Although I don't think it went nearly far enough, I have been generally in favor of the health care reform bill. I was doing some searching today about HSA's though, and I came across the new regulations that say that after January 2011, in order to use your HSA to buy over the counter medication, you have to have a prescription.
That just ain't cool. I fail to see the reasoning behind it, too. Upon finding that out, I did some more searching and came across this article, which is several months old: http://www.ncpa.org/pub/ba698
My high deductible PPO insurance plan, combined with my HSA, is very good and makes economic sense. We have a regular PPO and a high deductible PPO at my work. The plans are nearly identical, paying the same rates on most things after you meet the deductible. The differences are not major, and sometimes the regular plan is a little worse than the high deductible. The amount of the deductible for the high deductible family plan is LESS than the additional amount that would be paid in premiums on the regular ppo family plan, not counting that deductible. The regular ppo plan also has a $20 copay, the high deductible does not. The high deductible plan pays 100% for well care, including things like immunizations, whether or not you paid your deductible. The family plan may pay 100% on well care, too--I'm not sure.
So, at least where I work, if you put the full amount of the deductible in the HSA every year, you get the same coverage, you save money, and if you don't use your HSA, it's always there. If I were on the other plan, that premium money is gone forever.
I say all this because according to that article, some people in government think that it's a risky plan--but I don't think ours is. Our maximum out of pocket is about twice our deductible, so if something catastrophic happens, I might be stuck making payments for a while--but I can make those payments out of my HSA, too. I don't think I'd be any better off in that situation if I were in a regular ppo. I'd still have major bills, and I wouldn't have an HSA to pay my portion.
So, what's the real story? Am I missing something? Are there bad HSAs out there? Since enrollment in an HSA is not required to be in a high-deductible plan (right?), I guess that could spell disaster--but requiring participation in an HSA (unless you have a fully-funded one already) seems to be a better solution than destroying them altogether.
Posted by Mucus (Member # 9735) on :
*wikis HSA, PPO* Ow
Posted by Scott R (Member # 567) on :
IIRC, your nationalized health care will take care of that injury for you, Mucus.
Posted by Katarain (Member # 6659) on :
Mucus, am I supposed to understand what you mean?
Posted by Katarain (Member # 6659) on :
We are low income with members of the family who have serious health problems. It is STILL better for us, as I stated above, because we're paying less for the same coverage. I make little enough according to my family size, that I don't pay federal taxes (except SS and medicare, of course), I actually get EIC back. So while I don't see a reduction in my taxes because of my HSA contributions, I do see an increase in my EIC.
Posted by Katarain (Member # 6659) on :
Our deductible for the family plan is $3000, and the maximum out of pocket is $6000. I can see a plan with a maximum oop of $11,900 being a not very good thing.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by Katarain: Mucus, am I supposed to understand what you mean?
I just didn't expect the wiki article for HSAs to be longer and more complicated than, well, random example, the article for RRSPs (Registered Retirement Savings Plans).
*wikis EIC*
Posted by Katarain (Member # 6659) on :
Sorry. EIC is Earned Income Credit.
Posted by ambyr (Member # 7616) on :
This change affects FSAs as well, FYI.
(just to give Mucus more acronyms to google)
Posted by Wingracer (Member # 12293) on :
quote:Originally posted by Mucus: I just didn't expect the wiki article for HSAs to be longer and more complicated than, well, random example, the article for RRSPs (Registered Retirement Savings Plans).
*wikis EIC*
Why can't we all learn from Mikhail Kalashnikov?
"Anything that is complex is not useful and anything that is useful is simple."
Posted by DarkKnight (Member # 7536) on :
I think we were promised that if you like your current plan, you can keep it. So your plan should stay exactly the same as it is now...
Posted by katharina (Member # 827) on :
That's was one of the two most offensive lies told so people would pass that bill.
The other was that Congress would lower Medicare payments to pay for it.
Posted by Lyrhawn (Member # 7039) on :
That was a lie? I was under the impression that they promised to cut Medicare spending to pay for this, and that it was written into the final bill. In fact, wasn't that one of the major things that Republicans and AARP were up in arms about?
