Public Option - Op - Out

[ken123]

Senate Majority Leader Harry Reid ( D - Nevada ) has announced today the he and Senators Baucas ( D - Montana ) & Dodd ( D - Ct. ) have agreed on the Health Reform Bill that the Democratic leadership will submit to the full Senate . It will include a public option, a government financed plan, similiar to Medicare , for people without health insurance ,but it will also provide an state opt - out if any state or states care to do so by 2014. Liberals have fought tooth & nail for a health care reform bill that includes " a robust public option ",this plan falls short of that, but is much better than could be excepted, as little as two weeks the public option was viewed, at least by the pundits of the village, as being dead. Myself I would have preffered a a single payer plan,which in effect would be Medicare for all. Any opinions ?

[mrsl]

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Having been on Medicare for 4 years now, I agree wholeheartedly. Looking at the book and seeing what is not covered, or covered only by a small percentage would help people to know what to look for in an adjoining program. What I just cannot get a grip on, or understand why anyone would oppose an option plan. Are the Republicans in so tight with insurance companies that it is to their advantage to resist any government health assistance? Are they so cold and heartless that they don't care that the very people who voted them into office are the ones who are suffering? I know I'm not the nicest person in the world, but when I hear, see and read about how people are dying because they cannot afford medications, I can't help but wonder what kind of men are filling the Senate seats? I wonder if they've ever held a door open for a person on crutches, or helped a blind person cross a street. Maybe the best thing Obama could do is withdraw the health plan the Senate and House enjoy, and let their families try to make it on their incomes. In fact, thinking about it, that is probably the best plan.

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[silentscreen]

"Maybe the best thing Obama could do is withdraw the health plan the Senate and House enjoy, and let their families try to make it on their incomes. In fact, thinking about it, that is probably the best plan."

I couldn't agree more Anne. Or maybe they should have the "public option" too.They would surely be entitled to it. But I don't think they, or President Obama want it for themselves. At least they aren't jumping on it, are they? That's because they have some of the best insurance in the country, and it's paid for to a large degree by the taxpayer. Seems a bit hypocritical to me to say the very least. I think I should have the right at least to choose what type of insurance I want.

[Ollie]

I keep thinking, "Boy, how many people have HMOs screwed over? MILLIONS and for DECADES." Yet THOSE are the people saying their private alternatives are BETTER?!! ha ha... what a joke. For two decades, every biz has expressed alarm at the extreme increases in insurance premiums with absolutely no recourse. I know so many folks who've suffered maladies, lost jobs thru biz failings and then can't get insurance because of "pre existing".

Of course, Gov't Success needs no further examination than the Military and VA.

These aren't profit industries - these are rip-off predators.

[silentscreen]

There has been a large increase in premiums, but there will be an even larger increase in taxes when everyone has to pay for the people who don't have insurance. But this will all happen over time. No one will see it right away. And just for the record, I've always had private insurance and never had to pay more than $40 a month for it through my job. Co-pays were minimal too, and now I don't have them at all. I don't know anyone personally who has been "screwed over by HMO's." Last year I had a procedure done which cost thousands of dollars and I didn't have any out of pocket, plus a trip to the emergency room with no out of pocket. I don't know what I'm facing next year, but I don't think it's going to be better.

[jdb1]

There has been a large increase in premiums, but there will be an even larger increase in taxes when everyone has to pay for the people who don't have insurance. But this will all happen over time. No one will see it right away. And just for the record, I've always had private insurance and never had to pay more than $40 a month for it through my job. Co-pays were minimal too, and now I don't have them at all. I don't know anyone personally who has been "screwed over by HMO's." Last year I had a procedure done which cost thousands of dollars and I didn't have any out of pocket, plus a trip to the emergency room with no out of pocket. I don't know what I'm facing next year, but I don't think it's going to be better.

Then you are one of the lucky ones. I can say just the opposite: I don't know of anyone, friend or co-worker (or myself), who hasn't been victimized in some way by their health insurers. My poor daughter is now one of the young adult uninsureds, employed only part-time, with no benefits, and she seems to be sick all the time. I am paying for minimum hospitalization for her because the thought of her having nothing at all terrifies me. She does not qualify for an low-cost insurance now, because she had the ill grace to have too much money in the bank (and not all that much, either, but too much for any of New York State's "low-cost" health insurance offerings).

I've said it before, and I'll say it again: health insurance should not be the issue. The out of control cost of the medical services themselves should be the target. Doctors and pharmaceutical manufacturers charge too much because they can get away with it. What we buy is not "insurance," it's reimbursement for costs we can't afford. Tinkering with the health insurance industry is just putting a bandaid on a festering sore. Reining in those who are gouging us with high costs we are afraid not to pay is what will fix things for the consumer. At the very least, allowing all of us to purchase more reasonable coverage in other states will help. The selection of high-priced and very limited offerings in New York State is just shocking.

By the way, my employer has put us on new insurance coverage. Our previous insurer, Oxford, wanted 21% more in premiums for renewal. I can't believe it -- in this economic climate, with the healthcare battle raging, how can they even consider asking for more money from the consumer? Couldn't they have at least called that price hike something else, or hidden it in other costs, to soften the blow? I wonder how many other accounts they've lost. Maybe it's a ploy on their part so they can cry that business is decreasing. Just one more egg placed in the handbasket to hell.

