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petegz28
07-15-2010, 10:21 AM
Clarifying a much-anticipated new benefit in the new health care law, the Obama administration yesterday issued rules outlining how millions of consumers will soon be able get many preventive medical services at no out-of-pocket cost.

Here is how the new benefit will work:

Question: What does it mean that the services will be free?

Answer: New insurance plans will be prohibited from charging consumers a co-pay or deductible for services getting the top recommendation from the U.S. Preventive Services Task Force.

These plans will also have to cover immunizations recommended for children and adults by an advisory committee of the Centers for Disease Control and Prevention.

Insurers could still charge consumers for services delivered out of network and for treating conditions identified by screenings.

In some cases consumers could also be charged if a preventive service is not billed separately from another service, such as an office visit.

Q: Which services would be covered?

A: The benefits vary depending on consumers' age, sex and whether they are at higher risk for a medical condition.

The services covered include: colorectal cancer screening for adults over 50; hepatitis B screening and tobacco counseling for pregnant women; depression screening for adults and adolescents; HIV screening for adults at high risk; and obesity screening and counseling for adults and children.

Children would qualify for more than two dozen services, including vaccinations for influenza, diphtheria and tetanus, and screenings for hearing and vision impairment and autism.

A list of many of the services covered, as well as background about the benefits is available at healthcare.gov/law/about/provisions/services/index.html

Q: What about mammograms?

A: In a controversial move last year, the U.S. Preventive Services Task Force recommended that women between 40 and 50 do not need regular mammograms.

But lawmakers inserted a provision in the new law specifying that women older than 40 will still be able to get a mammogram screening every year or two at no cost.

The administration is also working with an outside panel of experts to develop a series of other preventive services for women that may be covered in the future.

Q: Will everyone qualify for this new benefit?

A: No. Only people in new insurance plans beginning after Sept. 23 or in existing plans that change substantially will be able to get the discounted preventive services.

The health-care law exempts so-called grandfathered plans offered by employers that have not substantially changed since the legislation was signed in March.

To maintain grandfathered status, employers cannot substantially raise co-pays, deductibles and other employee contributions or lower their contribution to their employees' premiums by more than 5 percentage points.

Q: How much difference will this make?

A: That's difficult to say. Many experts and consumer groups are hopeful it will ultimately have a huge impact.

Tens of millions of Americans still do not get basic screenings for diseases such as colorectal and cervical cancer. Numerous studies have suggested that early detection of diseases as well as interventions to address bad habits such as smoking and overeating can improve health and productivity.

But it is still unclear how many people will take advantage of the less expensive services, some of which, such as dietary counseling for obese Americans, may not be readily available in some parts of the country.

Q: Will the added benefits drive up premiums?

A: They could. The administration estimated that the new benefits may push up premiums by 1.5 percent on average.


http://www.concordmonitor.com/article/white-house-issues-health-care-rules

petegz28
07-15-2010, 10:22 AM
"The White House issued new rules on health care"


Just think about that for a second....

petegz28
07-15-2010, 10:26 AM
So, one has to ask the obvious, who is now paying for these "free" services??

Did the medical technicians start working for free??
Did the equipment to perform these screenings suddenly become free?


So basically, Dear Leader just pounded his gavel and said these things are now to be "free"!!!

You just cannot make this shit up no matter how good the acid is.

jiveturkey
07-15-2010, 10:38 AM
My current plan already covers preventative screenings at 100%.

It makes sense IMO. If people are more proactive with regards to basic preventative screenings then their long term costs will likely be lower. People who wait until they are bleeding from their ass to see a doctor likely cost more to maintain.

petegz28
07-15-2010, 10:42 AM
My current plan already covers preventative screenings at 100%.

It makes sense IMO. If people are more proactive with regards to basic preventative screenings then their long term costs will likely be lower. People who wait until they are bleeding from their ass to see a doctor likely cost more to maintain.

I think you are confusing the issue. Your employer pays premiums as you do as well. Your insurance company set their plan up to pay for your screenings with no cost out of pocket to you.

