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View Full Version : U.S. Issues I want... working Americans, to have a option


orange
09-17-2009, 08:19 PM
"I want, not for personally for me, but for working Americans, to have a option, that if they don't like their health insurance, if it's too expensive, they can't afford it, if the government can cobble together a cheaper insurance policy that gives the same benefits, I see that as a plus for the folks."

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Direckshun
09-17-2009, 08:25 PM
I get laughed at by a lot of liberals for saying O'Reilly is way more reasonable than his other conservative counterparts on talk radio and on the talking head circuit, too.

I'm not saying O'Reilly is reasonable, or brilliant, because he's neither of those things. He's an idiot.

But he's an honest idiot that isn't pure kneejerk hyperbole. Reminds me of somebody I know.

petegz28
09-17-2009, 10:18 PM
I get laughed at by a lot of liberals for saying O'Reilly is way more reasonable than his other conservative counterparts on talk radio and on the talking head circuit, too.

I'm not saying O'Reilly is reasonable, or brilliant, because he's neither of those things. He's an idiot.

But he's an honest idiot that isn't pure kneejerk hyperbole. Reminds me of somebody I know.

In other words, you take him "seriously" when he says what you want to hear. ROFL

BucEyedPea
09-17-2009, 10:30 PM
I want Americans to keep their own money.

NewChief
09-17-2009, 10:36 PM
So like. I'm against a public option, when it's called a public option and proposed by the opposition. I'm like, so against it that I'll rant and rave and call them socialists. That's how against it I am. But like... I'd like something similar. Just... don't call it a public option. And... let the Republicans propose it. Then yeah. I'm there, man. You can count on me.

BucEyedPea
09-17-2009, 10:47 PM
So like. I'm against a public option, when it's called a public option and proposed by the opposition. I'm like, so against it that I'll rant and rave and call them socialists. That's how against it I am. But like... I'd like something similar. Just... don't call it a public option. And... let the Republicans propose it. Then yeah. I'm there, man. You can count on me.

I was thinking about this very point today. I would not be at all surprised if Rs regained seats and were the ones to propose their own version of it. Afterall, the Ds pushed for a progressive income tax for many years, but it was the Rs that passed it. They do things like that.

Direckshun
09-17-2009, 10:59 PM
In other words, you take him "seriously" when he says what you want to hear. ROFL

I don't take him seriously.

petegz28
09-17-2009, 11:22 PM
I don't take him seriously.

Well let's do some math...

You want a Public Option

+

O'Reilly wants a Public Option

-

You don't take him seriously

=

You shouldn't be taken seriously


In summary, he wants the same as you but for some reason in your head he is not to be taken seriously yet you are. :rolleyes:

Direckshun
09-17-2009, 11:27 PM
Well let's do some math...

You want a Public Option

+

O'Reilly wants a Public Option

-

You don't take him seriously

=

You shouldn't be taken seriously

You're missing a couple huge steps there in your logic.

But I'll leave you to it.

Taco John
09-17-2009, 11:31 PM
I was thinking about this very point today. I would not be at all surprised if Rs regained seats and were the ones to propose their own version of it. Afterall, the Ds pushed for a progressive income tax for many years, but it was the Rs that passed it. They do things like that.

I can definitely envisioning that happening. Mitt Romney has the Republican nomination teed up at this moment for the "success" he had in Mass.

BucEyedPea
09-18-2009, 08:02 AM
I can definitely envisioning that happening. Mitt Romney has the Republican nomination teed up at this moment for the "success" he had in Mass.

My family back in Mass mostly, but also NH, Maine and Conn told me Mass had their taxes jacked way up too. They're pissed in Mass and hate the new governor. More people have moved up to NH as a result.
And my family members who have complained aren't exactly conservatives either.

Mitt Romney sucks.

RINGLEADER
09-18-2009, 10:45 AM
I can definitely envisioning that happening. Mitt Romney has the Republican nomination teed up at this moment for the "success" he had in Mass.