Also, anyone with half a brain could see that the fundamental promises Obama was making would alter your plan, even if you liked it and wanted to keep it. That promise is still true; he's not forcing people to pick a national health insurance plan. You can keep your plan, but the other changes in the bill are going to alter what your plan can and will be.
Honestly, I haven't taken a big look at the bill since before it passed, and other than one or two little things, I forgotten so much about it that I can't really even remember what it does or how it affects me. When does the whole mandatory insurance thing kick in?
Posted by rivka (Member # 4859) on :
quote:Originally posted by ambyr: This change affects FSAs as well, FYI.
I can't use my FSA for otc items beginning January? Are you sure?
Oh, that is VERY annoying.
Posted by rivka (Member # 4859) on :
My FSA now has posted two different OTC lists; one starting 1/1/11. That distinction was NOT there when I signed up, and I am annoyed. I'm sure I can get the paperwork from my doctor without a problem. But the main reason I signed up for this FSA was because it had much less work involved in getting stuff paid for (a debit card) than the old one, which I have had endless problems with.
Guess I'll be stocking up on all my OTC allergy meds and the like in December. Posted by Kwea (Member # 2199) on :
I had a HSA, and choosing it as an option while I worked at JCPenney was one of the worst financial decisions I have ever made. I went to use the last $1500 in it, because it was a use-it-or-lose-it version, and they closed the use 7 weeks before the actual end of the year.
I couldn't use it for mail order stuff, I couldn't use it for over the counter stuff, and I couldn't use it to pay for eye exams....all because they have an "eligibility window" they never told us about. Tye basically STOLE my money, and I couldn't do anything about it.
Posted by DarkKnight (Member # 7536) on :
quote:When does the whole mandatory insurance thing kick in?
It doesn't kick in until 2014.
quote: That promise is still true; he's not forcing people to pick a national health insurance plan. You can keep your plan, but the other changes in the bill are going to alter what your plan can and will be.
It is untrue because the health care bill fundamentally changes all plans. Health Care Reform
quote: This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.
The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.
The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.
The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.
The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.
Posted by Amanecer (Member # 4068) on :
quote:That just ain't cool. I fail to see the reasoning behind it, too.
The reasoning is that it's a revenue generator. Right now, all otc medicines being bought with FSAs or HSAs are bought with pre-tax dollars. Starting in January, they will be bought with post-tax dollars and the government will increase its revenue.
quote:So, what's the real story? Am I missing something? Are there bad HSAs out there?
It absolutely depends on your plan design and how often you go to the doctor. If you never go to the doctor and have no prescriptions, you're probably better of in the High Deductible. If you have any medical condition that requires a prescription or frequent doctor visits, you're probably better of in the regular PPO. Even then, it depends on the specifics of your plan. For the past two years I was in our High Deductible with an HSA and was very happy. This year they stopped contributing to the HSA, raised the deductible and Out of Pocket Max, and I no longer think it's the best plan for me. So, I think it's hard to make blanket statements about which is better when there's so much variance.
Posted by MrSquicky (Member # 1802) on :
quote:The reasoning is that it's a revenue generator. Right now, all otc medicines being bought with FSAs or HSAs are bought with pre-tax dollars. Starting in January, they will be bought with post-tax dollars and the government will increase its revenue.
In my cynical mind, this is aimed more at increasing insurance companies' revenue than the governments. Messing as they have with the HSAs makes them a much less viable option for many people, which leaves them paying higher premiums to the insurance companies.
Posted by Amanecer (Member # 4068) on :
quote:In my cynical mind, this is aimed more at increasing insurance companies' revenue than the governments. Messing as they have with the HSAs makes them a much less viable option for many people, which leaves them paying higher premiums to the insurance companies.
While people with HSAs do pay lower premiums to the insurance companies, they do so because the insurance companies pay less claims for those people. I see no evidence that insurance companies dislike HSAs.