That is not the same as a White House mandate.

jiveturkey
07-15-2010, 10:56 AM
I think you are confusing the issue. Your employer pays premiums as you do as well. Your insurance company set their plan up to pay for your screenings with no cost out of pocket to you.

That is not the same as a White House mandate.They're just mandating that insurance plans cover this. They're allowed to increase premiums.

A: The administration estimated that the new benefits may push up premiums by 1.5 percent on average.

Brock
07-15-2010, 11:26 AM
and the best part IT'S FREE!!11

notorious
07-15-2010, 11:29 AM
Is there due process? Can one person just say,"OK, this is how it is" without anyone else getting involved?


Sounds almost dictator-like to me........

Chief Faithful
07-15-2010, 11:30 AM
"The White House issued new rules on health care"


Just think about that for a second....

The beauty of creating a new bureaucracy that is accountable to the Executive Branch.

FD
07-15-2010, 11:39 AM
This policy seems designed to push down long-term medical costs, which is clearly a good objective. There is some mixed evidence on the ability of preventive care to do that but this is still probably a good policy. Whats troubling is when congress gets involved and begins overruling the task force, which unfortunately will happen with increasing frequency.

petegz28
07-15-2010, 11:46 AM
This policy seems designed to push down long-term medical costs, which is clearly a good objective. There is some mixed evidence on the ability of preventive care to do that but this is still probably a good policy. Whats troubling is when congress gets involved and begins overruling the task force, which unfortunately will happen with increasing frequency.

Again, I am not arguing the value of preventative care. I am arguing that it just doesn't sit right that the White House is mandating these things and that they be free on top of it.

The other concern is the White House dictating how much employers can increase premiums, co-pays, etc.. This is a trap. They know that employers are going to eventually get squeezed out and the people will be forced onto the Fed Gov plans. You can't dictate things are going to be free or pre-existing conditions are to accepted without charging them more and expect this shit to pan out. The math simply doesn't add up.

Saul Good
07-15-2010, 11:47 AM
This policy seems designed to push down long-term medical costs, which is clearly a good objective. There is some mixed evidence on the ability of preventive care to do that but this is still probably a good policy. Whats troubling is when congress gets involved and begins overruling the task force, which unfortunately will happen with increasing frequency.I keep hearing people say that free preventative care will make things cheaper in the long run. If that were true, the insurers would have made it free to begin with to lower their own costs.

jiveturkey
07-15-2010, 11:53 AM
I keep hearing people say that free preventative care will make things cheaper in the long run. If that were true, the insurers would have made it free to begin with to lower their own costs.Some have. The last two plans I've been on didn't charge co-pays or deductible for preventative care.

petegz28
07-15-2010, 11:56 AM
Some have. The last two plans I've been on didn't charge co-pays or deductible for preventative care.

Some. And again, these are plans that were designed and provided by the insurance company, not by the will of the President.

FD
07-15-2010, 11:57 AM
Again, I am not arguing the value of preventative care. I am arguing that it just doesn't sit right that the White House is mandating these things and that they be free on top of it.

The other concern is the White House dictating how much employers can increase premiums, co-pays, etc.. This is a trap. They know that employers are going to eventually get squeezed out and the people will be forced onto the Fed Gov plans. You can't dictate things are going to be free or pre-existing conditions are to accepted without charging them more and expect this shit to pan out. The math simply doesn't add up.

As I read the article, the White House was just clarifying the policy that was already written into the bill. As scary as the headline is, this isn't that different from how most governance works.

I agree very much that limits on increases in premiums, etc, is a stupid idea and can only end in failure. I suspect it will only be used as a bargaining tool against the insurers but we will see.

FD
07-15-2010, 12:00 PM
I keep hearing people say that free preventative care will make things cheaper in the long run. If that were true, the insurers would have made it free to begin with to lower their own costs.

