The PPACA - Implementation Phase I

[St. Clown]

Re: The PPACA - Implementation Phase I

Clown you will cover mammograms under the concept of a shared burden which is how insurance works. You can't get a policy tailored specifically to yourself, as then we'd have 310M different policies in this country. What your insurance is required to cover will be by and large dictated by state law in the state you live in. Buying a bare-bones policy from Texas will not allow you to escape New York state mandates.

It's not at all difficult to have 310M varying policies. We have these things called computers, and those computers make use of these other things called databases. It's all very easy to manage once the applications have been developed. Trust me on this, it's what I do, only for trust accounting and not insurance.

I'm well aware of pooling risks as the basis for insurance. You can pool the risk for prenatal coverage across policies for females and price accordingly.

As to covering state mandates, the idea of those arguing for purchasing insurance across state lines is that the state mandates would go away. If I was to purchase health insurance from a company in Alabama, the MN coverage mandates would no longer apply.

[Rover]

It's not at all difficult to have 310M varying policies. We have these things called computers, and those computers make use of these other things called databases. It's all very easy to manage once the applications have been developed. Trust me on this, it's what I do, only for trust accounting and not insurance.

I'm well aware of pooling risks as the basis for insurance. You can pool the risk for prenatal coverage across policies for females and price accordingly.

As to covering state mandates, the idea of those arguing for purchasing insurance across state lines is that the state mandates would go away. If I was to purchase health insurance from a company in Alabama, the MN coverage mandates would no longer apply.

We already have this thing called computers and in fact have had them for several generations now. Funny then that it hasn't seemed to bring down the costs, or if it has they're already baked in.

The only way any of this could even start to work is under a single payer system. Even still, 50 different variations of law is better than 310M of them which hopefully is pretty self explanatory.

PS - your wanting to only stick pre-natal costs on females is amusing. How exactly do you think those babies get into the womb anyway? Shouldn't there be some shared insurance burden in that case?

[St. Clown]

Re: The PPACA - Implementation Phase I

We already have this thing called computers and in fact have had them for several generations now. Funny then that it hasn't seemed to bring down the costs, or if it has they're already baked in.

The only way any of this could even start to work is under a single payer system. Even still, 50 different variations of law is better than 310M of them which hopefully is pretty self explanatory.

PS - your wanting to only stick pre-natal costs on females is amusing. How exactly do you think those babies get into the womb anyway? Shouldn't there be some shared insurance burden in that case?

The cost savings have already been baked in. There's just no significant cost technological costs to allowing users to set their own contracts with the companies, using an a la carte purchasing method.

There wouldn't be 310M variants of the law. The insurance companies would have their products available, plug in the variables and out comes the contract along with the pricing.

Fine, move from prenatal coverage. Would cervical, ovarian, or breast cancers be more to your liking? I just chose a coverage that I know my state requires in my policy and yet is generally considered a feminine health concern. And I was trying to avoid something as morbid as these cancers can be.

[Rover]

The cost savings have already been baked in. There's just no significant cost technological costs to allowing users to set their own contracts with the companies, using an a la carte purchasing method.

There wouldn't be 310M variants of the law. The insurance companies would have their products available, plug in the variables and out comes the contract along with the pricing.

Fine, move from prenatal coverage. Would cervical, ovarian, or breast cancers be more to your liking? I just chose a coverage that I know my state requires in my policy and yet is generally considered a feminine health concern. And I was trying to avoid something as morbid as these cancers can be.

You're seriously going to advocate that women pay more for insurance because they're more prone to getting breast cancer? Do you think that has any chance of becoming law in any realm of reality that we all live in? I mean, c'mon already. I like having a reasonable discussion but things like this only can happen in fantasyland and I'm not trying to be snide here.

Moving on, the problem with so many personalized policies isn't the technology, its the administration. Somebody has to review these claims, approve/disapprove etc. Currently medical billing staff is only reviewing insurers that operate in their state plus anybody under a federal plan. You've now increased that workload exponentially. Even with technology, that's going to cost money. IMHO, significant money.

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

You're seriously going to advocate that women pay more for insurance because they're more prone to getting breast cancer? Do you think that has any chance of becoming law in any realm of reality that we all live in? I mean, c'mon already. I like having a reasonable discussion but things like this only can happen in fantasyland and I'm not trying to be snide here.

Moving on, the problem with so many personalized policies isn't the technology, its the administration. Somebody has to review these claims, approve/disapprove etc. Currently medical billing staff is only reviewing insurers that operate in their state plus anybody under a federal plan. You've now increased that workload exponentially. Even with technology, that's going to cost money. IMHO, significant money.

If we're going to go along the lines of women's rights, perhaps we should also require all of them to enter into selective service.

Plus, I thought your beloved PPACA took approve/disapprove out of the picture?

[FadeToBlack&Gold]

Re: The PPACA - Implementation Phase I

There's no way the American public would ever convert to such a system, even if it were computerized. Insurance is a enough of a quaqmire without breaking it down to coverage of specific conditions. The public is lazy and wants a package deal that they can pretend covers everything, at least until the bill arrives with an explanation of coverage detailing what BigCo Insurance declined to pay for.

