Need a liberal's help

[silverscreenselect]

I guess you've never heard the definition of a prefatory clause then. Doesn't matter what it says as the operative clause is what counts and the Heller decision affirmed that.

I am well aware of what a prefatory clause is. It's a distinction invented by Justice Scalia and signed onto by four other members of the Supreme Court to justify reading about half of the Second Amendment out of existence. It's not based on any review of discussions of what the Founding Fathers said at the time the Constitution was drafted but a handful of "scholarly" arguments written decades (or even a couple of centuries) after the fact. If you're a fan of judicial activism that's fine, but it does go against Flock's original argument that the words of the Constitution are perfectly clear. They are clear only when you choose to ignore some of them to suit your own purposes.

[silverscreenselect]

Last month, [Barrette] received a letter from Blue Cross/Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she’s being offered would run $591 a month, ten times more than what she currently pays. “What I have right now is what I’m happy with, and I just want to know why I can’t keep what I have. Why do I have to be forced into something else?” [says Barrette]

More coverage may provide a deeper understanding of the ins and outs of Barrette’s situation: Her current health insurance plan, she says, doesn’t cover “extended hospital stays; it’s not designed for that,” says Barrette. Well, does it cover any hospitalization? “Outpatient only,” responds Barrette. Nor does it cover ambulance service and some prenatal care. On the other hand, says Barrette, it does cover “most of my generic drugs that I need” and there’s a $50 co-pay for doctors’ appointments. “It’s all I could afford right now,” says Barrette.

In sum, it’s a pray-that-you-don’t-really-get-sick “plan.” When asked if she ever required hospitalization, Barrette says she did. It happened when she was employed by Raytheon, which provided “excellent benefits.” Ever since she left the company and started working as an independent contractor, “I haven’t been hospitalized since then, thank God.” Hospitalization is among the core requirements for health-care plans under Obamacare.

This woman does not have health insurance. What she has is the medical equivalent of a buyer's club membership that, for about $600 a year entitles her to receive a limited amount of discounted health care services that the insurance company is able to negotiate with various doctors and pharmacies. There's value in that, just as there's value in a Costco membership. But it's not actual health insurance.

This woman is one serious illness away from bankruptcy court. The idea behind insurance is not to make normal expenses a bit cheaper... it's to protect against catastrophic loss. She has the equivalent of a "homeowners" policy that gives her discounted prices to repair a broken window or repair a leaky faucet but won't pay anything if her house burns down.

Although Obama has been disingenuous about his claims about "keeping your existing insurance," people conveniently forget that, Obamacare or not, there was never a guarantee that people would be able keep their existing insurance. Insurers withdraw from markets and nonrenew policies all the time. Many insurers are able to rerate people at renewal time and either nonrenew or jack up prices substantially. A lot of the people who are desparately seeking insurance today at one time had individual coverage they were "happy with."

Instead of focusing on what's wrong with Obamacare and trying to fix it, Republicans are out there claiming it's the worst thing that's happened in this country since slavery. They set the bar so low with these wildly exaggerated claims that the public will be willing to put up with anything that remotely resembles a working system.

[tlynn78]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

[macrae1234]

Truth behind the headline: “Florida Blue to ax 300,000 policies”
More Sharing ServicesShare on twitterSubmitted by Wayne Ezell on October 24, 2013 - 8:08am

Wayne Ezell's Blog
JView this blog post on the All-Access Members site

Kaiser Health News inspired lots of headlines and sound bites when it reported on Monday that insurance companies across the U.S. started sending out hundreds of thousands of cancellation letters in August.

In Florida, some 300,000 policy holders of Florida Blue got notices informing them that their policies would terminate at the end of the year. That would be 80 percent of Florida Blue’s customers who buy individual insurance as opposed to through an employer.

“State’s largest insurer puts blame on Affordable Care Act,” said the secondary headline on the Times-Union story.

How could this be?

Well, there’s more to the story – much more.

Florida Blue didn’t ax anybody. It merely sent its customers a letter explaining that policies that were expiring as scheduled had to be replaced with policies that provided better coverage, just as Florida Blue had been saying all along would happen.

Those 300,000 all bought their insurance after March 2010 when the Affordable Care Act went into effect. A few people who bought individual policies prior to 2010 could opt to be grandfathered in and keep their policies. Some did. Some didn’t.