There may be a coordination problem going on here, where for some insurers its not worth it on the margin to offer free preventive care because when customers switch plans later they are not going to be able to reap the benefits. If a large number of insurers don't offer it because of this, the coordination problem can be overcome by a federal policy mandating it. This results in everyone offering it and everyone reaping the benefits. If preventive care really does reduce long term costs then its a win-win situation for everybody.

petegz28
07-15-2010, 12:02 PM
There may be a coordination problem going on here, where for some insurers its not worth it on the margin to offer free preventive care because when customers switch plans later they are not going to be able to reap the benefits. If a large number of insurers don't offer it because of this, the coordination problem can be overcome by a federal policy mandating it. This results in everyone offering it and everyone reaping the benefits. If preventive care really does reduce long term costs then its a win-win situation for everybody.

This really doesn't make a lot of sense. If a company can't afford it then how is forcing them to do it going to make it affordable? Particularly when the WH is going to dictate how much you can and cannot increase premiums.

petegz28
07-15-2010, 12:03 PM
Some have. The last two plans I've been on didn't charge co-pays or deductible for preventative care.

I have to ask, have your premiums, employer paid or otherwise, gone up each year you have had these plans?

petegz28
07-15-2010, 12:04 PM
Let us all be clear on one little fact of life... NOTHING is free.

Saul Good
07-15-2010, 12:06 PM
Some have. The last two plans I've been on didn't charge co-pays or deductible for preventative care.
And the restaurant I went to for lunch gave me a hanburger, but they didn't do it because it was cheaper for them in the long run than letting me go hungry.

ClevelandBronco
07-15-2010, 12:06 PM
There may be a coordination problem going on here, where for some insurers its not worth it on the margin to offer free preventive care because when customers switch plans later they are not going to be able to reap the benefits. If a large number of insurers don't offer it because of this, the coordination problem can be overcome by a federal policy mandating it. This results in everyone offering it and everyone reaping the benefits. If preventive care really does reduce long term costs then its a win-win situation for everybody.

And at that point we can probably throw this part of the OP out the window...

Q: Will the added benefits drive up premiums?

A: They could. The administration estimated that the new benefits may push up premiums by 1.5 percent on average.

(As if that isn't bullshit already.)

jiveturkey
07-15-2010, 12:10 PM
I have to ask, have your premiums, employer paid or otherwise, gone up each year you have had these plans?
Exponentially

petegz28
07-15-2010, 12:12 PM
Exponentially

So you really weren't getting those services for free then. They just raised your premiums.

petegz28
07-15-2010, 12:13 PM
And at that point we can probably throw this part of the OP out the window...



(As if that isn't bullshit already.)

No kidding. "They could"???? This Admin truly does depend on the ignorant. Willfull or otherwise.

Saul Good
07-15-2010, 12:14 PM
There may be a coordination problem going on here, where for some insurers its not worth it on the margin to offer free preventive care because when customers switch plans later they are not going to be able to reap the benefits. If a large number of insurers don't offer it because of this, the coordination problem can be overcome by a federal policy mandating it. This results in everyone offering it and everyone reaping the benefits. If preventive care really does reduce long term costs then its a win-win situation for everybody.

If this was really the case, one insurer would offer it in order to gain a short-term competitive advantage knowing that all other insurers would quickly follow thus giving the entire industry long-term benefits.

The reality is that it costs more.

petegz28
07-15-2010, 12:15 PM
Ok, so for the nasty part of this you probably won't hear, for every 1 person that preventative screening benefits you will probably have 9 others getting tests they otherwsise do not need.

jiveturkey
07-15-2010, 12:15 PM
So you really weren't getting those services for free then. They just raised your premiums.I might have miss spoke earlier. I never meant for those services to be considered free. They are simply covered.

I do understand that they contributed to the premium increases. I certainly hope that the large increases weren't tied to a preventative program.

mlyonsd
07-15-2010, 12:16 PM
No kidding. "They could"???? This Admin truly does depend on the ignorant. Willfull or otherwise.

It isn't a lie only because there are probably certain plans the rich buy where premiums won't rise.

Of course they'll be taxed for having them though. ROFL:eek::doh!:

jiveturkey
07-15-2010, 12:16 PM
Ok, so for the nasty part of this you probably won't hear, for every 1 person that preventative screening benefits you will probably have 9 others getting tests they otherwsise do not need.What are some preventative tests that people don't need?

