Congratulations, Barry: ObamaCare Means No Health Insurance for Kids
The book that helped me understand economics was “Basic Economics” by Thomas Sowell. One of his main points is that government intervention almost always has unintended consequences. Take rent control, for example. It sounds great (from the standpoint of renters) to have the government control prices so that they will be affordable. Problem is, it’s not so great for the landlords, and due to the law of supply and demand, housing shortages result. What was intended as a boon for renters often turns out to be a burden on people seeking housing.
So what do you think might happen if you sought to make health insurance more widely available for children — by simply mandating that companies with child-only policies make those policies available to children with pre-existing conditions?
You cheated and looked at the headline, didn’t you?
Some of the country’s most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23.
Welcome to the Law of Unintended Consequences, Barry.
Well. Unintended, by the chuckleheads who wrote the law? Sure. Unexpected by those of us who warned against such a law? No.
[S]upporters of the new health-care law complain that the change amounts to an end run around one of the most prized consumer protections.
“We’re just days away from a new era when insurance companies must stop denying coverage to kids just because they are sick, and now some of the biggest changed their minds,” Ethan Rome, executive director of Health Care for America Now, an advocacy group, said in a statement. “[It] is immoral, and to blame their appalling behavior on the new law is patently dishonest.”
No, Ethan, what is patently dishonest — or simply stupid, if there must be an alternative — is to ignore the fact that the new law caused this. They were told they couldn’t raise rates. What did you expect them to do? Lose money to comply with your sense of right and wrong?
Remedial economics all around!
It would be laughable if it didn’t exact an actual human toll.
But…but…but….I thought it was FOR THE CHILDREN! Wasn’t one of the biggest talking points against Republican opposition something about, “what, don’t you think kids should have access to health care, you cruel, heartless monster?!”
Oh, look.
Steve B (5eacf6) — 9/21/2010 @ 1:48 amI have always been amazed that Leftist/liberals CANNOT grasp the most basic of economic facts; supply and demand and refuse to apply any sort of logical/critical thinking to any plan they have that purports to make life more fair.
It is true that liberalism is a MENTAL DISEASE.
jakee308 (e1996a) — 9/21/2010 @ 2:38 amI used to think these were unintended consequences. Now am not so sure. Put it this way: if they were trying to go single-payer as fast as possible with the approval of as much of the public as possible without simply making it fiat, what steps would they take?
But maybe Hanlon’s razor does apply here. The thing is, the level of stupid required for this trick is almost more scary than thinking they did it on purpose.
no one you know (72db9b) — 9/21/2010 @ 2:47 amnoyk nailed it.
That healthcare is now set up to be completely abhorrent, leading to a community so agitated that it demands the government step in and save the children is good enough to just fill in the blanks on Obama’s little Alinsky chalkboard chart.
It doesn’t take a genius to masterfully wield these tactics. It just takes ruthlessness.
Dustin (b54cdc) — 9/21/2010 @ 4:23 amRemarkably Obama’s illegal alien Aunt Zetuni survived serious illness before The One’s healthcare scheme was promlugated. Thought we killed sick illegals.
Bugg (4e0dda) — 9/21/2010 @ 4:55 amYes, this is but another step toward the “single payer” system that is the socialist holy grail. Once those pesky insurance companies are out of business, “who you gonna call?”: Barack Obama.
navyvet (b0f168) — 9/21/2010 @ 5:40 amNOYK and Dustin and navyvet are on to it.
Obama’s game all along has been to force such unprofitable burdens onto insurance companies that they exit the market. His next step is demonization of those companies for shirking their ‘obligations’ to run at a loss, and a demand that the noble gummint become the sugar daddy that lavishes the benefits of our labors on the uninsurable pobrecitos.
Insufficiently Sensitive (b6274d) — 9/21/2010 @ 5:56 amIt is nolonger a metaphoric thing, it is a real ‘death panel’
ian cormac (6709ab) — 9/21/2010 @ 6:05 amFor decades now, the Federal government has forced change on us to create a crisis so they could get more “change”. Illegal immigration is a prime example. We never voted for 20 million illegal aliens, but the government allowed them into the country and subsidized their entry, health care, education and legal aid. They act as if the couldn’t do anything, but the just didn’t want to do anything.
With health care they could have written a law that worked, but we had to get a bill that would force single payer socialized medicine on us. Because that is what President Obama wants. He has said that in public.