Ugh.

Iowanian
09-18-2009, 11:15 AM
If they can run health care as well as education, the road system et al....


oh.

The fed has proven itself to be soooo fiscally responsible, it makes complete sense why we'd want them in charge of HC.

Hydrae
09-18-2009, 11:28 AM
Can we please just disconnect health care from employment? Make the insurance companies market to each of us as individuals, not to our HR departments. Pre-existing condition issues usually only come up when someone changes jobs and has to qualify for a new policy. If your policy was not tied to the job this would become much less of a problem and there would be no need to try to force the insurance companies to accept anyone regardless of risk.

petegz28
09-18-2009, 12:43 PM
Can we please just disconnect health care from employment? Make the insurance companies market to each of us as individuals, not to our HR departments. Pre-existing condition issues usually only come up when someone changes jobs and has to qualify for a new policy. If your policy was not tied to the job this would become much less of a problem and there would be no need to try to force the insurance companies to accept anyone regardless of risk.

I agree with a lot of this.

Simplex3
09-18-2009, 01:12 PM
Can we please just disconnect health care from employment?

My insurance isn't through my employer. My employer has it, but I'm not on it. I have my own.

RJ
09-18-2009, 01:17 PM
Can we please just disconnect health care from employment? Make the insurance companies market to each of us as individuals, not to our HR departments. Pre-existing condition issues usually only come up when someone changes jobs and has to qualify for a new policy. If your policy was not tied to the job this would become much less of a problem and there would be no need to try to force the insurance companies to accept anyone regardless of risk.


I agree with most of your post, but I don't follow you on the bolded part. How would that happen?

RJ
09-18-2009, 01:17 PM
My insurance isn't through my employer. My employer has it, but I'm not on it. I have my own.


Through a spouse or privately?

Direckshun
09-18-2009, 01:19 PM
Can we please just disconnect health care from employment? Make the insurance companies market to each of us as individuals, not to our HR departments. Pre-existing condition issues usually only come up when someone changes jobs and has to qualify for a new policy. If your policy was not tied to the job this would become much less of a problem and there would be no need to try to force the insurance companies to accept anyone regardless of risk.

Except for the bolded part, this post is a pretty good idea. (Pre-existing conditions come up anytime somebody has to qualify for a policy, not just during job switches.)

I support the Wyden amendment because it does just that. I hope it can find its way onto the Finance bill before the committee votes. It ensures that companies will have to cover 70-80% of what their average insurance costs if an employee ditches the company's insurance offerings and goes to the Exchange.

Hard not to love that idea. Plus it'll make people mindful of choosing better priced plans. Everybody wins, including the deficit.

Direckshun
09-18-2009, 01:20 PM
My insurance isn't through my employer. My employer has it, but I'm not on it. I have my own.

Has it always been that way, or is this a relatively recent development over the past few years because you can afford it?

donkhater
09-18-2009, 01:38 PM
Can we please just disconnect health care from employment? Make the insurance companies market to each of us as individuals, not to our HR departments. Pre-existing condition issues usually only come up when someone changes jobs and has to qualify for a new policy. If your policy was not tied to the job this would become much less of a problem and there would be no need to try to force the insurance companies to accept anyone regardless of risk.

This

+ about a dozen other things that should be done immediately without government expense.

DJ's left nut
09-18-2009, 01:46 PM
I'm not sure why liberals hold up O'Reilly as the leader of the conservative movement.

He's pretty much a weathervain. He'll point whatever direction the wind is blowing that moment and he rides the fence better than anyone out there.

When it comes down to it, O'Reilly is incredibly moderate. Conservatives disagree with him on far more things than they agree with him on.

BucEyedPea
09-18-2009, 02:23 PM
I've never consider Bill a conservative. But it's the left that thinks he is. That's how much they now about the philosophy. He's a big govt guy with some conservative underlying sensibilities.