ClevelandBronco
07-15-2010, 12:31 PM
I might have miss spoke earlier. I never meant for those services to be considered free. They are simply covered.

I do understand that they contributed to the premium increases. I certainly hope that the large increases weren't tied to a preventative program.

I know what you mean. I'm hoping that the large increases were used exclusively for obscene and potentially scandalous perks for high-ranking executives.

Garcia Bronco
07-15-2010, 12:39 PM
You can do all the preventative care you want. You can exercise, eat your vitamins, eat right and everything in between, but when the good lord decides your number is up...it's up...and all the money and care in the world won't save you.

Saul Good
07-15-2010, 12:47 PM
What are some preventative tests that people don't need?

My wife, for example, could go without prostate exams.

Seriously, though, it was recently determined that mammograms aren't needed until later than previously thought.

You can screen for just about anything, but certain ailments are so rare that it's not practical to screen everyone.

petegz28
07-15-2010, 12:49 PM
What are some preventative tests that people don't need?

When you get down to brass tacks, if the test comes out negative then you didn't need it. Trivial as it may sound, you still end up paying, or someone does anyway, for a test that wasn't needed.

petegz28
07-15-2010, 12:50 PM
You can do all the preventative care you want. You can exercise, eat your vitamins, eat right and everything in between, but when the good lord decides your number is up...it's up...and all the money and care in the world won't save you.

My Brother-In-Law's Dad was just diagnosed with pancreatic cancer, stage 4. He worked out, ate healthy, didn't smoke and had been going to the doctor for the last 4 months because he hadn't felt good. And they never caught it until it was too late.

mlyonsd
07-15-2010, 12:53 PM
My wife, for example, could go without prostate exams.

Seriously, though, it was recently determined that mammograms aren't needed until later than previously thought.

You can screen for just about anything, but certain ailments are so rare that it's not practical to screen everyone.

Depends on the person.

My wife has cancer running rampant through her side of the family. She's lost several Aunt's Uncle's through various cancers, her first cousin died at 42 with a brain tumor, her mom died of pancreatic cancer at 65, and her sister was diagnosed with breast cancer at 46.

Because of her family history my wife goes in for all type of screenings every other year and she turns 48 today.

With that type of family history I'd hate to see any type of preventative care rationed for someone in that situation.

donkhater
07-15-2010, 01:01 PM
Exactly what diseases are they going to prevent? How do you prevent cancer?

Preventative care for uncommon, catastrophic diseases are not cost effective, so this idea that it'll save money in the long run is complete BS.

donkhater
07-15-2010, 01:02 PM
Depends on the person.

My wife has cancer running rampant through her side of the family. She's lost several Aunt's Uncle's through various cancers, her first cousin died at 42 with a brain tumor, her mom died of pancreatic cancer at 65, and her sister was diagnosed with breast cancer at 46.

Because of her family history my wife goes in for all type of screenings every other year and she turns 48 today.

With that type of family history I'd hate to see any type of preventative care rationed for someone in that situation.

How is screening for a disease preventing a disease from occuring?

petegz28
07-15-2010, 01:11 PM
Exactly what diseases are they going to prevent? How do you prevent cancer?

Preventative care for uncommon, catastrophic diseases are not cost effective, so this idea that it'll save money in the long run is complete BS.

The goal is, in a case like cancer, to catch it early enough to treat.

jiveturkey
07-15-2010, 01:12 PM
How is screening for a disease preventing a disease from occuring?
It's cheaper to treat if caught early and the rate of successfully treating are much higher.

I didn't realize that some many people are anti-preventative care.

mlyonsd
07-15-2010, 01:20 PM
How is screening for a disease preventing a disease from occuring?

Especially cancer it doesn't keep you from getting it, but it can keep you from dying or losing body parts.

donkhater
07-15-2010, 01:26 PM
The goal is, in a case like cancer, to catch it early enough to treat.

Not to sound cold, but you're not thinking like an actuary.

What percentage of the population is going to contract a ceratin cancer? At what age?