So either they don’t understand basic economics, or they are trying to make the health insurance companies look bad so they can be more easily removed from the economy.
Of course, if they had given us tort reform in the 1970’s during the Malpractice Insurance Crisis, we wouldn’t be having this discussion. But the proponents of socialism have a plan for our future.
tyree (cf6f25) — 9/21/2010 @ 6:09 amAnd this is how the statists work: they pass a law that does bad things (because they don’t know what they are doing, or worse, don’t even think about consequences).
But no worries. They’ll pass another law to fix it!
Anyone remember Einstein’s definition of “insanity”?
Eric Blair (9ed73e) — 9/21/2010 @ 6:17 amThere does not appear to be anything unintended about this.
JD (8ded14) — 9/21/2010 @ 6:36 amYou filed this under “General,” but you really need a couple of new categories: What Could Go Wrong and I Told You So.
The snarky Dana (3e4784) — 9/21/2010 @ 6:37 amIt’s true – it could be that this is all deliberate on the part of Obama and company. But the quote from Ethan Rome (the *Executive Director* of Health Care for America Now, and therefore presumably somebody who made it through some schooling, gained the confidence of some people, is able to string words into a sentence and appear rational, etc.) makes me hesitate. What it demonstrates is a fact that keeps being proved even when I don’t want it to…
There is no shortage of outrageous stupidity.
It is. It REALLY IS possible that Obama could be just this stupid. Heck, look at his upbringing. He was raised and lived and schooled in a total womb of entitlement. When and where would he have learned to deal with reality?
I used to believe that this country would be taken over by evil people. Now I know… it will be sunk by stupid people.
It begins to sound like something from Hitchhiker’s Guide to the Galaxy. A telephone handset sanitizer has been elected president, and he’s appointed an executive branch full of hairdressers and elevator operators.
Gesundheit (cfa313) — 9/21/2010 @ 7:10 amHe sounds a good deal like Zaphod Beeblebrox, without the extra heads
ian cormac (6709ab) — 9/21/2010 @ 7:18 am“There does not appear to be anything unintended about this.”
JD – Absolutely. Sebelius was the insurance commissioner in Kansas and head of the National Association of Insurance Commissioners before serving as Governor and assuming her current post. She knows the impact of the law on the behavior likely behavior of insurance companies. For her to jawbone them the way she has is deeply, deeply dishonest.
daleyrocks (940075) — 9/21/2010 @ 7:44 amThe potential good news to all this is it will make the incoming GOP majority (at least in the House) all the more willing to take a legislative meat axe to ObamaCare and, in turn, chop Reichsleiterin Sibelius down to size.
MarkJ (42fe5b) — 9/21/2010 @ 8:23 amWe need another law!
We need price controls!
We need government takeover!
We need martial law!
P.S. Anybody having trouble with their dishwasher lately? Don’t worry, it’s another well meaning government program.
Patricia (9c62d9) — 9/21/2010 @ 8:44 amGreetings:
But, then again, unintended is different from unforeseeable. A good while back, the federal government decided to involve itself in the protection of non-government employee pensions under a program called ERISA or some such. Since then, I don’t hear much about companies starting pension plans for their employees. Good work, Govie.
11B40 (b01817) — 9/21/2010 @ 8:57 am11B40 – Good point. The trend has actually been for companies to close traditional defined benefit pension plans and offer defined contribution plans, among which are 401k’s on a go forward basis. It doesn’t make ERISA considerations disappear, but it helps plan portability.
daleyrocks (940075) — 9/21/2010 @ 9:09 amPart of the problem is that we talk about the “law of supply and demand”, when we mean the “law of price, supply, and demand.” Congress routinely excludes themselves from laws for the rest of us, and thinks that the universe has granted them the same courtesy.
htom (412a17) — 9/21/2010 @ 9:24 amIt’s very dishonest for Rome to claim that the companies have “changed their minds.” They never agreed to this. A law was passed and they were told what they would have to do.
vsatt (22b656) — 9/21/2010 @ 9:29 amSame thing happened in California in 2000–the state legislature mandated that power companies could not raise rates unless they fulfilled a litany of conditions. The end result was the companies who could meet the conditions could gouge their customers, and the companies who could not had to buy power from Enron at outrageous prices.
Of course, back then we were dealing with blackouts, not dead kids.