BucEyedPea
09-18-2009, 02:26 PM
A few candidates that are a real choice.

Simplex3
09-18-2009, 02:31 PM
Through a spouse or privately?

Private. My wife and I are each on our own plan and the kids are on another, so technically we have three.

Simplex3
09-18-2009, 02:33 PM
Has it always been that way, or is this a relatively recent development over the past few years because you can afford it?

It's been several years. I first started getting my own plans when I was working for myself, but when I went back to traditional jobs I just started negotiating a higher salary in lieu of the health benefits and kept my own. Works like a champ.

Hydrae
09-18-2009, 03:04 PM
I agree with most of your post, but I don't follow you on the bolded part. How would that happen?

There has been a lot of talk about requiring insurance companies to cover people regardless of existing conditions. That is a lot of additional expense risk the insurance companies would have to take on and has the serious potential to sink companies.

Hydrae
09-18-2009, 03:16 PM
Except for the bolded part, this post is a pretty good idea. (Pre-existing conditions come up anytime somebody has to qualify for a policy, not just during job switches.)

I support the Wyden amendment because it does just that. I hope it can find its way onto the Finance bill before the committee votes. It ensures that companies will have to cover 70-80% of what their average insurance costs if an employee ditches the company's insurance offerings and goes to the Exchange.

Hard not to love that idea. Plus it'll make people mindful of choosing better priced plans. Everybody wins, including the deficit.

How often do we hear that health care costs are part of the drag on our companies compared to companies in other countries? Just moving it in the manner you mention does not address this issue. I would like to see a way to continue to have a tax break for your premiums, similar to what we have via cafeteria plans through our jobs now. This would help with the expense side compared to current out of pocket expenses.

Pre-existing conditions certainly can come up if you are changing policies but there is less need to change that policy if it is not tied to your employement. I am also sure that there would be policies/insurance companies that would write policies for higher risk people just as there are car insurance companies out there that specialize in covering drivers with bad records.

DJ's left nut
09-18-2009, 04:22 PM
There has been a lot of talk about requiring insurance companies to cover people regardless of existing conditions. That is a lot of additional expense risk the insurance companies would have to take on and has the serious potential to sink companies.

It'll have to be passed on to the insureds.

Then we'll get more bitching about the cost of insurance.

Then the government will come in to save the day and provide you with a 'low cost' option...paid for by the taxpayer.

This is a really obvious playbook if you're paying attention. It's the liberal roadmap to single-payer.

Hydrae
09-18-2009, 06:38 PM
It'll have to be passed on to the insureds.

Then we'll get more bitching about the cost of insurance.

Then the government will come in to save the day and provide you with a 'low cost' option...paid for by the taxpayer.

This is a really obvious playbook if you're paying attention. It's the liberal roadmap to single-payer.

Rather than just complaining about what they are proposing out there, I am trying to point out some alternatives. Ways that could help to "reform" the healthcare industry without costing more taxpayer money. Of course you have to remember that I will pretty much always advocate less government.

I Just want to know where this sort of thing is even being discussed.

vailpass
09-18-2009, 06:42 PM
Except for the bolded part, this post is a pretty good idea. (Pre-existing conditions come up anytime somebody has to qualify for a policy, not just during job switches.)

I support the Wyden amendment because it does just that. I hope it can find its way onto the Finance bill before the committee votes. It ensures that companies will have to cover 70-80% of what their average insurance costs if an employee ditches the company's insurance offerings and goes to the Exchange.

Hard not to love that idea. Plus it'll make people mindful of choosing better priced plans. Everybody wins, including the deficit.

Wrong. When I worked corporate I switched employers 4 times during my career and never ONCE had an insurance policy that had ANY pre-existing condition clauses for myself or my dependents.