[St. Clown]

Re: The PPACA - Implementation Phase I

You're seriously going to advocate that women pay more for insurance because they're more prone to getting breast cancer? Do you think that has any chance of becoming law in any realm of reality that we all live in? I mean, c'mon already. I like having a reasonable discussion but things like this only can happen in fantasyland and I'm not trying to be snide here.

Moving on, the problem with so many personalized policies isn't the technology, its the administration. Somebody has to review these claims, approve/disapprove etc. Currently medical billing staff is only reviewing insurers that operate in their state plus anybody under a federal plan. You've now increased that workload exponentially. Even with technology, that's going to cost money. IMHO, significant money.

Men would pay more for prostate and testicular cancers for which women would no longer pay. You pay for those risks to which you're prone. I'm fat, so I'd pay more as I'm at a higher risk for diabetes and heart issues than a thin man. It would behoove me financially to lower my weight and live a healthier lifestyle. That's how we're going to truly curb the rising costs of medicine.

And technology could handle the vast majority of the issues. If there's fallout that requires a human touch, then so be it. I've worked as a temp at an insurance company while trying to find full-time employment. I know for a fact that this is how it happens already. Now you're just changing the dynamic for those who choose it.

I don't think any of this will ever happen. To FtBG's point, the public doesn't want to take charge of their healthcare. They're more interested in being coddled and misled. I'm just saying that it should happen.

[Rover]

Men would pay more for prostate and testicular cancers for which women would no longer pay. You pay for those risks to which you're prone. I'm fat, so I'd pay more as I'm at a higher risk for diabetes and heart issues than a thin man. It would behoove me financially to lower my weight and live a healthier lifestyle. That's how we're going to truly curb the rising costs of medicine.

And technology could handle the vast majority of the issues. If there's fallout that requires a human touch, then so be it. I've worked as a temp at an insurance company while trying to find full-time employment. I know for a fact that this is how it happens already. Now you're just changing the dynamic for those who choose it.

I don't think any of this will ever happen. To FtBG's point, the public doesn't want to take charge of their healthcare. They're more interested in being coddled and misled. I'm just saying that it should happen.

You pay for lifestyle choices. Women don't choose to get breast cancer. Nor do men with testicular cancer, but I'm thinking breast cancer has a much higher occurance amongst women.

So yes, smokers and morbidly obese people should pay more. They made a choice. Socking people with extra bills based on their personal and in some cases inherited ailments is libertarian lunacy.

[Rover]

If we're going to go along the lines of women's rights, perhaps we should also require all of them to enter into selective service.

Plus, I thought your beloved PPACA took approve/disapprove out of the picture?

Be my guest regarding the selective service.

To your second point, you never answered my earlier question about whether you're posting from a place with a surplus of hay and/or manure....

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Be my guest regarding the selective service.

To your second point, you never answered my earlier question about whether you're posting from a place with a surplus of hay and/or manure....

I'm actually in support of the ERA (although it's not being attempted now), believe it or not.

As for your second jest, I don't even know what your point is, aside from the fact that you aren't able to refute what I had to type...

[joecct]

Re: The PPACA - Implementation Phase I

You pay for lifestyle choices. Women don't choose to get breast cancer. Nor do men with testicular cancer, but I'm thinking breast cancer has a much higher occurance amongst women.

So yes, smokers and morbidly obese people should pay more. They made a choice. Socking people with extra bills based on their personal and in some cases inherited ailments is libertarian lunacy.

Yet, if you're an unsafe driver, or in a particular class (unmarried male, under 25) the auto insurers sock it to you and nobody complains (well, not too much).

[FreshFish]

Re: The PPACA - Implementation Phase I

yes, smokers and morbidly obese people should pay more. They made a choice. Socking people with extra bills based on their personal and in some cases inherited ailments is libertarian lunacy.

Not necessarily, it depends a great deal upon the ailment and the situation. In many cases it does make sense overall to move certain classes of risk into a special subsidized high-risk pool rather than keep them in the general pool. This has already been done for decades in most states; it is nothing new and there is a widespread well-established consensus already in place.

Insurance is to pool "risk." When you have "certainty" it is a different matter. So you take some situations of "certainty" and say "we do need to help out this relatively tiny size group with relatively really large spending and treat them as a special case." Then the insurance industry can pool risk without all the distortions that would otherwise arise.

So people with certain congenital (inherited or developed at an early age) problems are covered by a special risk pool and are not part of the general insured population. If I am not mistaken, this had been a typical result of a successful malpractice lawsuit, in which money is set aside in a special fund ("structured settlement") to provide healthcare assuming that insurance would not be available.

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

There is data that is being released regarding how much hospitals are charging for procedures, and the disparity from hospital to hospital within the same community. My area is here, but you should be able to do a search for information on a set of hospitals near your home: http://www.syracuse.com/news/index.s...ramatical.html

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

The abortion pill mandate appeal has been dismissed. Disclaimer: This is some of the most insane spin I have ever seen on an article, and certain posters may view it as being "in my favour": http://www.wnd.com/2013/05/obama-sur...n-pill-battle/

[joecct]

The abortion pill mandate appeal has been dismissed. Disclaimer: This is some of the most insane spin I have ever seen on an article, and certain posters may view it as being "in my favour": http://www.wnd.com/2013/05/obama-sur...n-pill-battle/

But wouldn't the recent court ruling cutting any and all restrictions on Plan B trump this?

Need better legal minds than me to digest this development.