Roger Membreno (4bb0ce) — 9/21/2010 @ 9:38 amian – Exactly! Barack Obama displays a striking resemblance to Zaphod Beeblebrox! I KNEW he seemed familiar somehow.
Ego so large he could compare his importance with that of the universe? Check.
Impervious to logic? Check.
Sees everything through the lens of how it affects himself? Check.
Blissfully unaware and uncaring of the consequences of his actions? Check.
Puzzled and perplexed when people seem to not like him? Double check.
I honestly believe that Obama could not only promote this insurance disaster in ignorance – but that even after the inevitable consequences he is incapable of seeing that it’s his own fault.
Lowly Intern: “But Mr. President, if we force insurance companies to accept people who are already sick, won’t they have to stop offering those policies at all?”
Obama: “That’s just scare tactics from ‘the Man.’ That’s just far right wing extremist Rethuglicans making empty threats. That’s just greedy corporate fat cats trying to threaten us in order to get their way. But I’m not so easily threatened. They’ll find out they picked on the wrong guy!”
Obama: (aside) “And Rahm, I thought you told me you had gotten rid of anybody who might disagree with me. Get this kid out of here.”
Gesundheit (cfa313) — 9/21/2010 @ 9:45 amWhy is anyone suprised? This is the group that brought down the entire economy because they don’t understand or care about basic economics with the Community Reinvestment Act (CRA) that forced banks to loan to minorities and poor that couldn’t pay the loans back (but they could vote Democrap).
Then they forced Fannie Mae and Freddie Mac to accept these sub-prime time bombs and they promply packaged them into blocks of securities and inserted them like poison pills onto an unsuspecting Wall Street and the rest of the economy.
Most of them have never had a real job or run anything, and the ones who do know are just going about the objective of addicting all of us to the state by destroying our freedom and wealth. It’s the process they want to accelerate with Amnesty.
jackie (5d360b) — 9/21/2010 @ 10:17 amOnly with Ocommunismcare the consequence was intentional – single payer -government takes all for Godless socialism.
Pogo was so right about who the real enemy was.
I see the latest polls show that over 50% of the people still trust Obama with the economy more than Bush.
I suspect the left is right not to believe that the little man is capable of exercising leadership of the land. It’s not his lack of ability its his greed and envy that are in charge.
Don L (4a0a2c) — 9/21/2010 @ 10:26 amBeck plays a 2007 vid all the time where Baracky tells his audience that he will need a transition time to single payer. Of course this is intentional!!
Patricia (9c62d9) — 9/21/2010 @ 11:25 amIf you believe the anonymous insider nobody read the bill that voted on it including Obama.
they pushed it a bit further – suggested the president could do some town meetings and answer questions about the bill, alleviate all the concerns and fight back against the conservative chatter that was being put out there. Guess what they were told regarding that? They were asked one question – did they read the bill? This Congressperson admitted they hadn’t. Like a lot of them, they had voted for it, but hadn’t read it. That was a mistake, sure, but the thing is over 2000 pages, right? Well, after admitting they didn’t read the bill they are told in a laughing way mind you, “That’s ok – neither has the president, so you can’t expect him to take on a bunch of town meetings on it, right?” So that was it. Nice, huh? Bye-bye, thanks for playing, and good luck with the -explitive- storm coming your way this summer.
Mike K (d6b02c) — 9/21/2010 @ 12:14 pmIf only you felt that way about insurance for all the uninsured….
timb (449046) — 9/21/2010 @ 1:01 pmWhich isn’t going to happen with this bill, timmah.
Dmac (d61c0d) — 9/21/2010 @ 1:03 pmtimb, what’s your solution? Single payer leads to a horrible situation with a human toll. This agitation phase is bad too. The status quo wasn’t perfect either.
It’s almost as if… government… isn’t the solution… to the fact that reality… bites.
Ah, the horrible grip of perspective.
Dustin (b54cdc) — 9/21/2010 @ 1:23 pmtimb,
Check out the medical care given to Obama’s Auntie. Do you think this is unusual?
Auntie Z and the System.
Patricia (9c62d9) — 9/21/2010 @ 2:55 pmMy healthy stepdaughter is now uninsured because of this.
You are an insufferable jackass.