Hydrae
09-18-2009, 06:47 PM
Wrong. When I worked corporate I switched employers 4 times during my career and never ONCE had an insurance policy that had ANY pre-existing condition clauses for myself or my dependents.

If that was true for the majority this wouldn't be an issue I would guess. :shrug:

vailpass
09-18-2009, 07:00 PM
If that was true for the majority this wouldn't be an issue I would guess. :shrug:

Each employer was a large (10,000+ employees) corporation involved with the aerospace/defense industry. The volume customer base, I'm guessing, allowed the employer to negotiate more favorable terms for their employees. Perhaps other actuarial realities came into play as well, I don't know.

Simplex3
09-18-2009, 07:15 PM
I think I recall that pre-existing conditions only come into play if you've had a lapse in coverage of X amount of time.

bobbymitch
09-18-2009, 10:01 PM
I believe what everyone is missing is that the need is to reform health insurance NOT health care. Once that part is figured out, then we can focus on the needed changes.

1. Health insurance should be marketed somewhat like life insurance. Rates are posted for all to see. Family plans are rated per individual, not a lump sum.
2. A standard form is needed for all applications. One can opt in or out for additional coverages with rates for each shown. A male does not need OB/GYN coverage.
3. Any pre-exisitng conditions covered after 90 days.
4. All insurers required to have a medical benefit ratio of at least 85%
5. Any insurance company review of health provider recommended procedure must be done by a board certified, physician, with an active practice in the state where the insured is seeking treatment.
6. Health insurance coverage is accepted at any hospital, physician, clinic, etc.
7. Prescription drug prices in the US is at their world average price.
8. If you are receiving a government check you are automatically covered under Medicare, unless you have proof of continuous coverage elsewhere or are being treated under the VA. Health insurance cost is automatically deducted from your check.
9. Those earning less than 300% of the poverty level get all medical costs credited on any filled federal income tax.
10. Medical malpractice claims are rated on a body chart, similar to WC injuries, but based upon 100 years and either your actual weekly wage, adjusted for inflation. Retirees AWW would be that state's average for past occupation.
11. Anyone convicted of health insurance fraud shall pay 3 times the value of the fraud loss.
12. Anyone not having health insurance may be turned away for any type of care, (yea harsh, but it'll be up to the facility to enforce), unless they can pay out of pocket before treatment. Rates charged shall be the same as insurance reimbursement rates.
13. All insurance reimbursements shall be reasonable and customary for that state.
14. There shall be no lifetime maximum limits, unless one purchased a specifically priced policy.

Okay, flame away.

KILLER_CLOWN
09-18-2009, 10:01 PM
I support the option to have no options and no bill.

Hydrae
09-19-2009, 01:34 PM
More thought out than I have gotten. Just a couple comments below.

I believe what everyone is missing is that the need is to reform health insurance NOT health care. Once that part is figured out, then we can focus on the needed changes.

1. Health insurance should be marketed somewhat like life insurance. Rates are posted for all to see. Family plans are rated per individual, not a lump sum.

Agreed, this was the basis for my previous posting.

2. A standard form is needed for all applications. One can opt in or out for additional coverages with rates for each shown. A male does not need OB/GYN coverage.

Personally, I have no problem with each company handling their forms however they like. I don't see an issue there. Going a la carte with insurance would be an expected outcome from other changes, again each company can deal with that however they like. I am sure the ones that allow for customization, as long as they remain competitive monetarily, will do better going forward.

3. Any pre-exisitng conditions covered after 90 days.

Do you want to force all insurance companies to cover all cancer patients that apply no matter what? Again, I would expect the market to cover these kinds of issues. Part of that could be through the before mentioned a la carte purchasing but more from the side of the insurer. As is, we will cover basic expenses (regular checkups, anything new that crops up, normal health issues that come up in daily living) but we will exclude this particular area (I would think this would have to be very specific to protect both parties). Otherwise, I would fully expect there to be companies that specialize in the higher risk coverages.

