Health Care Thread

Tuco

Tuco

I got Tuco'd!
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Vaclav_sl said:
Heh, its how I respond to absurdity...
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I don't want to be mean because I respect you but it's usually a tool used by people to make reasonable arguments absurd so they feel more comfortable not believing or addressing them mentally.
 
Tuco

Tuco

I got Tuco'd!
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Royal_sl said:
It would be a hell of a loophole ..... if it were actually true. There are allowances for changing all of those and retaining grandfather status.Hereis a good explanation of the things that can and cannot be done under grandfathering.
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I'm a layman here, aren't all these things:
shit you can't do without losing your grandfathered status_sl said:
Q4: What must a plan do to maintain grandfathered status?

To maintain grandfathered status, a plan must look at its benefits and contribution levels as of March 23, 2010 and must not:

. Eliminate or substantially eliminate benefits for a particular condition.
-- For example, if a plan covered counseling and prescription drugs to treat certain mental and nervous disorders and eliminates coverage for counseling, the plan will lose grandfathered status.

. Increase cost-sharing percentages.
-- For example, if the plan had an 80 percent coinsurance rate in March 2010 and decreases the rate to 70 percent, the plan will lose grandfathered status.

. Increase co-pays by more than $5 or a percentage equal to medical inflation (currently 9.5 percent) plus 15 percent, whichever is greater.
-- For example, if the plan had an office visit copay of $30 in March 2010, it could increase it to $37.35 without losing grandfathered status.

. Raise fixed amount cost-sharing other than co-pays by more than medical inflation (currently 9.5 percent) plus 15 percent.
-- For example, if the plan had a deductible of $1,000 and an out-of-pocket maximum of $2,500 in March 2010, it could increase the deductible to $1,200 and the out-of-pocket limit to $3,100 without losing grandfathered status.

. Lower the employer contribution rate by more than 5 percent for any group of covered persons.
-- For example, if the employer contributed 80 percent of the cost of employee-only coverage and 60 percent of the cost of family coverage in March 2010, if the employer keeps its contribution percentage for employee-only coverage at 80 percent but reduces its contribution for family coverage to 50 percent, the plan will lose grandfathered status.

. Add or reduce an annual limit.
-- For example, a plan that previously had no limit on MRIs could not impose a $10,000 per year maximum on MRIs without losing grandfathered status.
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pretty big changes to a plan?
 
Tuco

Tuco

I got Tuco'd!
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Vaclav_sl said:
I know too well Tuco - on a personal level, since I refuse to take the 50/50 shot of having a kid with ODDD we've opted out of kids here. But I look at it like taxes (damn analogies I know) - I hate paying for expensive overseas bases in peaceful areas (60 in Germany I think?) but practically there's going to be some stuff I like I benefit from unequally that makes up for it.

Any shared pool dynamic is going to be similar - even a party pitching in for dinner equally - someone's getting more and someone's getting less almost every time if you're splitting the check evenly.
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Yeah I'll definitely feel better about paying $25 a month (or whatever) for cheaper maternal care for women and drug addicts than paying for a_skeleton_03 to get drunk in Germany.
 
Vaclav

Vaclav

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Tuco_sl said:
I don't want to be mean because I respect you but it's usually a tool used by people to make reasonable arguments absurd so they feel more comfortable not believing or addressing them mentally.
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Likely true never been a formalized debate person just a recent thing for me - and always been the type to interject similar absurd comparisons IRL as a humor thing. (Like a local 7-11 of ours that has had a 'Now Open' sign on it gave me a joke I overused for a stretch)

I blame Seinfeld in my formative years.
 
Vaclav

Vaclav

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fanaskin_sl said:
there's no law that requires you to have children or gives you a direct penalty for not having one
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Missing a tax benefit is fundamentally identical to most even some of our SC Justices...

Hook or Crook method either was viewed as equivalent in encouraging behavior in most of their summations on the ACA.
 
Dashel

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Royal_sl said:
It would be a hell of a loophole ..... if it were actually true. There are allowances for changing all of those and retaining grandfather status.Hereis a good explanation of the things that can and cannot be done under grandfathering.
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Nothing in the linked article refutes what you quoted. It gives a list of "regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."