Posted by MrSquicky (Member # 1802) on :
I don't have the data to back this up, but I'm thinking that a lot of the people who have high deductible (and thus low premium) and HSAs very often make few to no claims over the deductible in the course of a year.
edit: Which, thinking about it, depending on the numbers could support either of our assertions.
[ August 13, 2010, 11:53 AM: Message edited by: MrSquicky ]
Posted by Amanecer (Member # 4068) on :
You are right that people who have high deductibles have fewer claims over the year. Which means that insurance companies have to pay only those few claims for them, which is why they are so cheap. Insurance companies still keep the same profit margin. They don't lose money by people going to the doctor less.
This might be way more info than you wanted, but... I work for an Employee Benefit Consulting firm, and I think there are a lot of common misconceptions about how insurance works.
First off, there are essentially two methods a company can take to give employees insurance. The first is called "fully-insured" and it fits the idea most people have of insurance. In fully insured plans, the company pays the insurance carrier premiums for all of its employees. When the employee goes to the doctor, hospital, etc. the insurance carrier pays the bill.
Secondly, there is "self-insured". This means that the company pays the insurance carrier only an administration fee. When you go to the doctor, the insurance company pays for it and then essentially sends a bill to your company for that amount. This is actually the majority of the market. Almost all large companies are self-insured.
I bring this up because I think that sometimes motives are attributed to insurance companies that are not realistic. Insurance carriers get new business in the self-insured market by having excellent networks, lower administration fees, efficient and problem-free administration, good wellness programs, etc. How rich the plan design is (PPO versus High Deductible) can sometimes affect how big the administration fee is because it affects how many claims they will receive and have to administrate, but only to a very minimal extant. All major carrier are pushing their high deductibles at the moment because they are such a popular product.
Posted by Geraine (Member # 9913) on :
quote:Originally posted by Amanecer: [The reasoning is that it's a revenue generator. Right now, all otc medicines being bought with FSAs or HSAs are bought with pre-tax dollars. Starting in January, they will be bought with post-tax dollars and the government will increase its revenue.
This is a true statement. Oh, it is not a direct tax, but it is a round about way to raise revenue.
Many people are now receiving documentation on the costs of their health insurance for next year and finding that costs have sky rocketed. I'm scared to find out what my plan is going to cost next year. My plan already covered kids up to 26 years of age (As long as they were enrolled in school), covers domestic partnerships, pre-existing conditions, and all of the other things in the new bill. I have excellent coverage and my employer pays a very large portion of my coverage. I'm scared to see what my costs are going to be next year now that every plan is forced to cover these provisions.
The point of the bill was to lower costs, and the opposite is happening. The bill instituted costly changes without requiring everyone to get health insurance until four years later.
I honestly believe that the reason why some of these provisions went into effect now and others will not until 2014 is simply a political game. We were promised that this bill was passed to lower health care costs. When you add extra provisions four years before everyone is required to have health insurance, the insurance companies have to pay for it somehow. Prices are raised to pay for all of these new provisions.
My gut feeling (I hope I am wrong) is that in the next year or two you will see President Obama and others feigning outrage that Insurance companies are continuing to gouge the consumer and will take steps to institute a single payer government run system.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by Geraine: ... in the next year or two you will see President Obama and others feigning outrage that Insurance companies are continuing to gouge the consumer and will take steps to institute a single payer government run system.
I sure hope so.
Posted by Amanecer (Member # 4068) on :
quote:The point of the bill was to lower costs, and the opposite is happening.
That was one point of the bill and I agree it's not happening. The other point was to expand coverage and that most certainly will happen. I think at the end of the day they prioritized one over the other.
Posted by fugu13 (Member # 2859) on :
The argument was only that costs would be lowered in the long run, and in the aggregate. Since you are looking at the specific in the short run, this doesn't speak much to the bill's efficacy.
Personally, I doubt it will work to lower costs in the long run. The only reason it got a remotely acceptable budget score (though budget is not the only measure of cost-effectiveness) is inaccurate assumptions and pushing costs off on states (who are even less well-equipped to handle them than the federal government).