Is it then affordable to screen EVERYONE when only a small percentage may develop a certain cancer? Would it be more cost effective to treat the disease (even at a higher cost) than to screen millions more at a low cost?

Screening may save a lot of lives and make treatment less expensive, but that doesn't mean overall it is less expensive (monetarily).

jiveturkey
07-15-2010, 01:29 PM
What about checking cholesterol during an annual physical?

I found out my levels were elevated a couple of years ago. I made some changes and got the number back to normal. Should I have waited for a heart attack?

ClevelandBronco
07-15-2010, 01:31 PM
What about checking cholesterol during an annual physical?

I found out my levels were elevated a couple of years ago. I made some changes and got the number back to normal. Should I have waited for a heart attack?

You just picked one hell of an inexpensive test to make your point about expensive tests.

FD
07-15-2010, 01:34 PM
Not to sound cold, but you're not thinking like an actuary.

What percentage of the population is going to contract a ceratin cancer? At what age?

Is it then affordable to screen EVERYONE when only a small percentage may develop a certain cancer? Would it be more cost effective to treat the disease (even at a higher cost) than to screen millions more at a low cost?

Screening may save a lot of lives and make treatment less expensive, but that doesn't mean overall it is less expensive (monetarily).

Answer: New insurance plans will be prohibited from charging consumers a co-pay or deductible for services getting the top recommendation from the U.S. Preventive Services Task Force.

From the OP. A task force will decide whether preventative procedures are cost-effective or not.

petegz28
07-15-2010, 01:39 PM
Instead of mandating free screenings, I would rather see the Fed Gov make a move to get the nasty crap we put in our food yanked out. And no, I don't be sugar, salt or caffeine. I mean things like the nasty preservatives, the hormones, the fake sugars and HFCS, Nitrites, Sulfates, etc, etc.

petegz28
07-15-2010, 01:40 PM
From the OP. A task force will decide whether preventative procedures are cost-effective or not.

Isn't that grand??? I wouldn't want my doctor telling me what he thinks I need or anything.

vailpass
07-15-2010, 01:41 PM
And at that point we can probably throw this part of the OP out the window...



(As if that isn't bullshit already.)

X 1000

Hydrae
07-15-2010, 01:59 PM
Depends on the person.

My wife has cancer running rampant through her side of the family. She's lost several Aunt's Uncle's through various cancers, her first cousin died at 42 with a brain tumor, her mom died of pancreatic cancer at 65, and her sister was diagnosed with breast cancer at 46.

Because of her family history my wife goes in for all type of screenings every other year and she turns 48 today.

With that type of family history I'd hate to see any type of preventative care rationed for someone in that situation.

Happy B-day to your wife! :toast:

Guru
07-15-2010, 02:03 PM
Thats funny, my employer already provides me with insurance that doesn't require me to pay for preventative services. For a couple of years now as a matter of fact.

bsp4444
07-15-2010, 02:23 PM
You just picked one hell of an inexpensive test to make your point about expensive tests.

While it's not test for cancer, a cholersterol test, if it includes blood sugar, liver function, et. al., costs about $300 a pop if not insured. I've been having this test done quarterly for 2 years. So it's not what I'd call inexpensive. But even at that, it's cheaper than a heart attack, and my preventive screening alerted me that I needed to make some changes. Our company, too, has a cheaper policy if we participate in the screenings.

bsp4444
07-15-2010, 02:26 PM
Instead of mandating free screenings, I would rather see the Fed Gov make a move to get the nasty crap we put in our food yanked out. And no, I don't be sugar, salt or caffeine. I mean things like the nasty preservatives, the hormones, the fake sugars and HFCS, Nitrites, Sulfates, etc, etc.

Sorry, Pete, but I can't help but think that if then you'd be screaming bloody murder that the government was telling you what you could and couldn't eat. I mean based on historical data, and all.

petegz28
07-15-2010, 02:28 PM
Sorry, Pete, but I can't help but think that if then you'd be screaming bloody murder that the government was telling you what you could and couldn't eat. I mean based on historical data, and all.

