Saturday, March 24, 2012

The LuLac Edition #1996, March 24th, 2012

The Affordable Health Care Act's second anniversary.


I really think the Affordable Health Care Act opponents are really doing a disservice to the country by calling the Health Care measure passed in 2010 Obama Care. What that characterization does is completely muddy the intentions of the bill. For those who are saying Obama care will bankrupt the country, take away our freedoms or have governmental tribunals make life and death decisions, let me say say that those statements are dead wrong. The Affordable Health Care Act will do the following:
Creating new coverage options for individuals with pre-existing conditions.
As of the end of 2011, 4,567 previously uninsured residents of Pennsylvania who were locked out of the coverage system because of a pre-existing condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law. There is the misconception that those with pre existing conditions want free health care. THEY DON’T! They just don’t want to not have the option to buy insurance. When I worked at Blue Cross, if you had no prior coverage before and had a pre existing condition, you could buy individual insurance. You could get treatment for that condition but the insurance company would not pay for it in the first year. Now people can buy insurance. Plain and simple.
Removing lifetime limits on health benefits
The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. How would you like to battling cancer or have a catastrophic injury and be told that you hit your spending limit? Sarah Palin’s ridiculous comment on government death panels had a kernel of truth. Insurance companies that imposed that million dollar limit were the wielders of that death sentence.
Providing better value for your premium dollar through the 80/20 Rule
Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 3,421,000 Pennsylvania residents with private insurance coverage will receive greater value for their premium dollars. Health Care Insurers will now have to use 80% of their monies for health care. Not for CEO salaries of millions of dollars a year, not for surpluses and not for administrative costs. The 80/20 rule ensures that the Health Insurers use premium money for what is intended, to pay claims of its insured. For an area that bitches about other people’s higher salaries, and the political corruption, you’d think they might understand the 80/20 rule.
Making prescription drugs affordable for seniors
Thanks to the new health care law, 247,686 people with Medicare in Pennsylvania received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. In 2011, 235,820 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount resulted in an average savings of $662 per person, and a total savings of $156,108,903 in Pennsylvania. By 2020, the law will close the donut hole. The Drug Act for seniors was paid for with a government credit card. There was no talk of CBO estimates and how it would drive up the deficit because it was passed by a Republican President and a Republican Senate and House. And it screwed the elderly anyway because of that donut hole. The Health Care Act will close that donut hole forever by 2020. Yet I hear deluded senior citizens bitching about Obama Care and how their freedom is at stake. Please.
Scrutinizing unreasonable premium increases
In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Pennsylvania has received $5.3 million under the new law to help fight unreasonable premium increases. Insurance companies raise premiums because they can. Usually the Insurance Commissioner is in bed with the Insurance carriers. Even under the supposed liberal Rendell administration, rate increases from the insurance companies sailed through. And do you ever notice how rate increases for places like Blue Cross are just under 10%? The Blues in the state justify why they need the increase but others do not. This oversight is for when the Blues won’t justify it and the others just ask for it and get it.
The big thing with the argument against the Affordable Health care act is the mandate. That people will be forced to buy health insurance. We are told that this is an impingement on our freedom. “Gad dummit, I’m an Amurikan… cants tells me what to do!!!” You have to buy auto insurance. You have to vaccinate your kids for school. You have to get a permit to fix your house. You have to get a license for your dog. Those are just a few of the things government requires you to do. Why is there such an opposition to health care insurance? Here’s why. Americans want the very best health care in the world….but they don’t want to pay for it. A mandate gives people an opportunity to become insured. If they refuse, they get taxed. A friend of mine went for years without health insurance. He got into a horrible accident and was treated at an emergency room. He had no money to pay for any of it. Guess who paid for his care? WE DID! He was so irresponsible in not providing insurance for himself that we all paid. Why shouldn’t there be a tax on those who willfully are irresponsible? A Health Care mandate will not intrude any more on your freedom than any other regulation or law of the land that is currently on the books. But this issue was so full of demagoguery that it was shameful.
And for those political geniuses that want to repeal Obama care, let me ask these two questions. How the hell you going to do that and what is your alternative? Do you really want to kick young adults off their parents health insurance? Should seniors have to pay more for prescription drugs? Is holding Insurance companies feet to the fire socialism? Do they want to outlaw coverage for pre-existing conditions or let insurance companies set a lifetime limit of coverage that would result in a death sentence for some people? Do you want insurance companies to just keep on piling up surpluses, having management garner huge salaries while people try to eke out a premium? What is the difference between an insurance company denying your claim because it is not a covered benefit or Sarah Palin saying there will be death panels? Same thing. If you can’t pay, you either find the money, go into debt or die. People talk about government intrusion into health care and how everyone wants their own doctors to make their decisions for them as patients. Fair enough. But the health insurers employ medical directors (yep Doctors you see in TV commercials) that generally side with every argument of the entity that’s paying them, not the premium holder. Isn’t a health insurance company hiring a medical director a clear conflict of interest for the doctor and the entity? You bet.
This coming week the Supreme Court will hear arguments against the Health Care Bill. The individual mandate most likely will be struck down because of all the cry babies making an issue out of it. But I believe the rest of it will be upheld. Personally, I think the health care bill did not go far enough. There are good things in the bill but there should be a more reform.
1. A public option that Americans can choose. It would pay 80% of all costs. Enrolling in the public option would require purchasing a 20% supplemental policy sold by health insurers.
2.A comprehensive dental and vision plan. Same thing. 80/20.
With these two options, the insurance pool would increase. But the required 20% supplemental plans would make more money than the insurance companies ( who fought the public option and Medicare in 1965) busier than ever.
3. There would be no state to state competition. There would be Blue Cross of America, Aetna of America, etc. There would be a standardization of rates, claims and services.
4. A 5 cent charge on everything you buy in America would pay for it all.
It’s simple. It’s easy. But the problem is we’ve been making it hard for decades that when we see simple and easy…..we just don’t want to accept it. The Affordable Health Care Act though was a good start. I was around in 1965 when Medicare was passed and I heard my parent’s friends saying that this was socialized medicine, that old people were going to be put to death, that our freedoms would be gone. It didn’t happen. And when “Obama Care” as you call it starts to ramp up, all of those who demagogued it, refused to offer a solution and demonized it are going to look like first class jackasses. Which is ironic because their party symbol is an elephant.
Happy Anniversary Affordable Health Care Act. To quote Joe Biden, “You’re still a ****ing deal”.