4. All insurers required to have a medical benefit ratio of at least 85%

I honestly do not know what this refers to.

5. Any insurance company review of health provider recommended procedure must be done by a board certified, physician, with an active practice in the state where the insured is seeking treatment.

You have not mentioned it yet but I assume you are removing the barriers to shopping insurance across state lines. Given that, I like this idea to keep the state somewhat involved in this manner. It is a nice compromise for them.

6. Health insurance coverage is accepted at any hospital, physician, clinic, etc.

Can't agree with you here. As a hospital, physician, clinic, etc I should have the freedom to refuse to work with a company that I have problems with for whatever reason. Again, the ones who accept more coverages will get more business.

7. Prescription drug prices in the US is at their world average price.

Taking out the prices here would drop the world average by a hefty percent probably. :) While I agree prescriptions prices in general are outrageous I would not favor governmental intrusion. I will say that the $4 generics have been a big step forward on this piece of the issue.

8. If you are receiving a government check you are automatically covered under Medicare, unless you have proof of continuous coverage elsewhere or are being treated under the VA. Health insurance cost is automatically deducted from your check.

So you want to force everyone to be covered at all times? see below for more on this one.

9. Those earning less than 300% of the poverty level get all medical costs credited on any filled federal income tax.

As if most of those people (at 300% I would probably qualify for this suggestion although I just missed EIC last year) do not get enough of a boon from tax season now with EIC. This would just lead to unnecessary claims since there is no need to worry, they aren't paying for it. I don't see this as being much if any better than the way we do it today by allowing them to use the hospital emergency room for free coverage.

10. Medical malpractice claims are rated on a body chart, similar to WC injuries, but based upon 100 years and either your actual weekly wage, adjusted for inflation. Retirees AWW would be that state's average for past occupation.

This works I suppose. At least as a start on tort reform but tort reform needs to be beyond medical cases IMO.

11. Anyone convicted of health insurance fraud shall pay 3 times the value of the fraud loss.

No problem with this one at all.

12. Anyone not having health insurance may be turned away for any type of care, (yea harsh, but it'll be up to the facility to enforce), unless they can pay out of pocket before treatment. Rates charged shall be the same as insurance reimbursement rates.

Again, leave this to the facility, just allow them to make this decision. I would fully expect there to be charitable facilities (think Shriners) and groups that would step up to help out the ones with the most problems. But then again I tend to be a bit of a hippy in some manners.

This is why I can't agree with your earlier comment with regard to those on government assistance. I have no right to force anyone else to carry insurance, no matter their situation.

13. All insurance reimbursements shall be reasonable and customary for that state.

This seems to be pretty standard, are there problems in this area now?

14. There shall be no lifetime maximum limits, unless one purchased a specifically priced policy.

This would be dependent on each policy as written. I would certainly expect on with no limits to be more expensive and much less available for someone with a lower income. Please do not put them in the position of paying for something they may not need or want (this is directly opposite from you first point I believe). If there is a large demand for such policies, I am sure some company will step up and fulfill that need.

Okay, flame away.

No flaming needed, appreciate the chance for some solid discussion.

bobbymitch
09-19-2009, 06:41 PM
Hydrae - Medical benefit ratio is the ratio of medical benefits costs paid to premiums received.

As to my #13, each insurance company negotiates what they will pay for a procedure.

We agree that there is no one size fits all for insurance. Individuals must decide what their comfort level is with risk versus what they can afford.

One issue not really discussed anywhere is portability or in-network/out-of-network. If medical insurance can be used where the need arises, it would make it more appealing.

Part of the problems for many hospitals is non-payment for services. If we could reduce the number of those not covered, this should make reduce the negative impact that it has on them. One reason for cash payers paying out the nose is that the hospitals are trying to make up the shortages. Granted, we can't force everyone to get medical insurance, but if that number can be significantly reduced, then overall medical costs could be reduced.

Oops, gotta go.