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5. 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. 
    

6. 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.

7. 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

8. 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?

9. 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…

10. 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.

11. 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.

12. 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.

13. 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.)

14. 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.

15. when the dep married and came off the plan their rates dropped little over 30%

16. “but only after the group has been max rated.”
    Ok, what was the upcharge for the group?

17. 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.

18. 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.

19. 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

20. 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?

21. “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.

22. Nate I find you quite entertaining, whether I agree with you or not, I like your posts.

23. 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.

24. “The policies were canceled b/c the patient got sick.”
    Actually no Bev, the policies were audited becuase they got sick they were cancelled, like I have said, becuase they lied. There is a difference, you on the left like to pretend there isn;t because they make for great sob stories but the fact remains NO ONE that was honest on their app has ever been canceled for being sick, something your argument doesn’t allow for.
    Also prettier then I look, I like setting the bar low

25. “this group was fully insured not self funded and they didn’t have a high deductible.”
    So, the company policy stated specifically it did not cover dependents and their carrier had no legal obligation to cover the dependent but the State said the company had to pay out of it’s own pocket? If that’s true Nate you’ll need to get me a link.

26. SWITZERLAND? RIDICULOUS!
    How many Africans, Latinos and ILLEGALS live in Switzerland?
    http://www.indexmundi.com/switzerland/ethnic_groups.html
    Only six percent — not nearly 50% in USA.
    Arguing the USA be like Switzerland is so IGNORANT, I refuse to waste any more time on this.

27. Nate;
    The policies were canceled b/c the patient got sick. The invented reason for canceling the policies was b/c the patient (supposedly) lied on their application, which provides a convenient excuse for canceling b/c they got sick. If they (supposedly) lied on their application but never got sick, the insurance would not be canceled, as the premiums would still be collected but no payouts need to be made. All in the semantics, which of course you understand very well b/c you are smarter than you act.

28. “I suggest you do some reading– particularly about insurers in Cal. Insurers can go back and claim that when the person applied for the policy years earlier he or she “hid” a pre-existing condition that is related to their current health problems and cancel coverage.”
    You just proved my point, they weren’t canceled for being sick they were cancelled for lieing on their application to get a cheaper rate. As an ex journalist you should know how misleading your comment was to claim they are being canceled for being sick when you know full well that isn’t true as yur latest comment shows. This type of disinformaiton and propoganda is why we are in such a mess. Try being honest with the public then maybe the public will support an honest bill. With all the lies why should we trust anything labeled reform?
    “I suggest you read BKM’s comment and tell her that she should have “saved” more so that she could cover the cost of her child’s cancer. ”
    I answered BKM, I think what is even more disgusting is people such as yourself lieing to the public and telling them they can all have the best care available. You can’t even deliver poor care, Medicaid, or so so antiquated care, Medicare, yet you have no problem telling BKM and others we will do everything we can to save every life, complete lies, we must draw the line somewhere and some people will die, it’s reality.
    “Aren’t her claims spread over a much larger pool, such as all small employers contracted with that payer in that state?”
    Yes and no….there that will teach you to interupt rants with informative quesitons. Yes it is pooled but only after the group is max rated. Depending on the state that can be 10% higher then base line or 300%+ of baseline. This groups premiums would have been 40-50% lower minus this one dependent pushed on them by the State to save Medicaid money. If they weren’t pooled it would have been even worse.
    Peter you weren;t thinking, this group was fully insured not self funded and they didn’t have a high deductible. Assumptions will get you every time. There is a difference between an employee buying insurance then having a large claim and the state comming to you and telling you that you will now pay this person’s claim who doesn’t even work for you and is an adult.

29. praetorius,
    It took CMS 556 pages to write regulations defining which providers are eligible for stimulus incentives and what they have to do to get it.
    556 pages, about 1/5 of the entire health reform bill, to define something that in plain English would probably take 20 pages with a dozen tables.
    I guess that’s how they write in Washington.
    The biggest mistake the Dems made was failing to provide a good summary early on.

30. Maggie,
    Why is the bill so long? Maggie for Congress. There would be less animosity if people learned to read or had the benefit of your edits.
    The problem with the bill is its failure to address the genesis of the high cost and low quality conundrum which is 20 years of government policy itself.

31. Barry, this doesn’t look bad:
    http://www.osec.ch/internet/osec/en/home/invest/worldwide/handbook/living_in_switzerland/income_cost_of_living.html
    and this:
    According to an AC Nielsen Euro-Barometer study conducted in 2005, Switzerland is one of the most expensive countries in Europe, after Norway, Denmark and Finland. The main items of expenditure in one’s budget are insurance, such as health insurance, invalidity insurance, unemployment insurance and private insurance policies (23% of a typical household budget in 2004), accommodation and energy (17%), tax (13%) and food and clothing (11%).
    Other recurring monthly expenditure includes transport and fuel (12%), restaurant meals (6%), healthcare (5%) and communications (2%). In 2005, disposable income – the amount remaining after compulsory deductions (social security contributions, taxes, basic health insurance, etc.) – amounted to 72.6% of gross household income, averaging CHF 8 967.