Come Jan. 1, the rules are different for all who bought after March 2010. None should have been surprised; their existing policy informed that it would expire at the end of this year when new rules go into effect for both individual policies and employer-provided policies.

Florida Blue had no choice. The company had to write new policies to cover “essential health benefits” required by the ACA, including pre-existing conditions, doctor visits, emergency and hospital services, mental health and substance abuse treatment, prescription drugs, rehabilitation and devices that therapy requires, prevention and chronic disease management.

Real insurance, in other words, which means that fewer people will skate along with little or no insurance and be a burden on the rest of us when they wind up in the emergency room with acute conditions that could have been prevented or better managed with treatment.

The notice may have surprised some, but many if not most of those individual policy holders will qualify for at least some government subsidy to offset their costs.

With notices by Florida Blue went instructions about options available for insurance, invitations to visit the insurer’s customer centers or call for more information.

“People are migrating from their current policy to policies that cover revisions under the Affordable Care Act,” explained Jon Urbanek, Florida Blue senior vice president.

As is always the case with change, some people will be adversely affected. They may have to pay more or they may have a policy that they think provides coverage they don’t need.

But for the vast majority who have more options than ever before, this will mean better insurance and likely better health care.

And Florida Blue did just exactly what Florida Blue had been saying for months that it would do.

There was absolutely nothing unexpected here. Nothing.

[silverscreenselect]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

I don't know how smart "we" are but unless this woman is a plant trying to spread misinformation (which is entirely possible), and assuming she actually believes what she's been saying on the air, (1) this woman is too stupid to know that what she has is not health insurance and (2) she's too stupid to realize that there's a lot better alternatives out there than what she's claiming.

I went to the Kaiser Family Foundation site and plugged in the information based on what's reported in this story: that she's a 56-year-old woman (I assumed single with no dependents covered under 20), a nonsmoker, from Winter Haven, FL, with an annual income of $30,000. Her current "plan" cost $54 a month in 2013 (there's no telling what it might have gone up to in 2014 if the company didn't cancel it).

Her cost, after subsidies, for a $30,000 silver level plan (which pays 70% of actuarial value), would be $2512 or $209 a month. Expensive, but a lot less than 10 times what she was making. If she's willing to take a bronze level plan (which pays 60% of actuarial value), then her cost would be $1164 or $97 a month. What she would be getting for that money would be real health insurance that would guarantee that a serious hospitalization or lengthy course of medical treatment would not saddle her with a ton of bills instead of a discount rate on some prescription drugs and some doctor visits (which she would also get under the new plan).

I would urge anyone who hears nonsense about what these various plans do or do not cost to look up the Kaiser site, which allows you to plug in actual numbers and see how expensive plans are and how much of that is subsidized.

http://kff.org/interactive/subsidy-calculator/

[Bob78164]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

No. But those who are going with inadequate insurance are gambling with someone else's money, because they'll end up getting the care they need while someone else pays for it as they discharge their debts in bankruptcy. --Bob

[silverscreenselect]

Here's the list of essential health benefits all plans now have to provide (and what the Florida woman's plan did not provide):

(A) Ambulatory patient services.
(B) Emergency services.
(C) Hospitalization.
(D) Maternity and newborn care.
(E) Mental health and substance use disorder services, including behavioral health treatment.
(F) Prescription drugs.
(G) Rehabilitative and habilitative services and devices.
(H) Laboratory services.
(I) Preventive and wellness services and chronic disease management.
(J) Pediatric services, including oral and vision care.

These are not exotic benefits. With the exception of maternity and pediatric services, they are services that just about anyone would want to have covered on a health insurance plan. That woman did not have ambulance and hospitalization treatment covered, and possibly others. The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

[macrae1234]

Thanks sss I was working on getting those numbers now there is no need. For people in a slightly better situation then this lady and I am looking at their "typical" middle class family of 4 without insurance from work who fall of the grid and pay exhorbitant rates they always seem to list a gold policy. They never mention the Health Savings accounts with pre tax dollars.

[littlebeast13]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

[Bob Juch]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

No. But those who are going with inadequate insurance are gambling with someone else's money, because they'll end up getting the care they need while someone else pays for it as they discharge their debts in bankruptcy. --Bob

Not necessarily bankruptcy; often the providers will simply stop collecting, write off the bills and jack up what they charge us.

[Bob Juch]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Well then how about if you pay in advance for any future medical treatment?

