Health Care Markets- will this work?
brianlux
Moving through All Kinds of Terrain. Posts: 42,087
Maybe. I think it depends on how well orchestrated this goes.
What a pathetic state of affairs our health care is in today. In 1971 while living in San Francisco, I cut my head open and was bleeding all over the carpet. My roommate rushed me to the Haight-Ashbury Free clinic where I they charged on a sliding scale- basically what ever you could afford- and got stitched up by skilled hands. No hassles, no interrogation, no problems, good help.
Anyway- here's an article on the new Health Care Markets:
http://news.yahoo.com/consumer-alert-he ... nance.html
Consumer alert: new health care markets on the way
WASHINGTON (AP) — Buying your own health insurance will never be the same.
This fall, new insurance markets called exchanges will open in each state, marking the long-awaited and much-debated debut of President Barack Obama's health care overhaul.
The goal is quality coverage for millions of uninsured people in the United States. What the reality will look like is anybody's guess — from bureaucracy, confusion and indifference to seamless service and satisfied customers.
Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for.
Most people will go online to pick a plan when open enrollment starts Oct. 1. Counselors will be available at call centers and in local communities, too. Some areas will get a storefront operation or kiosks at the mall. Translation to Spanish and other languages spoken by immigrants will be provided.
When you pick a plan, you'll no longer have to worry about getting turned down or charged more because of a medical problem. If you're a woman, you can't be charged a higher premium because of gender. Middle-aged people and those nearing retirement will get a price break: They can't be charged more than three times what younger customers pay, compared with six times or seven times today.
If all this sounds too good to be true, remember that nothing in life is free and change isn't easy.
Starting Jan. 1, 2014, when coverage takes effect in the exchanges, virtually everyone in the country will be required by law to have health insurance or face fines. The mandate is meant to get everybody paying into the insurance pool.
Obama's law is called the Affordable Care Act, but some people in the new markets might experience sticker shock over their premiums. Smokers will face a financial penalty. Younger, well-to-do people who haven't seen the need for health insurance may not be eligible for income-based assistance with their premiums.
Many people, even if they get government help, will find that health insurance still doesn't come cheaply. Monthly premiums will be less than the mortgage or rent, but maybe more than a car loan. The coverage, however, will be more robust than most individual plans currently sold.
Consider a hypothetical family of four making $60,000 and headed by a 40-year-old. They'll be eligible for a government tax credit of $7,193 toward their annual premium of $12,130. But they'd still have to pay $4,937, about 8 percent of their income, or about $410 a month.
A lower-income family would get a better deal from the government's sliding-scale subsidies.
Consider a similar four-person family making $35,000. They'd get a $10,742 tax credit toward the $12,130 annual premium. They'd have to pay $1,388, about 4 percent of their income, or about $115 a month.
The figures come from the nonpartisan Kaiser Family Foundation's online Health Reform Subsidy Calculator. But while the government assistance is called a tax credit and computed through the income tax system, the money doesn't come to you in a refund. It goes directly to insurers.
Obama's law is the biggest thing that's happened to health care since Medicare and Medicaid in the 1960s. But with open enrollment for exchange plans less than 10 months away, there's a dearth of consumer information. It's as if the consumer angle got drowned out by the political world's dispute over "Obamacare," the dismissive label coined by Republican foes.
Yet exchanges are coming to every state, even those led by staunch GOP opponents of the overhaul, such as Govs. Rick Perry of Texas and Nikki Haley of South Carolina. In their states and close to 20 others that are objecting, the exchanges will be operated by the federal government, over state opposition. Health and Human Services Secretary Kathleen Sebelius has pledged that every citizen will have access to an exchange come next Jan. 1, and few doubt her word.
But what's starting to dawn on Obama administration officials, activists, and important players in the health care industry is that the lack of consumer involvement, unless reversed, could turn the big health care launch into a dud. What if Obama cut the ribbon and nobody cared?
"The people who stand to benefit the most are the least aware of the changes that are coming," said Rachel Klein, executive director of Enroll America, a nonprofit that's trying to generate consumer enthusiasm.
"My biggest fear is that we get to Oct. 1 and people haven't heard there is help coming, and they won't benefit from it as soon as they can," she added. "I think it is a realistic fear."
Even the term "exchange" could be a stumbling block. It was invented by policy nerds. Although the law calls them "American Health Benefit Exchanges," Sebelius is starting to use the term "marketplaces" instead.
Polls underscore the concerns. A national survey last October found that only 37 percent of the uninsured said they would personally be better off because of the health care law. Twenty-three percent said they would be worse off in the Kaiser poll, while 31 percent said it would make no difference to them.
Insurers, hospitals, drug companies and other businesses that stand to benefit from the hundreds of billions of dollars the government will pump in to subsidize coverage aren't waiting for Washington to educate the public.