Posted by scholarette (Member # 11540) on :
ok- stupid question on hsa plans. Right now, we go to the dr, we pay our deductible and in a few weeks, we usually get an explanation of beneftis that says the dr charged $250, we negotiated down to $50 and paid $35. You owe $15, which you paid as a copay. If paying on HSA, do you pay your dr the $250 at the time or do you wait until the insurance negotiates the price down? Do they still negotiate it down?
Though I do think it is ridiculous just how much the insurance negotiates. Our ER bill started at $8000 and the insurance negotiated to $1000. Seriously, because we are in the privileged class we get to pay 1/8th the cost that some poor individual without health care would be charged? In what world is that an equitable system- same service, but we have a better job, so we pay less for it. Absolutely ridiculous.
ETA- switched deductible to copay.
[ August 13, 2010, 04:01 PM: Message edited by: scholarette ]
Posted by Geraine (Member # 9913) on :
quote:Originally posted by Mucus:
quote:Originally posted by Geraine: ... in the next year or two you will see President Obama and others feigning outrage that Insurance companies are continuing to gouge the consumer and will take steps to institute a single payer government run system.
I sure hope so.
Because it has worked so well in every other country it has been implemented in right?
Posted by dkw (Member # 3264) on :
scholarette, I think you are confusing deductible and copay in your last post.
Posted by Amanecer (Member # 4068) on :
quote:ok- stupid question on hsa plans. Right now, we go to the dr, we pay our deductible and in a few weeks, we usually get an explanation of beneftis that says the dr charged $250, we negotiated down to $50 and paid $35. You owe $15, which you paid as a deductible. If paying on HSA, do you pay your dr the $250 at the time or do you wait until the insurance negotiates the price down? Do they still negotiate it down?
In this situation, a person would pay the $50 copay. They didn't really "negotiate" it after the fact, if the doctor is in your network they have a pre-existing arrangement with your insurance company and they will know what to charge you.
quote:Though I do think it is ridiculous just how much the insurance negotiates. Our ER bill started at $8000 and the insurance negotiated to $1000. Seriously, because we are in the privileged class we get to pay 1/8th the cost that some poor individual without health care would be charged? In what world is that an equitable system- same service, but we have a better job, so we pay less for it. Absolutely ridiculous.
Many doctors have special prices for the uninsured (that are essentially the same as the real price they get paid by the insurance companies), you just have to ask about it. I'm not sure how true that is for hospitals though. I do know that the vast majority of hospital claims for the uninsured are never paid. It's possible they're pricing that in to the cost. Which doesn't make it fair, but it does make business sense.
Posted by scholarette (Member # 11540) on :
If the hospital is charging 8 times as much to the uninsured, I am inclined to side with the uninsured not paying. If you are including the uninsured who don't pay in the cost (kind of like how groceries include shoplifting losses in the cost of food), that's fine, but charge it to everyone (like the grocery store does). If the service costs $1000, that is what should be charged to everyone, not $8000 to one person, $2000 to another, $1000 to a third.
Posted by Katarain (Member # 6659) on :
quote:Originally posted by Amanecer:
quote:So, what's the real story? Am I missing something? Are there bad HSAs out there?
It absolutely depends on your plan design and how often you go to the doctor. If you never go to the doctor and have no prescriptions, you're probably better of in the High Deductible. If you have any medical condition that requires a prescription or frequent doctor visits, you're probably better of in the regular PPO. Even then, it depends on the specifics of your plan. For the past two years I was in our High Deductible with an HSA and was very happy. This year they stopped contributing to the HSA, raised the deductible and Out of Pocket Max, and I no longer think it's the best plan for me. So, I think it's hard to make blanket statements about which is better when there's so much variance.
I'm beginning to see that not all high deductible plans are created equal. I'm very lucky to work for a company with a good one.
How likely do you think some sort of post tax is on health savings accounts, like when you reach a certain amount? I think something like that was mentioned in the first article I linked to. If I have 4 years until I'm kicked off my awesome plan, then I want to save as much as I can in my HSA.