[tlynn78]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Sorry - not allowed. The guvmint will tell us what we need and we should just shut up and be pleased. Fall in line, please; fall in line.

[tlynn78]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

No. But those who are going with inadequate insurance are gambling with someone else's money, because they'll end up getting the care they need while someone else pays for it as they discharge their debts in bankruptcy. --Bob

And as everyone knows, that's only acceptable from those on the dole. Got it.

[Bob78164]

Basically, we're too stupid to know what we want; we're too stupid to know what we can afford. Got it.

No. But those who are going with inadequate insurance are gambling with someone else's money, because they'll end up getting the care they need while someone else pays for it as they discharge their debts in bankruptcy. --Bob

And as everyone knows, that's only acceptable from those on the dole. Got it.

It really sounds like you're advocating here for the right to gamble with other people's money. You win, you keep the savings in the form of lower premiums. You lose, we pay in the form of health care costs that you receive but can't pay for.

I can understand why anyone would want that deal, if they could get it. Hell, socialization of costs and privatization of benefits has been a long-standing plank of the current incarnation of the GOP. But I'm not willing to agree to that deal, and I won't apologize for that. --Bob

[Bob78164]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Sounds fair. I imagine many women feel exactly the same way about paying for prescription drug plans that cover Viagra. --Bob

[macrae1234]

Sounds fair. I imagine many women feel exactly the same way about paying for prescription drug plans that cover Viagra.

Do any plans cover it I don't think so and I think just as many woman benefit from viagra as men

[silverscreenselect]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Sorry - not allowed. The guvmint will tell us what we need and we should just shut up and be pleased. Fall in line, please; fall in line.

Well, yes, otherwise we'd all get hit by adverse selection, with policies carving out more and more exclusions for coverage unless people decided to pay extremely expensive riders covering a particular condition.

Because insurance companies hold all the cards in terms of issuing policies, governments have required them to insert certain clauses favorable to insureds in policies for hundreds of years. If they didn't, the insurance industry as we know it would not exist today.

Suppose policies excluded coverage for cancer unless people purchased a separate rider. The people purchasing those riders would predominately be people at high risk for cancer which would drive the coverage for the rider much higher than it would otherwise be.

[macrae1234]

I was trying to think of an analogous situation for Ms Barrette's existing health care plan, the one that is being phased out because it doesn't meet the new requirements.
If we compare it to auto insurance it is like having an auto insurance plan with a 50,000 deductible for everything but if your windshield gets cracked they replace it for free

[flockofseagulls104]

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Sorry - not allowed. The guvmint will tell us what we need and we should just shut up and be pleased. Fall in line, please; fall in line.

Well, yes, otherwise we'd all get hit by adverse selection, with policies carving out more and more exclusions for coverage unless people decided to pay extremely expensive riders covering a particular condition.

Because insurance companies hold all the cards in terms of issuing policies, governments have required them to insert certain clauses favorable to insureds in policies for hundreds of years. If they didn't, the insurance industry as we know it would not exist today.

Suppose policies excluded coverage for cancer unless people purchased a separate rider. The people purchasing those riders would predominately be people at high risk for cancer which would drive the coverage for the rider much higher than it would otherwise be.

You can try and defend obamacare all you want, sss. People are just beginning to see what a train wreck it is and it will only get worse for all of us. And this is ALL on the dems. Not one repub voted for it, not one repub even had a say in it. Even the rinos have an out. (But not with conservatives). The more you try and 'fix' it the more out of control it will get. It is not sustainable by its structure. Thats what us crazy racist extortionist teabsggers knew from the start. We tried to stop it but at every turn we were called names stonewalled and attacked. Now theres no choice but to let the train wreck happen. Thank you all you democrats and rino republicans.

[littlebeast13]

The reason maternity and pediatric care are included is because otherwise they would be highly susceptible to adverse selection. Men, non-child-bearing women, and people without children would exclude them if they could, driving up the costs tremendously for others.

Fuck this.

Seriously... fuck this.

I want only what I need. I'm a selfish prick who really doesn't care about the needs of others....

lb13

Sounds fair. I imagine many women feel exactly the same way about paying for prescription drug plans that cover Viagra. --Bob

Sign me up for the Viagra-free plan as well....