At 8:10 AM, Anonymous Anonymous said...

Hear Hear Mr Yonki- Great explanation and defense of "ObamaCare". Although maybe not simple enough for the morons of the area to grasp.

At 12:44 PM, Anonymous Anonymous said...

You are correct. Government run health care is not free, it is merely competitive and putting the insurance companies feet to the fire to do right by its paying members.

At 4:47 PM, Anonymous Anonymous said...

Good outline of a complicated bill. If the WH explained it like you did, this thing would be won over in the hearts and minds of the American people.

At 5:02 PM, Anonymous Anonymous said...

This explananation of "Obamacare" deserves to be a full page ad in one of our local newspapers! I'll kick in $50 to help make it happen. How 'bout everyone else out there in LuLac land? Come on, let's start our own superpac.

At 6:24 PM, Anonymous Anonymous said...

As easy as that was explained Yonk, I just don't want a government involved in providing or managing my healthcare.

They can only go so far. We are expecting them to do too much and they can't. Period.

At 12:18 PM, Anonymous Anonymous said...

6:24 PM,
Have you ever heard of Medicare or Medicade?

At 12:39 PM, Anonymous Anonymous said...

Medicaid. Sorry about that!

At 4:29 PM, Anonymous Anonymous said...

Anonymous has left a new comment on your post "The LuLac Edition #1996, March 24th, 2012":

6:24 D U M B !!!!!!!!

At 6:09 PM, Anonymous Anonymous said...

Hey Brainiacs

You can opt out of both Medicare and Medicaid. It is not mandated. Social security is a a pathetic return on investment. I do better - let me.


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