EW1(SG) (edc268) — 9/21/2010 @ 4:03 pm“If only you felt that way about insurance for all the uninsured….”
timb – Were they denied health care?
daleyrocks (940075) — 9/21/2010 @ 4:11 pmThe only possible solution for all this is to repeal Obamacare in the next Congress and substitute an alternative that will be simpler, affordable and understandable. I have been an advocate of the French system for some time. They have less bureaucracy and it is local. We don’t have to adopt the whole thing but there are elements of it that would work. First you have free choice of physician. Second, the health plan pays a fixed rate for treatment and you negotiate with the doctor for the balance. Nobody out side the medical profession understands the economics of insurance right now.
Medicare is worse but the private insurance companies are following its lead. They are signing doctors and hospitals to contracts which specify that the doctor has to accept the payment the insurance company pay in order to be able to see patients with that company’s coverage. Then, the payment is heavily discounted but the patient doesn’t know.
Let’s say you are going to have a knee arthroscopy. It will be outpatient. Your policy says you pay 20% of the bill as many high deductible plans specify. You have, let’s say, a $1,000 deductible and then 20 % after that.
OK. You get a bill from the surgicenter for $10,000. You pay your $1,000 deductible plus 20% of the rest. That’s $2800 total. You think that the insurance pays the remaining $7200. Guess again. The insurance company has a contract with that surgicenter that pays $2800 for an arthroscopy. The insurance pays nothing. Maybe the contract is for $3800 and they pay $1,000.
The point is that this is all secret. Ditto for doctors. If we had a full disclosure system with free choice and the ability of doctors and patients to negotiate price, we would have the best elements of the French system.
It’s happening already in Medicare as doctors give up and drop out of the system. They practice for cash. It is a small movement right now but it is growing. The Phoenix Mayo Clinic branch notified patients last spring they would take no more Medicare.
The same problems exist with private insurance although they are less severe. The Obamacare bill does nothing but make all this worse. That’s why it has to go.
Mike K (568408) — 9/21/2010 @ 5:13 pmDr. Mike makes several excellent points, as always. I don’t support a specific answer to these problems but I would like to see more transparency so patients know who and what is being paid. Even under the current system it is difficult or impossible to convince health care providers to give patients copies of what they bill the insurance company.
DRJ (d43dcd) — 9/21/2010 @ 5:41 pm#34 Mike K:
According to the “explanation of benefits” from my insurance company, the medical equipment provider billed $8,000 for my CPAP~of which I was supposed to pay $1,790 out of pocket…but the equipment provider’s big selling point to patients is that the patient is never billed (even if the claim is not covered). The insurance company “paid” $3,010 (or whatever they really paid…more than enough to cover the actual cost of the CPAP).
It’s all Monopoly money…unless you don’t have insurance…and you get stuck with the bill for $8,000 for a $450 piece of equipment or whatever. And what about the claims that are denied from the medical equipment provider? The one that never charges the patients? Why should they care? Even if the insurance company really only paid $1,000 when they listed $3010 on the explanation of benefits, their making about a 100% profit on the device.
It’s all a shell game to follow the rulez laid down by some dumbass politicians who were interested in buying votes from morons.
EW1(SG) (edc268) — 9/21/2010 @ 5:58 pmMike K.–your example doesn’t actually work like that. At least, it doesn’t work that way under my insurance plan. The patient copay is 20 percent of the amount contracted between the insurance company and the medical provider. If the contract was $2800, and the deductible was actually $1000, the patient pays $1000 plus 20% of the remaining $1800, and the insurance company pays the other 80%.
The system is apparently too confusing even for medical bureaucrats. For a colonoscopy two years ago, I was billed not for my twenty percent, but for twenty percent of that twenty percent. Saved me a few hundred dollars, and the hospital has yet to figure out that I owe them some more money.
A year previous to that, I was hospitalized (same hospital because it was the same doctor) for three days, having been admitted through the ER. The hospital somehow failed to file the proper form, so the insurance company decreed that nothing was due the hospital because they had failed to gain pre-authorization. (How they were suppose to get pre-authorization for an ER admission made at almost midnight I can’t imagine. Perhaps I was supposed to call up the insurance company two days before to let them know I was going to need an ER visit later in the week?) Because of this not only did the insurance company not owe them any money, but I did not need to pay them anything at all.
