh Hidabrand,asked would it not be better to build on , instead of dropping off of the {A}{B}{C}
{E} up to $49000.00 per year,EST of monthly cost up to $50.00 per month
{F} up to $59000.00 per year,EST of monthly cost up to $60.00 per month
{G} up to $69000.00 per year,EST of monthly cost up to $70.00 per month
{H} up to $79000.00 per year,EST of monthly cost up to $80.00 per month
{I} up to $89000.00 per year,EST of monthly cost up to $90.00 per month
To balance a payment plan to fit within the bills, within a home……….{J} {K} {L} {M} exc………………….
Need to balance to stay around $200.00 for above income and below $300.00 for the rich ?
The same incentives apply if husband and wife wish to pay separate.
The same incentives apply for the poor, even if all they can pay is $3.95 per month. No one is cut out of the rebuilding of the inter structure of Health care and the USA.
The money is a investment into our further and is to be tax free, just the money paid in.
You may ask: what about Medicare ? {is it not possible to merge Medicare into this concept ?}
With in this movement the {A} {B} {C} {D} will remove health care from a company so that a company can see into the building of other projects and put people back to work.
With the formatted goal of the use of this new concept, to form a more perfect Union within the design of the Health Care program offered, we submitted the up to 2 Trillion dollars per year. This will build a safety net / a buffer to maintain balance.
The billion dollars per year is at a high EST. based at $10.00 x 250 million people. As you can see the numbers above suggest a very high in pack of funds, we can not project a high in pack because dollars are not a constant.
at 100 000 000 million people x 10= $1 000 000 000 billion low ball figures
1 billion x 4 weeks = $4 billion dollars
4 billion x 12 months = $48 billion dollars
so at 100 000 00 the numbers would have to increase to $40.00/per month x $40.00
$40.00 x 48 000 000 000 = $1 220 000 000 000 per year at 100 000 000 people
In the US the progression is:
Hundred – 100
Thousand – 1,000
Million – 1,000,000
Billion – 1,000,000,000
Trillion – 1,000,000,000,000
Quadrillion – 1,000,000,000,000,000
and the interfacing of the FASC Card http://www.federalactsecuritycard.mysite.com
We need to see into the inter structure of the Presidents concept,without this right we can not help,no matter how much we wish to. It would seem that if you do not play follow the leader on just one concept ,that the door is not really open.
We offer the following concepts and we believe that it will be one that all can respect.
A FASC Concept, Children should be covered by moms or dads coverage at no extra cost. I once heard that their was a saying that is within the Christian world, it is in the best of man that through a concept of God, that He smiles on those who help the poor. Now this is your faith, as shared with people.