(03-20-2014 11:58 AM)Machiavelli Wrote: If Republicans came up with a way to regulate the no caps and no pre existing conditions that would be a winner politically. How can they do that Hambone. I think that would be a win win for both sides. The report that came out earlier that 1/3rd of the uninsured still will be uninsured was a killer. All of this headache and 1/3rd of the problem is still a problem? D's can take credit for the new regulations the GOP can take credit for the common sense reforms.
The answer is so obvious that I don't know why you guys don't see it. The only thing that used to say that you couldn't keep your kids on your policy until they were 26 was a government rule that made children over 18 but not full-time college students no longer 'dependents'. All you have to do is write a rule that says they can keep them on until 26. This is pretty easy to regulate and enforce... How old are you? 25? Okay. 27? No. By the way... do the math... There is no particular benefit in math for keeping a child on your policy to 26 vs them having their own policy. The advantage is having 2+ kids on your GROUP 'family' policy as opposed to an individual policy or a single child. If you run 2 parents + 1 24yr old, and then run 2 parents and a separate policy for the 24yr old, the costs are the same.
As far as caps and PECs, again, just as they do in car insurance... establish minimum requirements for coverage. If you can't limit policies, then every existing policy goes up by a few bucks and is now unlimited. If you can't exclude for PECs, then the math for insurers changes and everyone pays more for insurance so that a few don't have to. A far better solution is for the government (through Medicaid) to make up this difference for those in the high risk pool, but it's really just a difference in whether we are being lied to or told the truth. The problem with the OLD way was merely that we under-funded the high risk pool... and not a problem with having a high risk pool in the first place. Mathematically, What's the difference between a high risk pool that subsidizes the difference in cost of insurance for high risk patients and having them be included in the premium calculation up front... which does exactly the same thing?
Obamacare PRETENDS to do these things, but it does so in such a power-grab, all-encompassing way that steals from the middle class because they don't want to be honest about what all these things cost.
These are generic numbers, but they aren't far off. If a typical health insurance plan for a family cost $1,000/mo 12,000 per year... and you uncap it, the cost probably goes up to $12,200/yr. The number of people who exceed these policy limits is actually quite small... so it doesn't take much money to 'buy off' these caps.
Minimum healthcare standards were SUPPOSED to be what Medicare and Medicaid taxes paid for, weren't they? OF COURSE they were... But nobody wanted to be honest and increase medicare taxes... in fact, Obamacare takes hundreds of millions AWAY from Medicare... and nobody wanted to be honest and just pay for those costs out of income taxes either... So instead we are doing it through premium increases on virtually everyone who makes more than about 75k/yr. Obviously that number has exceptions based on people's choices, but it's a decent ballpark. Plenty of people who make less than 75k already had high level insurance and many who made more did not... but that's pretty close. This is nothing more than a veiled income tax hike on the middle class.
I've got a hint for you... There are really only about 3 'general' choices in policies for everyone... and that is made clear by the gold silver and bronze plans that the government sponsors.... and that is basic coverage, medium coverage and full coverage. There really isn't much difference in what is covered... the differences are primarily in how the costs are shared. The basic coverage is a cheap policy, but you pay much more out of pocket. The middle is in the middle, and the top you pay a bigger premium but very little out of pocket. There is no mathematical difference (in aggregate) between something being 'not covered' and being covered, but subject to a deductible AND a premium. It is merely a question of how much financial 'opportunity' and personal choice you want in your healthcare.,.. and Obamacare has virtually eliminated those. They have taken away your incentive to make healthy choices so that you will consume less healthcare and thus save money so that they can deliver more healthcare to others... SOME of whom consume more healthcare because of their unhealthy choices, who are now less dis-incentevized (if that is a word) from doing so.
The reason I say 'the middle class' is because there is virtually no difference in the insurance policy that Warren Buffet and I could buy. We talk about 'luxury' policies and this tax on them, but because insurance is only math and not magic... all insurers have to do is design their policies to fit that criteria and then they create their own 'risk pool' with their concierge doctors to GET that extra care they were willing to pay for without the tax.
In other words, the most important things that you find Obamacare to accomplish are among the easiest to accomplish (other than the lies told to convince us that it isn't a tax)
Here are the things that healthcare reform NEEDS to do.
1) Increase the number of doctors. What good is insurance if you can't get an appointment? Obamacare doesn't do this
2) Decrease waste. Obamacare doesn't do this. If you say it does that is because of politics... Paying a doctor less to do a service isn't decreasing waste. I have a whole department of people who were hired specifically to deal with Obamacare. All of those costs are new and unrelated to delivering healthcare. Let's not even talk about all of the expenses to 'sell' and 'regulate' Obamacare.
Seriously... You realize that every disease and disorder has a clinical code number associated with it and reimbursement and coverage is PURELY based on these codes. How big would the regulating body have to be to allow policies to be sold across state lines and to assure that if someone is diagnosed with 348.30 Encephalopathy and 348.30 is on the list covered by the policy to be reimbursed at $85 * the government's regional adjustment factor that this actually happens? The VAST majority of these stories about people being denied coverage for things are either outright lies or complete stretches of the truth. There are something like 145,000 diagnosis codes in ICD-10 with iirc, 3 'acuity' and co-morbidity levels for each one... Most people don't have any idea what their policies cover and don't cover... but I can guarantee you that the insurers COULD provide you with a list of the (making up a number) 110,000 codes and acuity levels that ARE covered and the 35,000 that aren't. It's a huge number of diagnoses and unfortunately many of them are ALMOST the same, but sometimes one is covered and one is not... and THIS is where most of the trouble comes in...
and Obamacare does nothing to address this either. Instead, it actually makes it worse by tying the reimbursement to the doctors to 'patient satisfaction' more than outcomes. It doesn't matter if a doctor cures that pain in your leg... so long as you are happy that he gets you hooked on Oxycontin. If he tells you to go on a diet instead and this makes you unhappy, his reimbursement goes down.
Nice plan.
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Republicans plan for replacing Obamacare?