If I can choose the auto insurance policy that's fits what I need, I should (theoretically, not that I'd not use the Mecca plan anyway) be able to choose the health insurance plan that best fits what I need as well. I am actually keeping an open mind about the new insurance law, but this is one component I am absolutely, positively against. And BJ can take his increased costs for someone else and stick them where the sun don't shine, because like it or not, starting a family is a choice and if you ain't willing to suck up the extra costs of having a family, you better keep the pants on, because I sure as hell don't want to subsidize you....

lb13

[macrae1234]

We tried to stop it but at every turn we were called names stonewalled and attacked.

and your last ditch effort the shut down took $24 billion out of the U.S. economy, and reduced projected fourth-quarter GDP growth from 3 percent to 2.4 percent according to Standard and Poors and also the economic hardship for federal employess, contractor job losses and the innocent non tea party Rebublican representatives who will be voted out of office by an angry electorate

[jarnon]

If I can choose the auto insurance policy that's fits what I need

But every state has minimum standards (usually a certain amount of liability and no-fault medical coverage). And if you have a car loan, you probably have to shell out for comprehensive and collision too.

like it or not, starting a family is a choice and if you ain't willing to suck up the extra costs of having a family, you better keep the pants on, because I sure as hell don't want to subsidize you....

I have to put up with high property taxes to pay for local public schools, whether or not I have school-age kids. Society has decided that the institution of the family deserves public support.

[silverscreenselect]

People are just beginning to see what a train wreck it is and it will only get worse for all of us. And this is ALL on the dems. Not one repub voted for it, not one repub even had a say in it.

The Republicans opted out by not trying to participate in the process since none of them said they would support it under certain circumstances. And they've tried to be obstructionist every step of the way since then (over 40 votes that got them nowhere). Obamacare is a badly flawed law, but instead of trying to fix it, Republicans continue to opt out.

The problem with the line that you and Hannity spout out every chance you get is that the law is not as bad as you keep claiming since you do not understand the principles of insurance and what does and does not work (and yes, this is something I do know about). By continuing to claim the bill is a horrible disaster that's going to destroy the country, you all are coming across as increasingly desparate boys who cry wolf. And, instead of trying to fix the problems, you'll be content to sit on the sidelines as an increasingly smaller minority party proclaiming gloom and doom.

[macrae1234]

and the reddest of red herrings
Hospitalization. vs Maternity and newborn care.

A few facts I know most of your minds are made up and don't want to be confused but numbers for 2010

Adults ages 45–64 and 65–84 had the highest average cost per stay ($12,100 and $12,300, respectively). These 2 age groups accounted for nearly two-thirds of aggregate hospital costs and about half of hospital stays. Adults age 85 and older accounted for 8 percent of aggregate costs and hospital stays, and had an average hospital cost that was similar to the overall average cost per stay. Infants (children younger than 1 year) accounted for 5 percent of aggregate costs and 12 percent of hospitalizations. Infants also had the lowest average cost per stay ($4,500), which was less than half the overall average cost per stay.


Hospital costs by diagnostic category,
70 percent of aggregate hospital costs were attributable to 7 Major Diagnostic Categories
Circulatory conditions (primarily acute myocardial infarction, coronary atherosclerosis, congestive heart failure, acute cerebrovascular disease, and cardiac dysrhythmias) accounted for the largest share—nearly one-fifth—of hospital costs.
Other diagnostic categories that accounted for high shares of aggregate hospital costs included musculoskeletal conditions (broken bones, ligament damage, etc) (14 percent), respiratory conditions (11 percent), digestive conditions (9 percent), and nervous system conditions (8 percent), infectious and parasitic diseases (5 percent) and pregnancy and childbirth (5 percent). Obviously pregnancy and childbirth had the most stays but also the shortest duration and lowest cost.

[flockofseagulls104]

We tried to stop it but at every turn we were called names stonewalled and attacked.

and your last ditch effort the shut down took $24 billion out of the U.S. economy, and reduced projected fourth-quarter GDP growth from 3 percent to 2.4 percent according to Standard and Poors and also the economic hardship for federal employess, contractor job losses and the innocent non tea party Rebublican representatives who will be voted out of office by an angry electorate

No matter how loud you shout it, and how many main stream media types you have repeating your mantra, the dems and rino republicans in the senate, and the president are as much, or more, to blame for the shutdown as the house was. I do not care what the consensus is, and what the end result of the propaganda or the polls say, The House of Reps had every right in the world to do what they did. THAT IS THEIR FUNCTION! It was the Senate and the Pres who REFUSED to negotiate and shut down the government.