Pre-Existing Condition Insurance Plan Is Up

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Originally posted by b50m:
Seeweed,
I pay that much for family coverage.
Who do you have?

quote:

Originally posted by seeweed:

quote:

Originally posted by b50m:
Seeweed,
I pay that much for family coverage.
Who do you have?

I have Blue Cross . After leaving TVA, I could keep my insurance, but I had to pay the full price. It is currently around $1025 a month for me and my wife.
I was talking to another retiree just last week about the cost of our insurance. He had been to a meeting with BX a month or so ago, and they had stated that roughly 50% of the cost of our insurance was due to 5 (five) script drugs that are heavily advertised. I don't know what they are, but he is supposed to e-mail them to me.

I have had a lot of discussion on this forum down through the last few years with a lot of people blaming the "trial lawyers" for the large cost of our health insurance, but from what Blue Cross always tells us, it is the cost of script meds that cost 5 times more than the rest of the world here, that account for the high cost of our insurance. NEVER have they mentioned tort cases. I can believe that adds to the overall cost, and there was a government study showing our sue-happy society did raise the cost because doctors run more test to CYA, but it is a small percent.
(all that was probably way more than you wanted to know wasn't it )

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The bill “does give the secretary authority to limit enrollment in the plan ... nationally or on a state-by-state basis,” Popper said. “So that is present, but at this point, we’re starting with no one in the plan as of today ... so we don’t see that happening anytime soon.”

quote:

Originally posted by b50m:

quote:

Originally posted by seeweed:

quote:

Originally posted by b50m:
Seeweed,
I pay that much for family coverage.
Who do you have?

I have Blue Cross . After leaving TVA, I could keep my insurance, but I had to pay the full price. It is currently around $1025 a month for me and my wife.
I was talking to another retiree just last week about the cost of our insurance. He had been to a meeting with BX a month or so ago, and they had stated that roughly 50% of the cost of our insurance was due to 5 (five) script drugs that are heavily advertised. I don't know what they are, but he is supposed to e-mail them to me.

I have had a lot of discussion on this forum down through the last few years with a lot of people blaming the "trial lawyers" for the large cost of our health insurance, but from what Blue Cross always tells us, it is the cost of script meds that cost 5 times more than the rest of the world here, that account for the high cost of our insurance. NEVER have they mentioned tort cases. I can believe that adds to the overall cost, and there was a government study showing our sue-happy society did raise the cost because doctors run more test to CYA, but it is a small percent.
(all that was probably way more than you wanted to know wasn't it )

You must have the 80% coverage. We have the CDHP. It's $527 for family but has a really high deductible.
I don't know why they blame the cost on drugs, they refuse to pay for most brands names, charge penalties and expect you to mail order. I have had to change meds because of that. Canada has the best prices for drugs.

quote:

Originally posted by b50m:
gbrk,

quote:

The bill “does give the secretary authority to limit enrollment in the plan ... nationally or on a state-by-state basis,” Popper said. “So that is present, but at this point, we’re starting with no one in the plan as of today ... so we don’t see that happening anytime soon.”

So even Obama fools know it won't work and have an out ready. I wonder how many people thought they would get it for free?

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High-risk insurance pools will cost eight times more than forecasted, expert predicts
May 13, 2010 — 11:49am ET | By Dan Bowman

The federal government's $5 billion plan for creating state-based high-risk insurance pools for uninsured patients could cost five times that amount, according to one healthcare analyst's calculations.

If it currently costs $2 billion annually to cover 200,000 individuals under similar plans already operating in 34 states, there's no way that $5 billion will be enough to cover the 2 million additional people required under healthcare reform between now and 2014, Thomas Tobin, healthcare analyst at Connecticut-based research firm Hedgeye, writes in the Forbes healthcare blog The Science Business.

"The real cost will be more like $40 billion," he writes. Similarly, the CMS chief actuary recently estimated that the $5 billion set aside for high-risk pools could be exhausted as early as 2011.

The high-risk pools are to be established by January 2014 and provide coverage for uninsured individuals with pre-existing conditions and are required to cover 65 percent of a patient's healthcare costs.

"The $5 billion allocation attached to the high risk-pool initiative appears to represent a number dictated more by political feasibility than a fair assessment of true program cost....While the potential for an additional $40 billion in stimulus is a welcome sight for healthcare stocks, the bigger question will be the consequences inflaming the political debate over costs," Tobin writes.

Eighteen states have decided against accepting money to create the temporary high-risk pools on their own, meaning the federal government will step in and create pools in those states. Utah and Rhode Island remain on the fence about implementing the pools, with Utah Gov. Gary Herbert leaning more in toward Tobin's notion that the federally allocated money won't be enough; Utah would receive $40 million should it opt in to the plan.