Posted by Katarain (Member # 6659) on :
quote:Originally posted by Kwea: I had a HSA, and choosing it as an option while I worked at JCPenney was one of the worst financial decisions I have ever made. I went to use the last $1500 in it, because it was a use-it-or-lose-it version, and they closed the use 7 weeks before the actual end of the year.
I couldn't use it for mail order stuff, I couldn't use it for over the counter stuff, and I couldn't use it to pay for eye exams....all because they have an "eligibility window" they never told us about. Tye basically STOLE my money, and I couldn't do anything about it.
That sounds like an FSA rather than an HSA. Our employer arranged a grace period for ours last year, so we could incur costs and get reimbursed until March 15 of the following year. We barely made it even then, which was one reason I switched to the HSA. Some FSAs must have completely arbitrary and unfair rules, but I think those rules are set by the companies.
Posted by katharina (Member # 827) on :
quote:If the hospital is charging 8 times as much to the uninsured, I am inclined to side with the uninsured not paying.
No. Prices to the insured are higher, unless the insurance company is large enough to have clout. Prices to Medicare is lower, and prices for Medicaid patients is the lowest, with the effect that many doctors refuse to accept Medicaid patients.
Posted by Flying Fish (Member # 12032) on :
Why do different people get different costs? I think something like this is happening:
Let's say Mercy Medical decides to do widgetoscopies. By the time they pay the technicians who do them, account for the MD's time to read and interpret them, amortize the machine they use to do them, and account for the equipage (widgetoscopy film, lubricant, etc.) they determine that each one costs them $1000 dollars.
Alan comes in for one. His insurance will pay for it at "reasonable and customary cost."
Bob comes in for one. He is going to get billed later.
Charlie comes in for one. He is going to be billed later.
Dan comes in for one. He can pay cash in advance.
Edward comes in for one. He is on Medicare.
They bill Alan's insurance company $1800, knowing full well that the beancounters there are going to come back and say "Screw you -- those cost $1000 and that's all we're going to pay." BUT THEY ALSO KNOW THAT THE INSURANCE COMPANY MAY SAY, "Screw you, those shouldn't cost more than $1400 so we'll pay $1400." Either way, these payments take 14 months to get there, and require the services of two full-time billing clerks to process.
They then bill Bob $1500, he can't pay, they go to court, and settle the debt (after a year or two) for $500, which they then sell to a collection agency for $50. The collection agency harasses Bob for $970 dollars (debt + late fees + court costs). Depressed over his debts and his widgetoscopy results, Bob commits suicide.
They bill Charlie $1500 for the $1000 test, Charlie eats cat food for a month and sells his guitar and pays the debt, vowing to never go to Mercy Medical again. Two years later Charlie dis of a preventable melanoma.
They ask Dan for $1500 cash in advance. Dan, scowling, looks in his bank account and says "That's pretty steep. I only have $600 in my account until next month."
Mercy Medical, seeing that no lawyers or billing clerks will be involved, and that the cash will be the "right-now" cash (the best kind), says "We can do it for $550!"
Now for Edward on Medicare, one of two things might happen.
If the government realizes that it costs Mercy Medical $5000 to do 5 average widgetoscopies and that Mercy Medical has only made about $2000 so far, they may decide to pay about $3000 for Edward's procedure.
If the government realizes that an individual widgetoscopy costs no more than $1000, they may hold fast at $1100 or so -- in which case Mercy Medical decides to get out of the widgetoscopy business, because they are not a non-profit.
Or Mercy Medical keeps doing widgetoscopies because they save lives and keep your widgets healthy, they just put a big sign out front,
PROOF OF INSURANCE REQUIRED CASH IN ADVANCE SORRY, WE DO NOT ACCEPT MEDICARE OR MEDICAID
Posted by Darth_Mauve (Member # 4709) on :
Point of order--It is not the Health Care Bill. It is the Health Care Law. Every time you call it a "bill" instead of a "Law" you undermine it and help the Anti-Dem/Anti-Obama folks try to tear it down and repeal it not because its bad, or because they can replace it with something better, but because President Obama was for it so they must destroy it.