But if you had the surgery as a patient without any insurance–or if the insurance refused to cover the surgery for some reason–the hospital would in fact bill you for the full $10000. And in fact, it would expect you pay the full amount up front, or at least have a firm payment plan in place before you saw the first nurse. I ran into a similar situation with my mother–the doctor prescribed a PETscan to avoid giving her a long series of CATscans; Medicare would not pay for the PETscan because the diagnosis did not involve cancer; the hospital called to tell us that we would need to pay approximately $8,000 if we went ahead with the PETscan. After a little go around with the doctor’s office and Medicare, we went the CATscan route. Again, witness how screwed up the insurance rules are: Medicare cheerfully paid for them, no questions asked, although the final total for the CATscan series was actually more than for the single PETscan.
kishnevi (9ba54d) — 9/21/2010 @ 5:59 pmEven under the current system it is difficult or impossible to convince health care providers to give patients copies of what they bill the insurance company
I get EOBs from my insurance plan (administered by UHC) about a month after the medical service is provided. My mother gets them from Medicare, but sometimes until several months later. In one case, a year later.
What seems next to impossible is getting a medical provider to tell you in advance what you will pay–which makes it almost impossible to compare prices among MDs. The only exception seems to be dentists. From what I can tell this is not some nefarious scheme on the part of the doctors and hospitals. It’s the result of the fact that having contracted with many insurance companies, all of them at different rates, no two people will really get billed the same, and the medical providers simply don’t know what the real bill will be until they send in the claim to the insurance company.
Of course, if you have no insurance, see what I wrote in my previous comment (which should have made room for the exception of people admitted through the ER at public or non profit hospitals).
kishnevi (c89e0a) — 9/21/2010 @ 6:18 pmThis has seriously affected me personally, next month my daughter turns 1 and would be eligible for a child only policy (with coventry) that would cost $150 -$200 less per month than my group health plan with coventry. I had it all planned out and was going to write the policy in about two weeks. I really wish I had realized the date this part of obamacareless went into effect, I would have written it earlier. Now I am out $2400 that I really could use. (I’ll go back to lurking now, this is my first post in what 5 years?)
Janied (a0795b) — 9/21/2010 @ 7:09 pmMike K.–your example doesn’t actually work like that. At least, it doesn’t work that way under my insurance plan. The patient copay is 20 percent of the amount contracted between the insurance company and the medical provider. If the contract was $2800, and the deductible was actually $1000, the patient pays $1000 plus 20% of the remaining $1800, and the insurance company pays the other 80%.
This is what they want you to believe and you bought it As I said, private insurance is not as bad yet as Medicare but the contracts specify discounts and they are trade secrets. Insurance companies compete to get better discounts from providers.
When I was still in practice I did a lot of negotiating and now I work part time for workers comp carriers. A lot depends on whether you are in an HMO or PPO. My son developed diabetes at age 27. His new diabetic education consisted of a video tape. Not all are that bad.
Mike K (568408) — 9/21/2010 @ 8:53 pm“The book that helped me understand economics was “Basic Economics” by Thomas Sowell. One of his main points is that government intervention almost always has unintended consequences. “
A watertight premise! Of course, if there were a flipside, it would address whether government uninvolvement and lack of economic oversight would ALSO have unintended consequences.
Ah, if only there were an example of this unlikely, farfetched hypothetical!
T.R. Ickledown (547c8e) — 9/21/2010 @ 8:53 pmYet another cowardly sockpuppeting troll. Maybe it could point to us a time where there was government uninvolvement and lack of oversight. Anyone care to bet when it will claim, and how wrong it will be?
JD (8ded14) — 9/21/2010 @ 9:03 pmThis is what they want you to believe and you bought it
Perhaps we are misunderstanding each other.
I thought you said the patient payment, including the amount of the copayment, is based on the ‘official’ bill the medical provider sends, even though the insurance company pays based on a much lower amount negotiated through contract.
My personal experience is that the amount of the copayment is based on the figure in the contract, and not on the official bill. Thus if the procedure is billed at $4000 but the contract rate is $2000, the patient copayment is based on the $2000 figure, not the $4000.