Blue Cross and Blue Shield plans, for example, are trying to carve out a new role for themselves as explainers of the exchanges. Somewhere around 12 million people now purchase coverage individually, but the size of the market could double or triple with the new approach, and taxpayers will underwrite it.
"Consumers are expecting their health insurance provider to be a helpful navigator to them," said Maureen Sullivan, a senior vice president for the Blues' national association. "We see 2013 as a huge year for education."
One goal is to help consumers master the "metals," the four levels of coverage that will be available through exchange plans — bronze, silver, gold, and platinum.
Blue Cross is also working with tax preparer H&R Block, which is offering its customers a health insurance checkup at no additional charge this tax season. Returns filed this year for 2012 will be used by the government to help determine premium subsidies for 2014.
"This tax season is one of historical significance," said Meg Sutton, senior advisor for tax and health care at H&R Block. "The tax return you are filing is going to be key to determining your health care benefits on the exchange."
Only one state, Massachusetts, now has an exchange resembling what the administration wants to see around the country. With six years in business, the Health Connector enrolls about 240,000 Massachusetts residents. It was created under the health overhaul plan passed by former Republican Gov. Mitt Romney and has gotten generally positive reviews.
Connector customer Robert Schultz is a Boston area startup business consultant who got his MBA in 2008, when the economy was tanking. Yet he was able to find coverage when he graduated and hang on to his insurance through job changes since. Schultz says that's freed him to pursue his ambition of becoming a successful entrepreneur — a job creator instead of an employee.
"It's being portrayed by opponents as being socialistic," said Schultz. "It is only socialistic in the sense of making sure that everybody in society is covered, because the cost of making sure everybody is covered in advance is much less than the cost of putting out fires."
The Connector's executive director, Glen Shor, said his state has proven the concept works and he's confident other states can succeed on their own terms.
"There is no backing away from all the challenges associated with expanding coverage," Shor said. "We are proud in Massachusetts that we overcame what had been years of policy paralysis."
What a pathetic state of affairs our health care is in today. In 1971 while living in San Francisco, I cut my head open and was bleeding all over the carpet. My roommate rushed me to the Haight-Ashbury Free clinic where I they charged on a sliding scale- basically what ever you could afford- and got stitched up by skilled hands. No hassles, no interrogation, no problems, good help.
Anyway- here's an article on the new Health Care Markets:
http://news.yahoo.com/consumer-alert-he ... nance.html
Consumer alert: new health care markets on the way
WASHINGTON (AP) — Buying your own health insurance will never be the same.
This fall, new insurance markets called exchanges will open in each state, marking the long-awaited and much-debated debut of President Barack Obama's health care overhaul.
The goal is quality coverage for millions of uninsured people in the United States. What the reality will look like is anybody's guess — from bureaucracy, confusion and indifference to seamless service and satisfied customers.
Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for.
Most people will go online to pick a plan when open enrollment starts Oct. 1. Counselors will be available at call centers and in local communities, too. Some areas will get a storefront operation or kiosks at the mall. Translation to Spanish and other languages spoken by immigrants will be provided.
When you pick a plan, you'll no longer have to worry about getting turned down or charged more because of a medical problem. If you're a woman, you can't be charged a higher premium because of gender. Middle-aged people and those nearing retirement will get a price break: They can't be charged more than three times what younger customers pay, compared with six times or seven times today.
If all this sounds too good to be true, remember that nothing in life is free and change isn't easy.
Starting Jan. 1, 2014, when coverage takes effect in the exchanges, virtually everyone in the country will be required by law to have health insurance or face fines. The mandate is meant to get everybody paying into the insurance pool.
Obama's law is called the Affordable Care Act, but some people in the new markets might experience sticker shock over their premiums. Smokers will face a financial penalty. Younger, well-to-do people who haven't seen the need for health insurance may not be eligible for income-based assistance with their premiums.
Many people, even if they get government help, will find that health insurance still doesn't come cheaply. Monthly premiums will be less than the mortgage or rent, but maybe more than a car loan. The coverage, however, will be more robust than most individual plans currently sold.
Consider a hypothetical family of four making $60,000 and headed by a 40-year-old. They'll be eligible for a government tax credit of $7,193 toward their annual premium of $12,130. But they'd still have to pay $4,937, about 8 percent of their income, or about $410 a month.
A lower-income family would get a better deal from the government's sliding-scale subsidies.
Consider a similar four-person family making $35,000. They'd get a $10,742 tax credit toward the $12,130 annual premium. They'd have to pay $1,388, about 4 percent of their income, or about $115 a month.