[Lzcutter]

I don't know anyone personally who has been "screwed over by HMO's.

When my father was so sick in the summer and fall of 2007, his HMO was anything but helpful. We had to jump through a variety of hoops to get essential tests authorized. Though he was retired, he was on my mother's insurance and had Medicare as his secondary plan.

At the end of a two month journey for routine surgery that turned into a medical emergency, a loss of both his legs, and a month and a half in intensive care, we fought tooth and nail with the HMO to keep him from going to the authorized rehabilitation facility that they would pay for.

When the practitioners there did such a lousy job of caring for him within his first 12 hours of being there that he was rushed, in cardiac arrest, to the nearest hospital Emergency room, we again pleaded with the HMO that when he was stabilized to send him to a rehab facility outside their plan. We begged Medicare. We begged the doctors. The doctors, concerned as we were, but their hands tied by the HMO, kept my dad in their hospital for a month before they were forced to send him to the authorized rehab facility.

He died three weeks later.

If we had some choice other than paying completely out of pocket (which my family could not afford) for his care in another facility, my father would likely still be alive today.

My mother and father paid were customers of the insurance company for over 25 years. They paid their premiums like clock work despite all the rate hikes.

In the end, the money spent out for my dad's health care (that he had paid into for 25 years) was more important to the insurance company than seeing to it that he got good care.

[silentscreen]

I'm very, very sorry to hear about all this. It's shocking! I've never had a serious illness that I've had to deal with with an HMO. I had that type of coverage for many years. A couple of years ago, my company went to an HSA. (Health Savings Account) My company puts in $1500 for single people and $3000 for married couples. You use it like a debit card for anything- doctor's visits, perscriptions, aspirins, anything. I've never had to pay for a perscription in the past two years. After that money is used up, we were still covered 100%. If you don't use up all the money that's put in, it rolls over to the next year like a savings account. This year we did have to put exta money in ourselves in addition to what the company contributed. I put in $600, which gets taken out of my pay, but once you start doing it, you don't really notice it. It's not that much over a years time. The year before, we didn't have to do that. That's when I had the procedure done and had the emergency room visit.

There really does need to be some kind of health care reform. I think everyone agrees on that. It's just what form that will take that's the issue.

[jdb1]

My firm has an FSA, a fexible savings account, which uses your own money (you can specify how much from each paycheck) and reimburses you for expenses not covered by your insurance. You don't have to have insurance coverage at all to use the FSA. I haven't participated up to now, because I was uncomfortable with the notion of yet more deductions being taken out of my paycheck. But I enrolled this year. Even though it's your own money you are being reimbursed with, the money is taken out before taxes are deducted, so you are at least getting, in theory, the full dollar's worth of that reserve fund. But, of course, there's a catch: if you don't use up all the funds in your FSA by March of the following year, the amount is forfeited to the FSA's administrator. There's always a scramble at the end of the year, with people buying extra cold tablets and eyeglasses.

I neglected to mention yesterday that although we have a new insurance carrier, we are still paying more in premiums now, although not as much as Oxford would have charged us.

If we can live with FSAs and HSAs, what's the big difference from a national health plan? Is it just because it's called a healthcare "tax" that gets everyone so worked up? So let's call it a "personal healthcare contribution." I don't have any more faith in insurance executives or FSA administrators being in control of my health than I would with government health administrators. And, come on, if the government did implement national health, who would run it? Why, the very same people now working for private insurers. I don't think very many people in American would want the burden of doing all the paperwork and other arrangements by themselves, would they?

[mrsl]

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But, that's the beauty of thinking of it as an extension of Medicare. With Medicare, you show your card the first time you visit and that's it, until you get your bill, which is 10 or 20% of the total in most cases. This is what makes me so crazy regarding it. All the arguments against the public option, or whatever it's eventually called is total stupidity. Who cares who pays your medical bills as long as they're paid? I started working at 15 and had taxes taken out, now I'm using what I put in by being on Medicare. Every month you pay your house payment do you not? What makes you confident that that check each month will be attributed to your house and property? Everybody is taking a chance that their bills will be paid when they send a check, pay in person, or pay on line. Who's to say someone won't pocket your money? I agree the government is not the most trustful group, but it's not as bad as trusting that high school part time bank teller who can't add without a calculator, with your deposit. We have to put our trust in people 24/7 even to trusting drivers are alert when you are crossing the street.
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[silentscreen]

We have a FSA at work too. It's kind of become very secondary since the HSA because the HSA doesn't have to be used all in one year, and it's better than the FSA. But one year I put $1000 of my own money into it. Turned out I had to have extensive dental work done that year and I don't know how I would've managed without it. We were only getting $1000 per year on our dental plan which is a pittance if anything major happens.

It's all so complicated!

[movieman1957]

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But, that's the beauty of thinking of it as an extension of Medicare. With Medicare, you show your card the first time you visit and that's it, until you get your bill, which is 10 or 20% of the total in most cases.

Because Medicare is run so well.

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Who cares who pays your medical bills as long as they're paid?

Really?

[ken123]

Is there any reason why health care should be a for profit concern ?

[movieman1957]

It might give people a reason to go into that field. Ask a doctor.

[ken123]

It might give people a reason to go into that field. Ask a doctor.

Well maybe I should have said Health Insurance Industry. They are after all just the middlemen. Question - Are doctors, nurses,hospital staff income called profit ?