As for the truth, there is an estimate within the regulations itself if NBC is to be believed:

"Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, ?40 to 67 percent? of customers will not be able to keep their policy. And because many policies will have been changed since the key date, ?the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range."
 
Vaclav

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Because they were changed - by the insurance companies that no doubt knew the result and were doing it intentionally.

(Or if it was accidental still their fault as well...)
 
Royal

Royal

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Dashel_sl said:
Nothing in the linked article refutes what you quoted. It gives a list of "regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."
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I'm not going to go through an exercise with you of parsing what constitutes "significant change" but like Tuco, I'd consider a 24.5% increase in my deductible significant. It's allowed under those grandfather provisions.

Those limits are there to prevent an insurance company from grandfathering a plan, then stripping it down to barebones coverage or jacking the cost to the policy holder way up to maintain benefit levels. They do allow the company reasonable leeway in adjustments to maintain those plans.
 
Dashel

Dashel

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So instead of making changes within the parameters set, they opt to conform to the new AMA. Which tells me the AMA standards are more cost beneficial to the insurance companies than the supposed terrible plans that rape the consumer.

But you're right, no need to parse. It was changed, and it was known that it would be changed. People would lose their existing coverage. I think that is inarguable at this point and really it's a minor issue in comparison to the prices people are seeing. So again the real pitch for AMA should have been: pay more get more and cover more people, but that was not how it was sold.
 
Tuco

Tuco

I got Tuco'd!
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Dashel_sl said:
So instead of making changes within the parameters set, they opt to conform to the new AMA. Which tells me the AMA standards are more cost beneficial to the insurance companies than the supposed terrible plans that rape the consumer.
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This is probably true and makes me wonder what kind of cheeky shit insurance companies will do to get around the minimum non-coverage cost they can charge people.
 
Royal

Royal

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Dashel_sl said:
So instead of making changes within the parameters set, they opt to conform to the new AMA. Which tells me the AMA standards are more cost beneficial to the insurance companies than the supposed terrible plans that rape the consumer.
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Well those terrible plans didn't even qualify for grandfathering. They would have kept those around if they could.

Dashel_sl said:
But you're right, no need to parse. It was changed, and it was known that it would be changed. People would lose their existing coverage. I think that is inarguable at this point and really it's a minor issue in comparison to the prices people are seeing. So again the real pitch for AMA should have been: pay more get more and cover more people, but that was not how it was sold.
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Oh I agree, some people were going to loose access to those policies that utilized some of the more shady business practices of the insurance industry. Obama should have been upfront about that. He did say some people would pay more than they currently did.
 
TheBeagle

TheBeagle

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Araysar_sl said:
Yeah, I also cant believe that a private sector corporation that was hired to build this website has fucked up so badly.
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At this point nothing works right in this fucking country any more. Not the government, not the private sector. We're a bunch of fat, lazy, entitled assholes. Top to bottom this fucking apple is rotten. Part of me really hopes the whole fucking thing burns to the ground.
 
Grim1

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Vaclav_sl said:
Because they were changed - by the insurance companies that no doubt knew the result and were doing it intentionally.

(Or if it was accidental still their fault as well...)
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The absurd lengths you are willing to go to excuse Obama's lie is really putting a dent in your credibility. Everyone thought they knew what Obama meant when he said "You can keep your healthcare if you like it".

Nobody thought that they had to read the infinitesimally fine print running at the bottom of the screen while he said it. Just admit it was a bait and switch and save some of your self respect.
 
Grim1

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Tuco_sl said:
This is probably true and makes me wonder what kind of cheeky shit insurance companies will do to get around the minimum non-coverage cost they can charge people.
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As compared to the cheeky shit Obama claimed when he knew that people were not going to get to keep their plans?

When the government creates a loophole big enough for an elephant to run through, you can damn well bet that everyone is going to take advantage of it. Companies, individuals and even fellow lawmakers love loopholes. It's not their fault for being intelligent for using them, it's the government's fault for creating them in the first place.
 
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