The figures come from the nonpartisan Kaiser Family Foundation's online Health Reform Subsidy Calculator. But while the government assistance is called a tax credit and computed through the income tax system, the money doesn't come to you in a refund. It goes directly to insurers.
Obama's law is the biggest thing that's happened to health care since Medicare and Medicaid in the 1960s. But with open enrollment for exchange plans less than 10 months away, there's a dearth of consumer information. It's as if the consumer angle got drowned out by the political world's dispute over "Obamacare," the dismissive label coined by Republican foes.
Yet exchanges are coming to every state, even those led by staunch GOP opponents of the overhaul, such as Govs. Rick Perry of Texas and Nikki Haley of South Carolina. In their states and close to 20 others that are objecting, the exchanges will be operated by the federal government, over state opposition. Health and Human Services Secretary Kathleen Sebelius has pledged that every citizen will have access to an exchange come next Jan. 1, and few doubt her word.
But what's starting to dawn on Obama administration officials, activists, and important players in the health care industry is that the lack of consumer involvement, unless reversed, could turn the big health care launch into a dud. What if Obama cut the ribbon and nobody cared?
"The people who stand to benefit the most are the least aware of the changes that are coming," said Rachel Klein, executive director of Enroll America, a nonprofit that's trying to generate consumer enthusiasm.
"My biggest fear is that we get to Oct. 1 and people haven't heard there is help coming, and they won't benefit from it as soon as they can," she added. "I think it is a realistic fear."
Even the term "exchange" could be a stumbling block. It was invented by policy nerds. Although the law calls them "American Health Benefit Exchanges," Sebelius is starting to use the term "marketplaces" instead.
Polls underscore the concerns. A national survey last October found that only 37 percent of the uninsured said they would personally be better off because of the health care law. Twenty-three percent said they would be worse off in the Kaiser poll, while 31 percent said it would make no difference to them.
Insurers, hospitals, drug companies and other businesses that stand to benefit from the hundreds of billions of dollars the government will pump in to subsidize coverage aren't waiting for Washington to educate the public.
Blue Cross and Blue Shield plans, for example, are trying to carve out a new role for themselves as explainers of the exchanges. Somewhere around 12 million people now purchase coverage individually, but the size of the market could double or triple with the new approach, and taxpayers will underwrite it.
"Consumers are expecting their health insurance provider to be a helpful navigator to them," said Maureen Sullivan, a senior vice president for the Blues' national association. "We see 2013 as a huge year for education."
One goal is to help consumers master the "metals," the four levels of coverage that will be available through exchange plans — bronze, silver, gold, and platinum.
Blue Cross is also working with tax preparer H&R Block, which is offering its customers a health insurance checkup at no additional charge this tax season. Returns filed this year for 2012 will be used by the government to help determine premium subsidies for 2014.
"This tax season is one of historical significance," said Meg Sutton, senior advisor for tax and health care at H&R Block. "The tax return you are filing is going to be key to determining your health care benefits on the exchange."
Only one state, Massachusetts, now has an exchange resembling what the administration wants to see around the country. With six years in business, the Health Connector enrolls about 240,000 Massachusetts residents. It was created under the health overhaul plan passed by former Republican Gov. Mitt Romney and has gotten generally positive reviews.
Connector customer Robert Schultz is a Boston area startup business consultant who got his MBA in 2008, when the economy was tanking. Yet he was able to find coverage when he graduated and hang on to his insurance through job changes since. Schultz says that's freed him to pursue his ambition of becoming a successful entrepreneur — a job creator instead of an employee.
"It's being portrayed by opponents as being socialistic," said Schultz. "It is only socialistic in the sense of making sure that everybody in society is covered, because the cost of making sure everybody is covered in advance is much less than the cost of putting out fires."
The Connector's executive director, Glen Shor, said his state has proven the concept works and he's confident other states can succeed on their own terms.
"There is no backing away from all the challenges associated with expanding coverage," Shor said. "We are proud in Massachusetts that we overcame what had been years of policy paralysis."
“The fear of death follows from the fear of life. A man [or woman] who lives fully is prepared to die at any time.” Variously credited to Mark Twain or Edward Abbey.
Democracy Dies in Darkness- Washington PostPost edited by Unknown User on
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Comments
If you bring on 30 million new patients with no new doctors, quality of care will drop dramatically! MATH
If you bring on 15 million illegal immigrants whom dont pay federal income taxes, and they have lots of ANCHOR BABIES here in our hospitals, the hospitals are taking on those costs and passing them down to the consumer that DOES pay for their services. Costs rise for the services. NOT FAIR
If you have frivolous lawsuits against doctors because people are greedy or money hungry or lazy, then the doctors are fearful to do all they can do with patients and the people who do play by the rules lose out! Doctors also fearful to do more. NOT FAIR
Competition is always a great method for improving quality of care or improvement of service. HUMAN NATURE
Insurance across state lines would be effective
Only in a theoretical world, can we expect to pay for every single persons health care and the quality of the care remain good! Thats asking alot!