I think you are Philadelphia? Perhaps the insurance companies operate things differently there from here (South Florida): we are apparently one of the most competitive markets for health insurance in the nation. On the other hand, my insurance is actually a nationwide plan that’s funded by the company, not by the insurance company, which acts only as administrator. (I work for a retail corporation that has stores and facilities in every state, including Hawaii, Alaska, and for langiappe Puerto Rico) So there may be wrinkles in my plan that aren’t found in most plans. Officially we are a PPO. I don’t know what diabetes education would be under our plan; there is supposed to be a program under the plan for people with certain chronic or serious problems–cancer, diabetes, heart disease, asthma–but I don’t know how they actually manage the program. I do know the insurance plan tries to micromanage our health (for instance, those that don’t keep track of their cholesterol, blood glucose levels, and blood pressure on at least an annual basis will end up paying an extra six hundred dollars a year).
Hope that clarifies.
kishnevi (c89e0a) — 9/21/2010 @ 9:49 pmNow I understand why I could never understand the Medicare EOB’s from my father’s estate.
Patricia (9c62d9) — 9/21/2010 @ 10:39 pmOnce again, slowly: we are talking about health *insurance,* not health *care!* No one is denied health *care* in this country. Health insurance is not really “insurance” in the classic sense, because disease and injury are not “infrequent, random, and unpredictable.” So-called “health insurance” is a form of welfare. Money is taken from the many in the form of premiums, and given to the few, in the form of benefits. Except that the “few” keep increasing, once they realize they can shift some or most of their costs onto others. No business is obliged to offer a product just because some liberals think that they should. Raise the cost of doing business, and businesses will simply exit the field. Only profit keeps them in the game. But the Obami know nothing about business; no top-tier member of this Administration has ever been in business. All they know is how to wield the power of government to compel others to do their bidding.
OldBull (8b0130) — 9/22/2010 @ 2:03 amAnd so what if it did?
The universe is unfair. A government of laws doesn’t make the universe more fair, it punishes villains for their skulduggery~hopefully to make it clear to other villains that skulduggery is ultimately unfruitful.
The “liberal” approach to life, rather than acknowledging that the universe is unfair and getting on with it, is to make skulduggery the rule of the day to punish those whom the universe appears to like more. Ergo, my daughter is now uninsured, and even if I were to have unlimited funds, I cannot reinsure her.
And for that, liberals are very much to blame, singly and collectively. Their crap just doesn’t work.
EW1(SG) (edc268) — 9/22/2010 @ 3:57 pm“My personal experience is that the amount of the copayment is based on the figure in the contract”
kishnevi – I think you and Mike are talking past each other, not necessarily in disagreement.
In your PPO plan, does it specify a $2,000 deductible per employee? Is that what you mean by the contract?
What I believe Mike is referring to is a plan with a $1,000 deductible with with a 20% copay above that. A bill from a provider comes in and the EOB from the insurance company shows the employee/insured what to pay, sometimes after disallowing some things from the bill. What Mike is saying is that the employee/insured never see what is actually paid to the provider because the insurance companies have negotiated discounts with them.
I think what you are saying is that you see those discounts reflected on your EOB. I have seen discounts reflects for in network services in Illinois as well.
Then again, I could be misinterpreting both parties.
daleyrocks (940075) — 9/22/2010 @ 4:54 pmdaley–you understand me correctly. To be very precise my plan has a deductible of $1150 with copayments of twenty percent after that; In addition we pay a flat fee of $25 to see an internist (=primary care physician) and $35 to see a specialist, if they are in network. I haven’t ever needed to see an MD who was not part of the network, so I’m not sure how that would work out. These flat fees don’t count to the deductible. I do see how much the insurance plan pays these doctors over and above the flat fee I pay. It’s not much. Normal yearly eye checkups are not included. Preventative checkups and tests like colonoscopies are supposedly paid in full by the plan regardless of whether the deductible has been met–a new feature I haven’t tried yet.
kishnevi (8731ef) — 9/22/2010 @ 8:10 pmThere’s also a set up for prescriptions which cuts my medicine bill from full retail of about $4500 a year to about $1200 a year (most of that is for one medicine that keeps my Crohn’s in remission most of the time)–but acid reflux meds are not covered because allegedly OTC equivalents are just as good. I don’t get anything to show me how much, if any, Walgreens gets from the insurance company over and above what I pay them. From my point of view, it’s a good plan, and flexible enough to meet all my needs–which from Crohn’s, chronic sinusitis, osteoporosis, osteoarthritis and a slightly screwed up leg can be considerable. Just have to cross my fingers that Obamacare won’t screw it up too badly. Biggest drawback is the plan’s tendency to micromanage my health, by sending me friendly reminders (==warning letters?) when it thinks I’m not taking the correct medicine, etc. (It can’t understand that a GI MD will prescribe Questran not for cholesterol lowering but to prevent diarrhea.) But it is fairly expensive compared to rates from just a few years ago; about $200 a month split equally between my employer and me, or about twice what an almost identical plan charged in premiums about five years ago. (That’s for myself alone: I have no dependents or spouse to enroll with me.) We just got the figures for enrolling in next year’s plan–what I pay will go up about $5.00 a month. I do know in general that my employer has viewed health benefits as its biggest expense for almost a decade now, when it first began rearranging and tinkering with our health plans.
