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Thread: Supreme Court Rules in Favor of Obama on Health Care

  1. #46
    Elite Member lurkur's Avatar
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    I wonder how it affects people who tried to get health insurance but were DENIED. Will they get charged fees because they don't have coverage?
    If being cunty is wrong, I don't wanna be right.

  2. #47
    Elite Member MontanaMama's Avatar
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    You can't get denied under the law. Each state has a "high risk" policy pool and they must be covered. In addition, the expanded medicare/medicaid provisions should (theoretically) open up coverage for a lot of people who were denied without government protection/intervention.
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  3. #48
    Elite Member lurkur's Avatar
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    Quote Originally Posted by MontanaMama View Post
    You can't get denied under the law. Each state has a "high risk" policy pool and they must be covered. In addition, the expanded medicare/medicaid provisions should (theoretically) open up coverage for a lot of people who were denied without government protection/intervention.
    I guess there are some lawww-breakuhs in heah...
    If being cunty is wrong, I don't wanna be right.

  4. #49
    Elite Member MontanaMama's Avatar
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    Well the law doesn't fully go into effect until 2014, but every state does have the high risk policies in place now.
    If i hear one more personal attack, i will type while drunk, then you can cry! - Bugdoll
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    Quote Originally Posted by shedevilang View Post
    (Replying to MontanaMama) This is some of the smartest shit I ever read

  5. #50
    Elite Member CornFlakegrl's Avatar
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    Quote Originally Posted by louiswinthorpe111 View Post
    It's not even reforming insurance. It's expansion of insurance. Sorry, but insurance companies are a for profit entity. They make profits by either making over pverpay for premiums or denying claims. My health and well being is not their priority, their profits and shareholders are. THAT's BS.
    =

    There are not for proft insurance companies out there. Their rates aren't much lower than for profits.

    I've been out of the game for a while now, but 6 years or so ago, the average HMO made about 5% profit, non hmo was higher at about 15-17%. Your phone company has a higher profit margin. The company profits you see are from investments. Insurance companies have capital and are major stakeholders in the market. Also, roughly 95% of claims are paid within 45 days of submission. That's out of BILLIONS of claims. They aren't trying to make quarterly earnings from denying claims. Myth.

    If you look at the history, HMOs and other managed care companies drove DOWN the cost for the people. Prior to HMOS people were at the mercy of health care providers. Their insurance coverd 80% of whatever doctors/hospitals charged and the patient paid the rest. HMOS and the like intervened and negotiated better rates with providers. Driving DOWN cost to the patient. Premiums lowered and out of pocket was minimal.

    Over time, providers said fuck that. The AMA and Hospital Associations have powerful lobbyists. They started pushing back on negotiated rates, worked the states to mandate coverage, increase reimbursement rates and generally drove the costs right back up. . Insurance companies raised premiums as a result. Add to that aging population (skyrocketing usage) and new technologies (very expensive) and premiums continued to climb.

    I hate to defend insurance companies but the issue is far more complex than big bad corporation trying to rape the little guy. The COST of healthcare is the main driver, as well as a population that insists on low premiums with premium coverage (insure my dog goddamn it!).

  6. #51
    Elite Member witchcurlgirl's Avatar
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    Quote Originally Posted by CornFlakegrl View Post
    What was the argument that this was Constitutional? Where the hell does it say in the Constitution that the federal government can order citizens to buy something?????
    Roberts signed off on the mandate, not as part of Congress’ power under the Commerce Clause, but from the power to tax. His opinion ruled that the mandate violates the Commerce Clause, but as a tax that no longer matters.

    The Supreme Court has signed off on what is, in practical terms, a tax levied by the insurance industry. It should have both the right and left angry.

    Defending the constitutionality of the mandate, the government’s primary argument was that Congress can require everyone to buy health insurance using its power under the Commerce Clause of the Constitution, because the failure to buy insurance shifts the costs of health care for the uninsured to health-care providers, insurance companies, and everyone who does have health insurance. Five Justices – the Chief Justice and Justices Kennedy, Scalia, Thomas, and Alito – all rejected that argument. But the government still won, because a different set of five Justices – the Chief Justice and Justices Ginsburg, Breyer, Sotomayor, and Kagan – agreed that the mandate was constitutional, but for a different reason............................

    Although the Chief Justice rejected the government’s Commerce Clause argument, he agreed with one of the government’s alternative arguments: the mandate imposes a tax on people who do not buy health insurance, and that tax is something that Congress can impose using its constitutional taxing power. He acknowledged that the mandate (and its accompanying penalty) is primarily intended to get people to buy insurance, rather than to raise money, but it is, he explained, still a tax. If someone who does not want to buy health insurance is willing to pay the tax, that’s the end of the matter; the government cannot do anything else.

    Justice Ginsburg (joined by Justices Breyer, Sotomayor, and Kagan) agreed with the Chief Justice’s bottom line – that the mandate is constitutional under Congress’s ability to tax – even while disagreeing with his Commerce Clause conclusion; those four Justices would have also held that Congress could use its power to regulate commerce to pass the mandate.


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  7. #52
    Elite Member CornFlakegrl's Avatar
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    Goddamn, the way I must twist my mind to understand law. The tax argument makes more sense, as it were, than the Commerce Clause. (How do you spell clause? that looks wrong to me). Thanks Witchcurl. Your posts are among my favorites.

    I"m a little drunk right now, but tomorrow I"m going to seriously attack that logic.