Well, that was a mighty fine display of twisting my words.

Garcia Bronco
07-15-2010, 02:29 PM
What about checking cholesterol during an annual physical?

I found out my levels were elevated a couple of years ago. I made some changes and got the number back to normal. Should I have waited for a heart attack?

You don't need to go to the doctor to check your cholesterol. In fact you can get a test for 8 bucks. The problem here will always be knowledge. Testing ones blood sugar and other vitals shouldn't require a trip to the doctor. Testing yourself and understanding how to mitigate risk can save us a great amount of money. Every one should be taught how to do it on their own and we can decrease doctor visits.

ClevelandBronco
07-15-2010, 02:32 PM
While it's not test for cancer, a cholersterol test, if it includes blood sugar, liver function, et. al., costs about $300 a pop if not insured. I've been having this test done quarterly for 2 years. So it's not what I'd call inexpensive. But even at that, it's cheaper than a heart attack, and my preventive screening alerted me that I needed to make some changes. Our company, too, has a cheaper policy if we participate in the screenings.

It's even more expensive if it includes a pregnancy test, a drug screening and a massage with a happy ending.

$300 isn't what he's talking about.

EDIT: And what Garcia said.

bsp4444
07-15-2010, 02:37 PM
Well, that was a mighty fine display of twisting my words.

Sorry. Not entirely my intention. But there's no way you can tell me that the direction we were headed with health care costs going up every year, and the insurance companies getting richer (did you know KCP&L was actually owned by an insurance company?) that we needed change. Preventive screenings just make sense, and who is going to make you do it if not the almighty dollar? I'm not entirely sold on the health care reform (obviously you are not for it at all, that's ok) but there are some ideas that make sense.

petegz28
07-15-2010, 02:42 PM
Sorry. Not entirely my intention. But there's no way you can tell me that the direction we were headed with health care costs going up every year, and the insurance companies getting richer (did you know KCP&L was actually owned by an insurance company?) that we needed change. Preventive screenings just make sense, and who is going to make you do it if not the almighty dollar? I'm not entirely sold on the health care reform (obviously you are not for it at all, that's ok) but there are some ideas that make sense.

For the 3rd time, I am not opposed to preventitive screenings. My concern is the industry wide (more or less) mandate from the White House. That is what concerns me. The President does not need to be in charge of our health care.

Amnorix
07-15-2010, 02:43 PM
"The White House issued new rules on health care"


Just think about that for a second....

Pretty sure HHS issued them, not the "White House".

Obviously, all regulations of the federal government are done under executive authority, but generally the agencies themselves are dealing with this type of minutiae.

Amnorix
07-15-2010, 02:43 PM
For the 3rd time, I am not opposed to preventitive screenings. My concern is the industry wide (more or less) mandate from the White House. That is what concerns me. The President does not need to be in charge of our health care.

Do you get that every President is in charge of all the federal agencies?

vailpass
07-15-2010, 03:24 PM
Do you get that every President is in charge of all the federal agencies?

Do you get that a very large percentage of the American public that represents an even larger percentage of the spending power of the American public disagree with obama's health care debacle and are mad as hell about it?

donkhater
07-15-2010, 04:23 PM
What about checking cholesterol during an annual physical?

I found out my levels were elevated a couple of years ago. I made some changes and got the number back to normal. Should I have waited for a heart attack?

Not to burst your bubble, but there has never been conclusive evidence linking high chlolesterol to heart disease.

orange
07-15-2010, 04:43 PM
Instead of mandating free screenings, I would rather see the Fed Gov make a move to get the nasty crap we put in our food yanked out. And no, I don't be sugar, salt or caffeine. I mean things like the nasty preservatives, the hormones, the fake sugars and HFCS, Nitrites, Sulfates, etc, etc.

They (FDA) actually tried to ban nitrites back in 1978. The meat industry fought it tooth-and-nail and it was eventually dropped.

It's a good case study in how hard (maybe "next to impossible" would be a better word choice) what you're suggesting is.

Medicine: No Nitrite Ban http://www.time.com/time/magazine/article/0,9171,922137,00.html