Posted by Kwea (Member # 2199) on :
FF, you pretty much gave a very basic explanation of what is wrong with our system, and why it costs so much to do some very simple, easy procedures that could save peoples lives.
In Marion County, FL, where I live and work, there is 1 hospital that delivers babies. One. MRMC is the ONLY hospital that delivers normal risk babies. Shands, up in Gainesville, has a severe neonatal ward, but they only accept specific cases, most of them high risk pregnancies.
It costs the hospital over $2800 to deliver a normal birth, AFTER all charges are paid by the parents. Each baby COSTS them profit, they LOSE money on EACH birth, even if it goes like clockwork.
Not every birth does.
But MRMC can't NOT deliver babies, even though all of the other hospitals in the area shut down their Labor and Delivery wards. Because if they did...where would people go to have a child? How would they be serving the needs of their patient population by refusing to deliver babies?
Medicare babies pay out even less than normal births, and have a much higher rate of complications, meaning that each child is born costing the hospital MORE money than average.
And MRMC is a not for profit hospital, so it's not like they gouge people to increase profits.
All across the country, not just here in FL, ER's are FILLED with people who would be better treated, at a more cost effective rate, by other medical facilities. Yet we keep paying ER rates for it, because we are afraid of what the change over will cost.
It boggles the mind, especially if you see it first hand like I did.
Posted by fugu13 (Member # 2859) on :
quote:Point of order--It is not the Health Care Bill. It is the Health Care Law. Every time you call it a "bill" instead of a "Law" you undermine it and help the Anti-Dem/Anti-Obama folks try to tear it down and repeal it not because its bad, or because they can replace it with something better, but because President Obama was for it so they must destroy it.
No, not really. The health care bill is a useful cohesive unit for talking about what passed. It did not constitute an entirely new law; instead, it amended numerous laws in numerous places. Calling it "the Health Care Law" would just be incorrect, as it is not a law, but a series of changes to lot of laws.
Posted by Darth_Mauve (Member # 4709) on :
While technically true Fugu, it is far closer to a "Bill" than a "Law" as a "Bill" is something that when passed by congress and signed by the President becomes a Law and you say this change in existing laws is not, nor can be, a law.
But by calling it a "Bill" we foster the impression, especially on those who don't know any better, that it is something not legally binding and that can be stopped by a quick vote. Bill's don't count for anything. Law's do. The Health Care Reform legally does.
Posted by fugu13 (Member # 2859) on :
quote:But by calling it a "Bill" we foster the impression, especially on those who don't know any better, that it is something not legally binding and that can be stopped by a quick vote.
No, we really don't. Calling it a bill provides a concise way of encapsulating the set of changes, and is a long standing way of referring to such things. There is no nefarious conspiracy, there is only a fairly standard set of nomenclature.
What's more, I feel sad for the people you feel are such idiots as to be swayed by what you perceive as a verbal trick. While words matter, this is about the silliest of political word battles I have ever heard anyone allege.
Posted by Dan_Frank (Member # 8488) on :
quote:Originally posted by Darth_Mauve: ...Anti-Dem/Anti-Obama folks try to tear it down and repeal it not because its bad, or because they can replace it with something better, but because President Obama was for it so they must destroy it.
Do you really believe that's the only reason people want to repeal it? Nobody sincerely believes it's bad, or that they could replace it with something better?
Posted by Lyrhawn (Member # 7039) on :
I bet if you did a national poll where you specifically asked people what they didn't like about the bill, a majority of the answers wouldn't sync with what's really in the bill.
Polls before the bill was passed show that if you broke it up into its constituent parts and asked people if they liked it, more than half liked it. When you called it Obama's health care bill, less than half liked it, and it was identical to the things they just said they wanted.
Clearly the Obama brand is a force at play here. Not the only one, surely, as many liberals dislike the bill too (I'm not thrilled with it myself), and by all accounts there IS a lot to take issue with. But it's certainly a big force to be reckoned with.
Posted by fugu13 (Member # 2859) on :
I suspect if you did a national poll where you specifically asked people what they did like about the bill, the majority of the answers wouldn't sync with what's really in the bill .
