The PPACA - Implementation Phase I

[FreshFish]

Re: The PPACA - Implementation Phase I

The intent of allowing people to purchase insurance from across state lines is to allow the public the potential to purchase cheaper insurance from states that do not hold the same mandates for coverage as the state in which the consumer currently resides. It's to create freedom within the market place for the consumer to choose his/her level of coverage. I'm a single man, why should I be mandated to purchase a policy that covers prenatal or mammography care? Why should women be forced to purchase prostate exam coverage? The idea of opening the markets across state lines is to allow the people choice. If I want Cadillac coverage, I'll purchase an all-encompassing plan. If I want something that's only going to cover me in case of an emergency, the old major medical coverage, then I can do just that. It's all about choice, and not dictating said choice to people.

Agree totally that the concept is very sound.

The challenge is getting your state to allow a stripped down basic catastrophe only plan.

Years ago, a person could buy a policy with a $5,000 deductible or even a $25,000 deductible. As you might imagine, the premiums would be very low. This is ideal for insurance: protect against catastrophic loss, then decide how much you can afford to self-insure under the limit.

States, and now the Feds, have made it harder and harder to buy pure insurance. As you noted, they keep loading it up with all sorts of mandatory features, often with the best intentions at heart (the American Psychological Association wants mental illness to be covered similar to a physical illness, for example; not saying they are right or wrong or whether this is good or bad, merely observing that the more you mandate coverage, the higher the premium becomes).

In practice it is not feasible to allow the sale of health insurance across state lines given the jurisdictional issues involved.

 

[Rover]

Re: The PPACA - Implementation Phase I

Once again Fishy is dead on accurate. (did I just say that?). I see a sign up the road that reads "Welcome to Bizzaroworld. Population: You"

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.

Revisiting a previous topic, this is an excellent article about employers making all their workers part time...

http://www.washingtonpost.com/blogs...iding/?wprss=rss_ezra-klein&utm_source=feedly

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Once again Fishy is dead on accurate. (did I just say that?). I see a sign up the road that reads "Welcome to Bizzaroworld. Population: You"

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.

Revisiting a previous topic, this is an excellent article about employers making all their workers part time...

http://www.washingtonpost.com/blogs...iding/?wprss=rss_ezra-klein&utm_source=feedly

Once again, though, states actually can be overruled by federal will once insurance is able to cross state lines due to the Interstate Commerce clause. That's the price you pay for wanting to enforce a tax with the ability to gain a rebate by purchasing an insurance plan.

Regarding your link, that's actually not all that surprising. To paraphrase the famous quotation, when the door closes, a window opens. One thing that seems to always be forgotten is that labour is an expense for the life of a business, and is very similar to individuals purchasing groceries. With this law, you've just jacked up the price of labour, similar to how one would jack up the price of Cheerios. The demand is not inelastic, though, because there is the part-time option, similar to the store brand of cereal. Welcome to opportunity cost. How much is purchasing full-time labour worth to you?

 

[FreshFish]

Re: The PPACA - Implementation Phase I

You can't get a policy tailored specifically to yourself, as then we'd have 310M different policies in this country.

Actually, given today's technologies, there should be no reason in theory why a person shouldn't be given a menu of choices regarding coverage, check off what they want, and then see what the corresponding premium would be. You can do something like this with auto insurance already, as long as you at least have the minimum mandated liability coverage*.

The problem as we've both noted is state mandates. If a state were to mandate that you at least had to have catastrophic coverage, and eveything beyond that were elective, then you could pick and choose at many people would like.

It's not a question of states vs feds, it's a question of legislators vs citizens. Legislators receive <strike>bribes</strike> campaign contributions from various groups and then insert language into legislation favoring those groups. So we have mandatory chiropractic, or mandatory this that or the other, stuck in here and there every now and then and it all adds up to a mess.





* states can regulate in ways that the Feds cannot.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

I just had a thought:

There's going to be a tax charged upon the people of this country for simply having citizenship. From then, you are able to take a credit by proving your purchase of a federally-approved health plan. That we know. Now, here's the question: How do they plan to collect this? Do they intend to do it through income taxes? Some other method? How do they intend to do the credit? Would they be sneaky enough to throw it within itemized deductions so that it isn't even worth it to much of the population to claim the credit?

 

[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.ssf/2013/05/hospital_bills_vary_dramatical.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-surrenders-in-abortion-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-surrenders-in-abortion-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.