I took money out of my HSA to buy some new shoes. System seems to be working just fine you whiners.
I took money out of my HSA to buy some new shoes. System seems to be working just fine you whiners.
This whole thing is really depressing to me, mainly because it's one of the few issues I completely agree with the republicans on. This whole "mandate" to buy private insurance was dickless fallback strategy after Obama failed to push the public option through. The only reason congress even passed it was because the health insurance industry obviously approved of a bill that would require people to buy their shitty product, and did nothing to address the issues that make private health insurance such a ripoff in the first place. The sad thing is there was a lot of good measures in that bill that may fall by the wayside because of the mandate. Couldn't they have figured out a less intrusive way to sell the concept? Like offering tax incentives to people who have health insurance rather than penalizing those who don't?
1. The mandate is a completely separate issue from the public option. Even in versions of the bill that had a public option in it, the mandate was still there. The "dickless fallback strategy" you are thinking of is the CO-OPs, which are the government-funded, member-owned, nonprofit entities that are being created in lieu of the public option.
2. There are a lot of very good reasons in favor of the mandate. The main one involves adverse selection. Google it, you'll find a million articles, scholarly and otherwise, that talk about this. You might even find one or two written by me. Or, if you prefer: http://www.cbsnews.com/8301-500395_1...rance-mandate/ for example. Note that 20 years ago the conservatives were touting the individual mandate as the magic solution for reform.
3. PPACA does lots of things to address private health insurance value and affordability. Minimum loss ratio requirements, rate increase review requirements, elimination of pre-existing condition exclusions, etc. Your statement that the bill "...did nothing to address the issues that make [it] such a ripoff..." is really not based in any sort of fact whatsoever.
4. They 'figured out' the least intrusive way to 'sell the concept'. The reverse approach (tax incentives) was considered and rejected because in order to fund it, it would have required a substantial tax increase across all income levels, and the democrats decided that just the act of healthcare reform was a big enough of a battle to fight without taking on tax code reform at the same time. (Same reason they didn't address malpractice reform, which they really should have).
You have been sold a bill of goods by the republican propagandists. You need to grasp the facts before forming your opinions.
Last edited by TomAz; 03-27-2012 at 04:01 PM.
Fui quod es, eris quod sum. I once was what you are, you will be what I am - epitaph carved on Roman gravestones.
I spent an hour reading through the oral argument transcripts today. I really want to punch something. Mostly the Solicitor General for fucking up the Government's argument so badly. I still think Kennedy and Roberts may vote to save the mandate (and the Act as a whole), but it is going to be closer than I had ever imagined.
2. The penalty is a reduction of your tax refund.
3. The penalty is quite a bit less than the cost of insurance.
4. The mandate is intended to create an incentive mainly for those people whose incomes are above the subsidy level (which start at 138% FPL and grade out at 400% FPL). The subsidy will create a significant incientive for lower income workers and so the mandate is expected to have much less of an impact there.
5. Your last question is the hardest. The Court could (1) throw out only the mandate (2) throw out the mandate, plus the restrictions on pre-existing condition limitations and other barriers to coverage, under a 'severability' argument, which is what will be debated tomorrow (3) strike down the entire law. I think (3) is highly unlikely, myself.
If I have a good job with good benefits n
And I pay for health insurance already( has been raising 10$ a month twice a year it seems)
How will this effect me if obamacare passes? Is there any way it will pass?
I'm a simple man (moron) so please help me here Tom. Tell me what I can bitch about and why.
1. Does your employer have 50 or fewer employees?
If the answer is 'no', i.e., your employer has more than 50 employees, then the answer is 'almost no effect at all except for that coverage of dependents to age 26 part that no one is complaining about'. You're done, no need to look at question #2.
But if the answer is 'yes', then
2. Do you live in one of the states that has already mandated community rating and guaranteed issue in the small employer market, e.g., New York?
If the answer is 'yes', then you may see your insurance costs come down.
If the answer is 'no', then you may see your insurance costs rise substantially.
2. California (remember, moron...try to use smaller words and direct questions)
Now please tell me who I can blame and why.
What can I do to fix this problem ?
You should be fine, you're fucked, blame Karl Rove and Kathleen Sebelius.
Lol whoever that is.
All I know is Keith Morris and Johnny Walker!! whewww!!!!!!
The White Stripes 9/18
I eagerly await your bullet-pointed response pointing out further inaccuracies in my thinking and logic.