Posted by Lyrhawn (Member # 7039) on :
I agree.
Posted by Dan_Frank (Member # 8488) on :
quote:Originally posted by Lyrhawn: I bet if you did a national poll where you specifically asked people what they didn't like about the bill, a majority of the answers wouldn't sync with what's really in the bill.
Polls before the bill was passed show that if you broke it up into its constituent parts and asked people if they liked it, more than half liked it. When you called it Obama's health care bill, less than half liked it, and it was identical to the things they just said they wanted.
Clearly the Obama brand is a force at play here. Not the only one, surely, as many liberals dislike the bill too (I'm not thrilled with it myself), and by all accounts there IS a lot to take issue with. But it's certainly a big force to be reckoned with.
Certainly. I'm not even trying to make a value judgment on the bill, here. If you've seen my posts in other threads you can likely guess how I feel about the bill, but that's not really relevant to my comment.
I just think it's disingenuous to say that the only possible reason anyone could oppose it is because they hate Obama, and not because they actually object to the bill itself. The same way I think it's disingenuous to say the only reason anyone could be opposed to gay marriage is because they hate gay people, or the only reason people could oppose offshore drilling is because they hate oil companies.
I tend to think most people actually aren't motivated by spite or hatred or maliciousness most of the time. Most people feel like their opinions and ideas make sense, based on what they know. I may think that they are woefully wrong, and they may think that about me. But claiming that they know they're wrong and are just doing it anyone to be an evil jerk seems... silly, to me.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: Polls before the bill was passed show that if you broke it up into its constituent parts and asked people if they liked it, more than half liked it. When you called it Obama's health care bill, less than half liked it, and it was identical to the things they just said they wanted.
For me, part of the issue is the timing. I'm not opposed to making the insurance companies cover people with pre-existing conditions, and I'm not opposed to making everyone have insurance. However, I am opposed to making the insurance companies spend a giant pile of money for years before you make more people give them money in return. I feel that it was an attempt to bankrupt the insurance companies and put in a national plan instead.
I even think there should be some layer of national health care, and I still think that's the single worst way to go about doing it.
The ideas of the bill weren't the problem. The bill itself was.
Posted by DDDaysh (Member # 9499) on :
Ok, back to the original topic, that really ticks me off! It was FINALLY getting easier to use your FSA or HSA for OTC items, and now they're taking it all away. *pout*
On a side note, I was extremely displeased to find out that with an HSA you do not get all your money "up front" like you do in an FSA... or at least not in my HSA. In all previous years I had had an FSA because my company did not offer HSA. Since I've been on the high deductible plan, I needed the extra cash, and it worked pretty well. This year they offered the HSA, and I thought it was a better deal because that way you don't lose the money at the end of the year (or, like I previously did, spend it to stock up on OTC for the entire next year). However, I ran into a problem. Even though my entire deductible has to be paid up front, the only money available in my HSA is what I've actually deposited into it. With my FSA, if I said I was going to put $3,000 in for the year, then on day 1 I could spend $3,000 and they'd just keep taking it out of my check for the rest of the year. Unfortunately, the HSA doesn't work that way, which has meant scrambling to find money for some medical bills this year - though I guess it also means I'm going to have plenty left in my HSA for future years. I'm not saying this is totally unfair, and I'm sure if I'd read the fine print, it probably spells it out, but it sure was a nasty surprise for me!
Posted by Amanecer (Member # 4068) on :
quote:However, I am opposed to making the insurance companies spend a giant pile of money for years before you make more people give them money in return. I feel that it was an attempt to bankrupt the insurance companies and put in a national plan instead.
The insurance companies are just raising premiums to cover the added expense. Their financial integrity is not threatened by this. If you were saying you were annoyed that everyone is going to have increased premiums before the uninsured have to either get insurance or pay a fee (which is supposed to offset that somewhat), then I would agree.