32. “The government provides subsidies to help pay those premiums only if the premiums exceed 8% of your income.
    30% to 40% of Swiss households receive subsidies.”
    Maggie — So, in Zurich, if we use the low end estimate of $14,400 per year for family coverage combined with having to spend at least 8% of income before you qualify for a subsidy and only 30%-40% of the population qualifies, it implies that most of the population, at least in Zurich, makes more than $180K per year ($14,400/.08). This just doesn’t sound right. What am I missing?

33. “Now 80 hard working people and the employer are forced to pay her $250,000 a year in claims.”
    Nate, since you always talk employer self insured I thought the employer purchased stop loss insurance for the big claims? Also you say the employer and employees are stuck with the claim, I thought you sold them high deductible insurance with a large carrier? And wouldn’t the employees like to know that if they get sick there’s also $250K there for any one of them? The nature of risk is just that – risk, most of the time you win, but a few times you loose.

34. “Privately they have told Medicare that, in the future if it leads the way in cutting waste and overtreatment, they would be happy to follow.”
    Ok Maggie, would this include reimbursement negotiations with large hospitals that control large percentage of their local market? And which insurance company is going to go first with these “tough medicine” reimbursements? And when patients find that the hospital they were going to suddenly won’t cover certain procedures what do you think they’re going to do – go down the street.

35. Ah, Margalit, you posted just the same link I was thinking of! Good for you; and Nate knows better, of course.
    And for Exhausted MD, here is your exit strategy:
    http://www.nonclinicaljobs.com/

36. Here is yet another “new” reason why insurance companies need not apply for sainthood anytime soon, and why this bill must become law ASAP!
    http://www.reuters.com/article/idUSTRE62G2DO20100317
    There is no other “free market” where sellers are allowed to routinely exhibit such predatory behavior in full daylight.

37. One thing that seems to largely be left out of these discussions are the costs to the states vis-a-vis the changes in Medicaid. We are getting into some serious billions here and the states cannot operate at a deficit to cover the state share of the costs. Any serious discussion of the costs really must include the impact on state governments. Otherwise we have the mother of all unfunded mandates heading down the pike.

38. Some have previously stated that no one is denied care in the current system and certainly a lot of uninsured patients show up at the ER and get treated and or admitted. Sounds like the same people are now saying that their rates, already jacked up to cover the care delivered to the unisured, will go up a lot more? Isn’t a lot of this uncovered care already figured in the current increasingly high rates? Those opposed – is the predicted increase in utilization via more cost efficient methods (primary care for instance)that is predicted to occur when unisured become insured a lot higher than the very cost-inefficient ER care that is currently being delivered?
    And lets get over the idea that suddenly the majority of people are going to lose weight and act responsibly any time in the near future.
    I agree with Nate when I see someone reaching for my wallet but on the other hand I want kids covered with effective care regardless of the economic sins of their parents.
    I guess I just need to get harder and tell the acute MI that we can’t let him sit in the ER until his daughter gets the payday loan approved.
    Hopefully we can convince the Core Measure overlords to include language to the effect that Quality Care definitions that are time or resource related will be tiered according to ability to pay:
    For those with independent means, the Platinum AMI plan standard, which incorporates best evidence, will be door to balloon of less then 90 minutes. Platinum plan patients will be seen first and treated first.
    Gold AMI plan patients able to pay on an ammortized schedule will be seen after platinum plan patients.
    Bronze and tin plan patients will be seen only as time and the charity fund allow and are excluded from Core measures.
    Performance on the AMI core measures will be publically posted for each plan, so each economic class of Americans can decide which hospital serves their economic class best.

39. Nate, maybe this angry thread is not the place to ask informative questions, but I would like to understand.
    You say that “Now 80 hard working people and the employer are forced to pay her $250,000 a year in claims.”
    Aren’t her claims spread over a much larger pool, such as all small employers contracted with that payer in that state?

40. ALREADY COVERED
    “Being able to get specialist treatment makes a difference in pediatric cancer, and lots of kids are shut out due to insurance problems.”
    Sir, all sides have agreed to regional/national coverage pools for cancers, et. al. That is a settled issue.
    It is the STEAL-O-CRATS who have added 2,700 pages of SOCIALISM to your son’s problem.
    Blame STEAL-O-CRATS, not others.
    Shame on you, STEAL-O-CRATS, Socialists, and Commie-lovers.

41. WRONG, WRONG, WRONG
    CBO said Medicare was going to be 1/10th of what it is today.
    Why should anyone with a brain believe the CBO?
    Get out a calculator and start adding. This is a MESS.
    And a lot of flat-out lying by incompetents who could not hold a job in a solvent organization. They refuse to guarantee this will work — shame on them.
    ——————
    “Today’s news about the CBO mark-up make it all but certain that the bill will pass.”