    How lame that my drunk posts are about arguing the finer points of healthcare costs.

  8. #53
    Elite Member lurkur's Avatar
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    Quote Originally Posted by CornFlakegrl View Post
    Goddamn, the way I must twist my mind to understand law. The tax argument makes more sense, as it were, than the Commerce Clause. (How do you spell clause? that looks wrong to me). Thanks Witchcurl. Your posts are among my favorites.

    I"m a little drunk right now, but tomorrow I"m going to seriously attack that logic.

    How lame that my drunk posts are about arguing the finer points of healthcare costs.
    It's for medicinal purposes.
    If being cunty is wrong, I don't wanna be right.

  9. #54
    Elite Member CornFlakegrl's Avatar
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    Well in that case, I've got some serious healing going on!

  10. #55
    Elite Member witchcurlgirl's Avatar
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    a little vitamin xxx is never a bad thing for what ails you

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  11. #56
    Elite Member louiswinthorpe111's Avatar
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    Quote Originally Posted by CornFlakegrl View Post
    =

    There are not for proft insurance companies out there. Their rates aren't much lower than for profits.

    I've been out of the game for a while now, but 6 years or so ago, the average HMO made about 5% profit, non hmo was higher at about 15-17%. Your phone company has a higher profit margin. The company profits you see are from investments. Insurance companies have capital and are major stakeholders in the market. Also, roughly 95% of claims are paid within 45 days of submission. That's out of BILLIONS of claims. They aren't trying to make quarterly earnings from denying claims. Myth.

    If you look at the history, HMOs and other managed care companies drove DOWN the cost for the people. Prior to HMOS people were at the mercy of health care providers. Their insurance coverd 80% of whatever doctors/hospitals charged and the patient paid the rest. HMOS and the like intervened and negotiated better rates with providers. Driving DOWN cost to the patient. Premiums lowered and out of pocket was minimal.

    Over time, providers said fuck that. The AMA and Hospital Associations have powerful lobbyists. They started pushing back on negotiated rates, worked the states to mandate coverage, increase reimbursement rates and generally drove the costs right back up. . Insurance companies raised premiums as a result. Add to that aging population (skyrocketing usage) and new technologies (very expensive) and premiums continued to climb.

    I hate to defend insurance companies but the issue is far more complex than big bad corporation trying to rape the little guy. The COST of healthcare is the main driver, as well as a population that insists on low premiums with premium coverage (insure my dog goddamn it!).
    I am very familiar with health insurance companies. My mother worked for an HMO for 25 years, which was bought out by United Healthcare, and she spent her last few years before retirement with United. I have great respect for HMO's, but they seem to be dwindling due to corp buyouts. My mother has told me horror stories about the practices at United, which disgusted her, because they would have NEVER allowed those things to be done at the HMO.

    Part of the reason for rising health care costs is the fact of non payment of services, and malpractice insurance is ridiculous. I was talking to a family doc who at one time delivered babies. When he decided not to do that anymore and went to take it off his covered services for malpractice insurance, the insurance company charged $30K because he was changing his policy. THAT's bullshit, and those are the hidden costs of healthcare that the average person doesn't know anything about.
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  12. #57
    Elite Member CornFlakegrl's Avatar
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    Small world. I was in insurance for 15 years, the very company your mother ended up in. Maybe I knew her.

    I assume the insurance that charged the obgyn for dropping a covered service was the malpractice insurer, not the health care insurance company. And yeah, that's some bullshit right there.

  13. #58
    Elite Member louiswinthorpe111's Avatar
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    Quote Originally Posted by CornFlakegrl View Post
    Small world. I was in insurance for 15 years, the very company your mother ended up in. Maybe I knew her.

    I assume the insurance that charged the obgyn for dropping a covered service was the malpractice insurer, not the health care insurance company. And yeah, that's some bullshit right there.
    yes it was the malpractice insurer.

    My mom was COB. I think they were just waiting for her to retire before they elminated her position.
    RELIGION: Treat it like it's your genitalia. Don't show it off in public, and don't shove it down your children's throats.

  14. #59
    Elite Member CornFlakegrl's Avatar
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    I was fraud.

    I'm glad she got to keep her position until she was ready to retire.

  15. #60
    Gold Member mamaste's Avatar
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    While single payer is ideal, that is simply not possible in this climate. You see people are already apoplectic over reform. I can't imagine how they would react to single payer. However, we can always look to single payer in the future because ACA sets the groundwork for it. When Medicare was passed, it was not the same law we see today. Over time Congress has been able to make the law stronger and cover more Americans.

    Insurance companies have been fighting against ACA. This is not a big moneymaker for them. In August, consumers will receive rebate checks from their insurers because insurance companies spent too much money on profits, executive bonuses and overhead, but not enough on actual care. ACA requires insurance companies to spend 80% of premiums on care or refund the rest to the customer. This is not an easy way for insurers to make money. The mandate would be awesome for them, but several provisions prevent them from doing business as usual.

    I would prefer single payer myself, but most Americans don't agree with me. They want low cost insurance that will actually cover them when they get injured or sick. So, they get it. IMO, ACA is a babystep toward single payer because insurance companies will over time get out of the healthcare business. They will find other areas to insure Americans and businesses.

    Here is the timeline for what changes and when:

    Timeline of the Affordable Care Act | HealthCare.gov

    ETA: I am very concerned about how this will affect employees of insurance companies. I'm afraid that won't end well at all.

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