Posted by GentleGiant (Member # 12377) on :
I am here in the UK; I pay a percentage of my wages as "National Insurance". I need a doctor I go make an FOC appointment, could be 1-2 days. If I want to see him/her now I pay extra and see him/her in an hour. If I need meds I pay a set fee of about $10 per item
I have a serious medical condition and need hospital treatment; same as above, but the meds are free and the waiting time might be longer.
If the hospital doesnt have the meds/treatment I want/need I can pay for the meds and/or treatment privately.
Actually I DO have a serious medical condition, and thank GOD I am in the UK!! Perhaps I cant get the latest treatments and meds for it; but the ones I get dont cost me an extra $. (The newer meds would cost me $15,000 a month for the rest of my life)
Posted by scholarette (Member # 11540) on :
DDDaysh- we have two accounts for different things (one preschool, the other medical) and one you can pull the full amount on day one, the other requires the money be made up. I can understand how hard it is to keep up with changing rules every year. I only know which is which cause I have been having fun with paper work.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Amanecer: The insurance companies are just raising premiums to cover the added expense. Their financial integrity is not threatened by this.
I disagree. As the premiums rise, young healthy people who really only need catastrophic coverage anyway tend to drop their insurance. So everyone left in the premium pool has to pay more then just the premiums not being paid - everyone left tends to spend more in claims.
I bet somewhere there's even an actuarial chart for it. When X number of people who file less than Y in claims cancel their policies, the price per person changes tiers. To make up some numbers, if 500 people drop your bill goes from $600 to $630, but if 5,000 drop, it jumps to $1,000. And when it goes up a tier, another group of people have to stop and ask themselves if they can afford their insurance.
While the health care bill was being debated, everything I read was calling this effect a "death spiral" for insurance companies. I'm assuming the insurance types thought they could ride out the three year gap or they would've fought harder against it, but I don't think anyone anticipated the recession being this bad. When I was Googling yesterday for the latest estimate of when hiring would pick back up, most of the articles were claiming late 2009. How many people lost their insurance after COBRA ran out? What did that do to the risk pools?
And as often as Congress worries about extending unemployment, I've never seen them discuss this. Why not a plan to add workers to Medicaid while they're on unemployment? A provision in the behemoth bill that makes loss of a job one of the events that lets you change your coverage so a spouse or family can be added outside of open enrollment?
Why are the easiest ways to protect the consumers overlooked? Why are taxpayers still just doing without? I truly believe it's because Congress had ulterior motives. Ones they think will lead to a better standard of care for everyone and a greater good in the long run, granted. But I still find it dishonest and potentially dangerous.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by AvidReader: While the health care bill was being debated, everything I read was calling this effect a "death spiral" for insurance companies.
Well, if I had been prepared for it, it probably wouldn't have been such a big deal. I was just caught off guard. That, and both my son and myself ended up having to have some pretty heavy medical expenses as soon as the new plan year started, so it was just... annoying. Luckily, one of his doctors was willing to set up a payment plan, so I was able to pay it over the course of a couple of months.
Posted by DDDaysh (Member # 9499) on :
Oh, and AvidReader, loss of a job was already considered a qualifying life event in all of the things I've ever read at any of my employers.
Posted by AvidReader (Member # 6007) on :
Really? I only remember getting married, divorced, having kids, or a death in the family. That one I apologize to Congress for. It doesn't make it any easier to pay for, but it's certainly not evilly shutting people out of the semi-affordable heath care market.
Posted by Jhai (Member # 5633) on :
Loss of a job or getting a new job for you or your spouse qualifies.
Posted by Kwea (Member # 2199) on :
Even loss of insurance. My wife works at the same job, but lost insurance coverage. If insurance was offered by my employer, then i would have ben a "qualifying lifestyle change" and I could have enrolled in it, even if it was past my normal enrollment window.
Posted by Samprimary (Member # 8561) on :
I just went through my open enrollment window and had to pour through the details, since (annoyingly) you had to enroll to decline coverage, otherwise they would automatically put you in the most ghettolord health coverage available.
Even if you had told them a ten billion times when asked that you are already covered and decline the option to change plans.
After having done so I can confirm everything said here. If I lost coverage or a jorb or whatever, it all counts.
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