"I have strong concerns that the program is severely underfunded and will ultimately result in yet another unfunded mandate on our state," Herbert wrote in a letter to Department of Health and Human Services Secretary Kathleen Sebelius on Wednesday. "Please help me, as governor, assure Utahns that their federal government will be fiscally responsible for the costs associated with the laws it passes."

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Originally posted by luvurnabor:
Well I voted for Obama, partly because I hoped we would expand health care insurance to everyone. I figured we rich people would have to pay for it, although Parker Griffith (back then) said getting healthcare to people without them going to the emergency room for it would save a lot of money.
And what was the Republican plan? Go back to the drawing board, after all, this has only been discussed for fifty years.

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Originally posted by gbrk:

quote:

Originally posted by luvurnabor:
Well I voted for Obama, partly because I hoped we would expand health care insurance to everyone. I figured we rich people would have to pay for it, although Parker Griffith (back then) said getting healthcare to people without them going to the emergency room for it would save a lot of money.
And what was the Republican plan? Go back to the drawing board, after all, this has only been discussed for fifty years.

I sure won't say or propose to know exactly why the Republicans haven't introduced their own plan but one possible reason is that the Constitution that our lawmakers are supposed to uphold limits the powers that the Federal Government (Executive and Legislative) branches can do. That would be a very good reason that nothing has been done as of this time.

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What I oppose is the faulty thinking that that will make our health care less expensive,

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The Trial Lawyers, Inc. project at the Manhattan Institute's Center for Legal Policy concludes this area of litigation is significant because "health care represents over 15 percent of the U.S. economy, up from only 5 percent in 1961" according to U.S. Centers for Medicare and Medicaid Services (CMS) data.

The authors outline several areas of high cost associated with health care litigation, including:

* Medical malpractice liability -- the "tort tax" on doctors and hospitals -- has grown much faster than overall health care inflation and costs the average American family of four more than $3,300 a year, according to a Tillinghast-Towers Perrin study in 2003.
* Defensive medicine inflates health care costs by encouraging unnecessary procedures and referrals that doctors and hospitals prescribe in order to limit their exposure to future litigation.
* Vaccines are particularly susceptible to litigation, and although Congress has shielded some existing vaccines from liability, new vaccines and other drugs vital to public health threats remain vulnerable.

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Tort reform and fee-for-service reform are two sides of the same coin
By: E. D. Kain
Special to The Examiner
07/01/10 7:18 PM EDT

Reihan Salam has a very good piece on why tort reform is necessary if we want to rein in out of control health costs. This bit jumped out at me:

This week, Archives of Internal Medicine, an influential medical journal run by the American Medical Association, has published a survey of 1,231 physicians conducted last summer (subscription required). The poll, which queried a broad range of primary care physicians, medical specialists, surgical specialists, and other specialists, were asked to agree or disagree with two statements: (1) “Doctors order more tests and procedures than patients need to protect themselves against malpractice suits”; and (2) “Unnecessary use of diagnostic tests will not decrease without protections for physicians against unwarranted malpractice suits.”

A remarkable 91 percent of physicians agreed with both statements.

Admittedly, this is only one problem associated with doctors over-testing (and thus over-charging) for their services. The other is the fee-for-service model set up under Medicare and used by most private insurance companies as well, which pays doctors not by the outcomes of their services but simply by services rendered. This is akin to paying a mechanic not to fix your car but only to try to fix it, regardless of outcome.

Tort reform and fee-for-service are two sides of the same coin, however. If doctors not only have to perform too many tests and procedures because of fears over being sued, and they’re paid for each of these tests and procedures, the end result is an increasingly expensive and ineffective healthcare system.
Reform would lead to lower costs and less wasted time for everyone involved. Doctors would have less paperwork, lower litigation insurance costs, happier patients, and more time on their hands to work as doctors rather than glorified accountants. Patients would have more money in their pockets to spend on things other than broken windows, and they’d be paying for results.


The problem with reforming the fee-for-service model is that it leaves doctors in an even worse legal and financial position. They are still required to over-test but now the costs of all these tests and procedures are not reflected in their fee.

In other words, without tort reform, doctors are left holding the bag at the end of the day. This leads to a shortage of doctors and medical providers as fewer and fewer people are interested in becoming doctors in the first place. A short supply coupled with an increasing demand for medical services leads to higher costs. The vicious cycle continues.

Tort reform taken as an independent issue may not be the most vital reform needed to fix our broken healthcare system, but taken as a piece of a larger whole it becomes clear quite quickly how important it really is. Unfortunately tort reform is as absent from the recently passed Affordable Care Act as meaningful market reforms.

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Blue Cross tells us (and has told us for some years) that the cost of script meds is the problem, so that is what I want to see addressed.

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In some instances, teams of plaintiffs' lawyers are spending several million dollars preparing cases for trial, in the hopes of winning billions of dollars in settlements and jury verdicts from the drug companies, which have some of the deepest pockets among American corporations.