My doctor was considering Questran for me after my gall bladder assploded.
JD (8ded14) — 9/22/2010 @ 8:14 pm“I do know in general that my employer has viewed health benefits as its biggest expense for almost a decade now, when it first began rearranging and tinkering with our health plans.”
kishnevi – It is one of the biggest employer expenses. At one of my more recent employers we designed the employee contribution portion percentage to increase based on compensation levels.
I do object to the huge discounts I see negotiated from providers that ordinary people cannot obtain. That does not seem fair, although I understand the appeal of volume referrals to providers.
daleyrocks (940075) — 9/22/2010 @ 8:24 pmKishy …
The 20% you are liable for is not Co-Payment — it is called Co-Insurance.
Co-Payment is when you get charged a flat amount typically some type of office visit or hospitalization. $25 to see a Doc. $15 for Generics, etc.
How you “use” your deductible depends on each plan. Some apply co-pays to the draw down, Some don’t.
It get really complicated and to some degree I can see why Government gets involved in mandating some standardized version of how the product should be presented to consumer so they can buy logically..
Anyway.
Heavensent (e230a5) — 9/22/2010 @ 8:33 pmHad a patient today (Wed0 who was just blindsided by this.Young mother of two
corwin (35b5f0) — 9/23/2010 @ 4:38 amI do object to the huge discounts I see negotiated from providers that ordinary people cannot obtain. That does not seem fair, although I understand the appeal of volume referrals to providers.
My own suspicion is the full “official” rate is not really paid that often, and usually only by the most naive–that very often it’s simply a tactic to get the highest possible payment out of the insurance or Medicare, or a tactic to get them to raise their reimbursement rates in the future (since Medicare at least supposedly pays at the local prevailing rate). Apparently, if you’re savvy enough, you can negotiate some discounts of your own with at least some doctors and medical facilities: of course, if you’re that savvy, you probably have insurance in place already, or can find a doctor who is willing to bill at a lower figure in the first place if you pay him cash on the barrel head.
I wonder if anyone has figures that show what doctors and hospitals actually collect versus what they officially bill. It might be interesting.
We also have the higher compensated employees pay higher contributions feature–but it makes an important difference only at the very highest levels of the company. Middle management pays somewhat more than basic sales associates, but not that much more.
kishnevi (957315) — 9/23/2010 @ 8:35 amLocal news in Philly tonight commented that this aspect of “Health Reform” was going into effect today, and wasn’t it wonderful. Of course the news-caster is the wife of a Dem Congressman…
MD in Philly (3d3f72) — 9/23/2010 @ 8:15 pmWell once again the party of No complains about Obama care but had no solution of their own during the eight years of the Bush administration. They contributed exactly nothing except obstructionism during the last debate. If they weren’t so busy trying to block any reform for political purposes they might have made a better bill. But they have nothing to offer except racism and negativity. They dont want healthcare reform or anything else except more guns, tax breaks for the wealthiest and a white man in the white house! Deal with those facts!
VietnamEraVet (35c6c1) — 10/3/2010 @ 6:46 amToo much Agent Orange. It’s a sad thing.
ColonelHaiku (fb9945) — 10/3/2010 @ 8:17 amWhy is it that if you do not have a plan for whatever universe destroying problem there is, people like VeV get all hyperventilated? RACISTS!!!
JD (0f9c01) — 10/3/2010 @ 8:52 amJD – VEV obviously likes the Obama solution “we have to burn the village to save it” as it is applied to the insurance industry. The irony does not escape notice.
daleyrocks (940075) — 10/3/2010 @ 9:49 amMaybe he’s snorting powdered orange peels
Icy Texan (ec9185) — 10/3/2010 @ 10:22 am