^^That's a great article, thanks for sharing. My next question, if you care to reply, regards the bit below:
Should the mandate pass:Without an individual mandate, the health insurance market is likely to break down due to the adverse selection problem, but such a mandate can place a considerable burden on some households. Thus, while the individual mandate is necessary to make these markets work, it is also necessary to provide subsides to lower and middle class households who wouldn't be able to purchase the insurance without such help.
1) Will there be subsides for low-income people/families?
2) And will their be any kind of regulation of the costs of insurance once all young healthy people are back in the market, or are we just going to "let the market sort itself out?"
There are provisions in the law intended to address each point you make in both your posts. Whether they succeed or not, we'll see. I will address tomorrow in detail when I'm not typing on an iPad.
1) Yes. Plus the definition of the "poverty level" for Medicaid coverage gets expanded to include more people.
2) Yes, to the extent that statewide "exchanges" get set up which are (in theory) more transparent "marketplaces" for health insurance for those buying personal insurance to comparison shop.
Admittedly I'm in the dark on this more then I care to admit. I've got some homework to do. Bravo for all of you having thoughtful conversations, it's refreshing from all of the pissing and moaning on other parts of this board.
northside groove...southside groove....eastside groove...westside groove
Second, PPACA calls for health insurance premium and cost sharing subsidies for individuals and families whose income is in the range of 138% to 400% of FPL. The subsidies are set based on formula (the average cost of the second-least-expensive Silver insurance plan on the Exchange in that state) and are intended to directly address the affordability issue. Recall that for most Amercians who get their health insurance at work, the employer generally subsidizes a large portion of the cost; this subsidy is intended to fill that role. The full subsidy is available at the lower end of that 138-400% range and then it grades down on a percentage basis.
2. Insurance premium rate regulation: yes in several different ways. As MJA noted there is this notion of the Exchange, with its standardized benefits etc (note also that the standardization of benefit levels will also check, to some extent, the increases in deductibles and copays you mentioned). The Exchange includes risk sharing mechanisms so that any one insurer won't get hit too hard with adverse selection; this is good because it should prevent the market from overpricing due to fear of unknown costs. There are minimum loss ratio requirements: insurers have to spend x% of premium on healthcare costs; if they spend less they have to refund premium to policyholders. (That portion of the law is already in effect and refunds are actually happening in some cases). There are rate increase review requirements: any premium rate increase greater than y% (y currently set to 10 by HHS) is subject to much closer actuarial scrutiny from both the state and the feds. Not sure how that part will play out in the long run, though.
Now, regulating health insurance premium rates is not the same thing as controlling healthcare costs. Much of ACA is not devoted to health insurance regulation at all (that's just Title I; there are 8 other Titles as well) but focus on things like Accountable Care Organizations and Electronic Medical Records that are intended to streamline the way healthcare is delivered in the US and eliminate waste and overutilization (e.g., repeating a medical test because the specialist you are seeing now doesn't know that you just had that test done two months ago by another doctor). Again, will these work? Can't tell yet. But these are bona fide attempts to bring costs in line.
Last edited by TomAz; 03-28-2012 at 07:20 AM.
Insurance doesn't cover shit anyways.
I have like four life insurance policies I pay into....yet I feel like I will never die and I have no one that will be living that deserves the money.
I pay a grip for health insurance and it keeps raising...I'm healthy as fuck, I hate medicine, antibiotics, vaccinations, check ups ect. I feel like I will never get hurt or need insurance. I'm sure I'll break my leg after saying this.
I pay more and more taxes every year and they seem wasted too. I hate paying into a failing system. This stuff is all just too much for my little retard mind to grasp. It all seems retarded. If I am injured or sick and I need health care, I should be able to pay when there is a problem. That money should go to a doctor or clinic. The doctor or clinic should pay staff.
Insurance companies are just middlemen taking money for doing nothing. Just like our government. Doing a bunch of unnecessary shit and getting paid too much for it.
edit: correction: Most of the costs are the subsidies PLUS the Medicaid expansion. Both of which involve the government buying insurance for low income people, and so like any other 'entitlement' program, they get expensive.
Last edited by TomAz; 03-28-2012 at 10:18 AM.
Need to stop handing shit out. The struggle for equality and democracy will be the downfall of our country.
There is much in PPACA that I would have done differently. I would have made the mandate stronger, and I would not have imposed the 3:1 age rating limit (this provision was AARP's price for support), and I don't think I would have allowed off-Exchange business. And it could be that (what I perceive to be) those flaws in the law could be its undoing. But, maybe not, too. And yes, it is a noble attempt at fixing a broken system.
FYI if you are really curious, google articles about the Dutch and Swiss health insurance systems. Much of what they're doing there is being mimicked in PPACA.