Health care costs are out of this world and will only go UP with socilialized medicine!
Corruption will grow significantly!
GODSPEED!
A man that stands for nothing....will fall for anything!
All people need to do more on every level!
It is asking a lot. I understand your concerns but to my way of thinking, cost and immigration concerns should not trump people's ability to get decent health care. Do you agree with that and if so, what do you suggest in order for everyone to get the health care they need? If not, which people do you suggest we let go without adequate care?
I think the same as you in regards that everyone should get the quality care but we need to pay for it from elsewhere, this is where you and I would greatly disagree....we need to have major cuts in other areas to pay for health care.
MOST IMPORTANTLY health care can be run privately with competition. Also, cut waste and corruption.
The govt. is not frugal in any area and it costs more to run anything under the govt. than what the private sector can do!
I see it as a drop in quality of care for sure. I believe we can give more people better quality care under private run program. Thats where we differ!
A man that stands for nothing....will fall for anything!
All people need to do more on every level!
I'm not convinced the poor and many on limited incomes can afford private health care. In fact, I seriously doubt it.
I assume (and correct me if I'm wrong) that many of the immigrants you refer to here are from south of the border. I get a little upset when I hear American's complain about giving these people health care. If it weren't for Latino immigrants, most of us would not eat nearly as well as we do. We expect them to do out harvesting but don't want to pay for their health care.
Farm work is damn hard work and it's hard on one's health. I spent a couple of summers right along next to some Mexican workers (some of the nicest, hard working people I've ever met) hoeing rows of crops and picking lettuce, bush beans, cucumbers, beets, a variety of cucurbitaceae, etc., all of which grow low to the ground. It's intensely hard work and hard on the body. On top of that, many of these folks work as migrants and spend far fewer time at their home base- assuming they have one- than most of us do. Instead of complaining about them being here or attending to their medical needs we should thank our lucky stars they do what they do.
We'll never get out of this situation until people learn to separate the two in their minds.
We'll also never get out until we as a people take back the responsibility for our own health care from out employers and the government.
Employer-provided insurance is one of the biggest reasons we're in this mess.
...are those who've helped us.
Right 'round the corner could be bigger than ourselves.
I think the same as you in regards that everyone should get the quality care but we need to pay for it from elsewhere, this is where you and I would greatly disagree....we need to have major cuts in other areas to pay for health care.
MOST IMPORTANTLY health care can be run privately with competition. Also, cut waste and corruption.
The govt. is not frugal in any area and it costs more to run anything under the govt. than what the private sector can do!
I see it as a drop in quality of care for sure. I believe we can give more people better quality care under private run program. Thats where we differ![/quote]
I'm not convinced the poor and many on limited incomes can afford private health care. In fact, I seriously doubt it.
I assume (and correct me if I'm wrong) that many of the immigrants you refer to here are from south of the border. I get a little upset when I hear American's complain about giving these people health care. If it weren't for Latino immigrants, most of us would not eat nearly as well as we do. We expect them to do out harvesting but don't want to pay for their health care.
Farm work is damn hard work and it's hard on one's health. I spent a couple of summers right along next to some Mexican workers (some of the nicest, hard working people I've ever met) hoeing rows of crops and picking lettuce, bush beans, cucumbers, beets, a variety of cucurbitaceae, etc., all of which grow low to the ground. It's intensely hard work and hard on the body. On top of that, many of these folks work as migrants and spend far fewer time at their home base- assuming they have one- than most of us do. Instead of complaining about them being here or attending to their medical needs we should thank our lucky stars they do what they do.[/quote]
Brian you can find something good in anything....you have to realize that the cost on our society from illegal immigrants is over 300 billion per year! If you think picking some vegetables and having nice lawns equates to that, your nuts! I am very middle of the road and I have friends who are illegal. I know the entire trade and I see the good, however 300 billion and alot of that is in our hospitals! Those costs are sent down to the consumer who does pay, like you and me! We pay more for it. We pay more for many things. Its not the latinos or hispanics fault, I would have done the same thing! Im just saying that the weight on our society is HUGE and it needs fixed now.
A man that stands for nothing....will fall for anything!
All people need to do more on every level!
I live in the west where lawns are a bad idea. They use too much fresh water which will continue to become more scarce in the west, they are grown of non-indigenous species, and they pollute our streams, rivers and lakes with chemical run off and fertilizers. But why are we talking about lawns? I never said anything about "having a nice lawn".
As for "picking some vegetables" did you think I was talking about a nice little garden outside the kitchen window? :fp: