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Health Care discussion continues - part 9

Old 05-28-13, 11:43 AM
  #1276  
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Re: Health Care discussion continues - part 9

unlimited is:

un·lim·it·ed
/ˌənˈlimitid/
Adjective
Not limited or restricted in terms of number, quantity, or extent.


But, I guess that depends on how you define is
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Old 05-28-13, 12:19 PM
  #1277  
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Re: Health Care discussion continues - part 9

It is silly to define those things both by dictionary terms, and by what common sense tells us they mean.
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Old 05-28-13, 12:37 PM
  #1278  
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Re: Health Care discussion continues - part 9

Originally Posted by kvrdave View Post
It is silly to define those things both by dictionary terms, and by what common sense tells us they mean.
Perhaps it should be defined in an unlimited manner
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Old 05-28-13, 12:57 PM
  #1279  
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Re: Health Care discussion continues - part 9

Just to be clear, you're arguing over the proposition -- a proposition that nobody in the universe supports -- that everyone is entitled to infinite amounts of medical care no matter what until the end of time, no take backs?

I think it's pretty clear from context that CRM is saying that provision of healthcare to the entire population at the standards to which the majority of us are accustomed is sustainable. Is anybody interested in actually debating that rather than playing Meriam-Webster smeantic gotcha games with him?
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Old 05-28-13, 01:02 PM
  #1280  
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Re: Health Care discussion continues - part 9

Originally Posted by BearFan View Post
Perhaps it should be defined in an unlimited manner
Hmmmm, how do you mean that?
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Old 05-28-13, 01:03 PM
  #1281  
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Re: Health Care discussion continues - part 9

Originally Posted by JasonF View Post
Just to be clear, you're arguing over the proposition -- a proposition that nobody in the universe supports -- that everyone is entitled to infinite amounts of medical care no matter what until the end of time, no take backs?
Fuck you, that's a basic human right!!!
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Old 05-28-13, 01:53 PM
  #1282  
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Re: Health Care discussion continues - part 9

Originally Posted by kvrdave View Post
Hmmmm, how do you mean that?
It means whatever you want it to mean, hence unlimited meaning of unlimited
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Old 05-28-13, 02:08 PM
  #1283  
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Re: Health Care discussion continues - part 9

Well no shit. Thanks. At least I got you people to open a dictionary. But I don't think the US has anywhere close to "unlimited" healthcare. I thought we were speaking about reality and not once again playing semantics. My bad. At some point, actual discourse may happen.
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Old 05-28-13, 02:20 PM
  #1284  
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Re: Health Care discussion continues - part 9

But in the example and post mentioned earlier, buy a "middle" plan while obviously not unlimited has a 30% co-pay.

Which totally boggles my mind. I mean someone can't get coverage on their own or can't afford the coverage they find so they go to one of the exchanges. Not only will there similar limits and coverages as currently available, but there will be a 30% co-pay (depending on plan chosen). If some couldn't afford coverage without going thru an exchange how are they going to afford a 30% co-pay?

So your going to force people to buy a plan regardless of their ability to pay for it. And then when they do go to use it they have to pay a large chunk out of pocket.
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Old 05-28-13, 02:26 PM
  #1285  
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Re: Health Care discussion continues - part 9

Originally Posted by Sdallnct View Post
If some couldn't afford coverage without going thru an exchange how are they going to afford a 30% co-pay?

So your going to force people to buy a plan regardless of their ability to pay for it. And then when they do go to use it they have to pay a large chunk out of pocket.
Wonder I they would be required to pay the co pay up front prior to receiving services.. They could have 'insurance', but still not be able to afford to go to the doctor.
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Old 05-28-13, 02:27 PM
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Re: Health Care discussion continues - part 9



Mrs. Simpson, what did you and your husband do after you were ejected from the restaurant?
We pretty much went straight home...
Mrs. Simpson, you are under oath!
We drove around until 3AM looking for another all-you-an-eat fish restaurant.
And when you couldn't find one?
We went fishing...
Do these sound like the actions of a man who had all he could eat?

If only the Frying Dutchman didn't have fucked up priorities its mantra of "all you can eat" would be sustainable nonetheless.
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Old 05-28-13, 04:34 PM
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Re: Health Care discussion continues - part 9

Obama is illegally trying to give the IRS power beyond that which is in Obamacare, and without approval from Congress:


http://www.washingtonpost.com/opinio...8ca_story.html

The unwelcome role of the IRS in Obamacare

By Michael Gerson

May 23, 2013

Let us stipulate that now might not be the best time — with IRS officials exposed for abusing power, caught in self-serving deceptions, invoking their constitutional right against self-incrimination — to dramatically expand the authority and size of their agency. But this is what Obamacare requires. Thousands of new IRS agents will implement 40-odd provisions of the Patient Protection and Affordable Care Act — the exact number is a matter of dispute since the law itself is so confusing. The largest tax law and social policy change in a generation will be imposed on a skeptical public by a government agency whose credibility is in ruins.

But the IRS is not merely implementing Obamacare. It engaged in a regulatory power grab to ensure that it could implement Obamacare.

As written, the Affordable Care Act provides tax credits and subsidies for the purchase of health insurance through exchanges that are run by “a governmental agency or nonprofit entity that is established by a state.” Since the federal government is constitutionally forbidden from ordering states to create exchanges, the law provides incentives to ensure their cooperation. This was part of the reform’s political appeal: Federal subsidies would be mediated through state institutions, undermining the criticism that U.S. health care was being nationalized.

But 33 states have so far refused to create health exchanges, with reactions ranging from “no” to “hell no.” The law allows the Department of Health and Human Services to set up federal health exchanges in the holdout states. But the statute makes no mention of the IRS providing credits and subsidies through federal exchanges. Without subsidies, employers and some individuals in those states would be exempt from mandates. Obamacare would be unworkable in over half the country.

The IRS resolved this conundrum by denying its existence. In a May 2012 regulatory ruling, it asserted its own right to provide credits outside the state exchanges as the reasonable interpretation of an ambiguous law. But the language of the law is not ambiguous. And health scholars Jonathan Adler and Michael Cannon, in an exhaustive recent analysis, find no justification for the IRS’s ruling in the legislative history of Obamacare. “The statute,” they argue, “and the lack of any support for the IRS rule in the legislative record put defenders of the IRS rule in the awkward position of arguing that it was so obviously Congress’ intent to offer tax credits in federal exchanges that despite a year of debate over the PPACA, it never occurred to anyone to express that intent out loud. A better explanation is that the PPACA’s authors miscalculated when they assumed states would establish exchanges.”

So: The IRS seized the authority to spend about $800 billion over 10 years on benefits that were not authorized by Congress. And the current IRS scandal puts this decision in a new light. What was the role of politics in shaping this regulatory decision? What pressure was applied?
Surely the IRS is above such things. Or maybe not. “It doesn’t look good from the road,” says Cannon, the director of health policy studies at the Cato Institute, “when IRS employees violate the clear language of federal law in a matter that just happens to rescue the top domestic policy achievement of their boss, the president.”

The IRS ruling is being challenged in a case brought by the attorney general of Oklahoma. Chief Justice John Roberts’s decision on the first Obamacare case made clear that the federal judiciary is reluctant to intervene in health matters. But lawsuits brought by states are generally taken seriously in federal court, and this one might also make its way to the Supreme Court. Both the statutory language and the legislative history are on Oklahoma’s side. A ruling against the administration could force Congress to revisit Obamacare.

As the implementation of health care reform moves forward, Congress may need to take another look at the law anyway. The unintended effects of Obamacare now seem unavoidable: higher premiums in employer plans; additional burdens on a Medicaid system already struggling with quality issues; cost controls in Medicare that will drive out providers; a perverse incentive structure that encourages businesses to dump employees on the exchanges while discouraging the young and healthy from signing up, eventually raising costs.

But the IRS power grab is a reminder of how shoddy the law really is. The whole enterprise is precariously perched atop a flimsy bureaucratic excuse. And the agency providing that excuse is a discredited mess.
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Old 05-28-13, 04:42 PM
  #1288  
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Re: Health Care discussion continues - part 9

Define op-ed.
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Old 05-28-13, 05:14 PM
  #1289  
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Re: Health Care discussion continues - part 9

Originally Posted by cpgator View Post
Wonder I they would be required to pay the co pay up front prior to receiving services.. They could have 'insurance', but still not be able to afford to go to the doctor.
Unlikely. Especially in cases of emergency. You would be billed.

But here is the thing, you would be billed by the Dr or hospital just like today.

Dr sends $5,000 bill to insurance plan you purchased through the exchange. Assuming all is covered (note that is a big assumption), the insurance company sends the Dr. A check for $3,500 and bill you the rest. Now that is not taking I to account any deductible. What happens if you can't pay that bill (after all you needed to go to the exchange to get coverage you could afford)? The dr sends several bills and then sends it to a collection company, your credit is hosed, etc.

Of course this is what happens in today's system assuming you have a group plan or other non-HMO plan.
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Old 05-28-13, 05:19 PM
  #1290  
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Re: Health Care discussion continues - part 9

No, no. This law keeps that from happening. And it is budget neutral. And covers everyone. And if you like your current insurance you can keep it.
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Old 05-28-13, 05:55 PM
  #1291  
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Re: Health Care discussion continues - part 9

Originally Posted by kvrdave View Post
No, no. This law keeps that from happening. And it is budget neutral. And covers everyone. And if you like your current insurance you can keep it.
That is a relief ... I also guess my insurance increases are an illusion as well.
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Old 05-28-13, 06:05 PM
  #1292  
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Re: Health Care discussion continues - part 9

Originally Posted by CRM114 View Post
Depends how you define "unlimited". You could take that to ridiculous lengths.
Well, you could define it the same way phone companies define "unlimited" data plans...
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Old 05-28-13, 09:09 PM
  #1293  
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Re: Health Care discussion continues - part 9

I still don't understand how the Exchanges will work,

-Will they actually be providing coverage or negotiating rates with existing private companies? Maybe some sort of bidding process?
-Will a person buying from the exchange not only have a choice of plans, but also providers? So if the policy they buy is not responsive or provide good service could a person switch?
-Will all Dr's and Hospitals be required to accept insurance purchased at an exchange?

Edit, Found this,

ObamaCare Exchange: The Health Insurance Exchange Pool

Health insurance will be made available through the ObamaCare Health Insurance Exchange Pool. The exchange is a group of health insurance providers that will offer coverage. You will choose the provider you want for you, your family or business based off of who offers the most attractive package in regards of affordability and quality of coverage.

The exchange pools are meant to be competitive so this will help drive the quality up and cost down. Consumer Reports has provided a great breakdown of how to buy ObamaCare, we have provided this information on our site to help you better understand what the Affordable Care Act means for you. Tax credits and up-front assistance will be avaiable to low and middle income Americans and small businesses.

Last edited by Sdallnct; 05-28-13 at 09:25 PM.
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Old 05-29-13, 04:43 PM
  #1294  
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Re: Health Care discussion continues - part 9

This is a great idea. I hope a lot more doctors do this:


http://bangordailynews.com/2013/05/2...prices-online/

South Portland doctor stops accepting insurance, posts prices online

By Jackie Farwell

May 27, 2013

OUTH PORTLAND, Maine — Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

The change took effect April 1.

“It’s been almost unanimous that patients have expressed understanding at why I’m doing what I’m doing, although I’ve had many people leave the practice because they want to be covered by insurance, which is understandable,” Ciampi said.

Before the switch, Ciampi had about 2,000 patients. He lost several hundred, he said. Some patients with health coverage, faced with having to seek reimbursement themselves rather than through his office, bristled at the paperwork burden.

But the decision to do away with insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.

“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

Ciampi expects more doctors will follow suit. Some may choose to run “concierge practices” in which patients pay to keep a doctor on retainer, he said.

Gordon Smith, a spokesman for the Maine Medical Association, wasn’t so sure, saying most patients either want to use the insurance they pay for or need to rely on Medicare and Medicaid.

Even with the loss of some patients, Ciampi expects his practice to perform just as well financially, if not better, than before he ditched insurance. The new approach will likely attract new patients who are self-employed, lack insurance or have high-deductible plans, he said, because Ciampi has slashed his prices.

I’ve been able to cut my prices in half because my overhead will be so much less,” he said.

Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.

Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50
, he said.

Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.

That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”
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Old 05-29-13, 05:13 PM
  #1295  
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Re: Health Care discussion continues - part 9

Obama lied!


http://news.yahoo.com/health-care-po...184848899.html

Like your health care policy? You may be losing it

Health law surprise: Many private policies could be canceled because they don't measure up

May 29, 2013

WASHINGTON (AP) -- Many people who buy their own health insurance could get surprises in the mail this fall: cancellation notices because their current policies aren't up to the basic standards of President Barack Obama's health care law.

They, and some small businesses, will have to find replacement plans
— and that has some state insurance officials worried about consumer confusion.

Rollout of the Affordable Care Act is going full speed ahead, despite repeal efforts by congressional Republicans. New insurance markets called exchanges are to open in every state this fall. Middle-class consumers who don't get coverage on the job will be able to pick private health plans, while low-income people will be steered to an expanded version of Medicaid in states that accept it.

The goal is to cover most of the nation's nearly 50 million uninsured, but even Obama says there will be bumps in the road. And discontinued insurance plans could be another bump.

Also, it doesn't seem to square with one of the president's best known promises about his health care overhaul: "If you like your health care plan, you'll be able to keep your health care plan."

But supporters of the overhaul are betting that consumers won't object once they realize the coverage they will get under the new law is superior to current bare-bones insurance. For example, insurers will no longer be able to turn people down because of medical problems.

Other bumps on the road to the new health care law include potentially unaffordable premiums for smokers unless states act to waive them, a new $63-per-head fee that will hit companies already providing coverage to employees and dependents, and a long-term care insurance program that had to be canceled because of the risk it could go belly up

The Obama administration did not respond directly to questions about the potential fallout from cancellation notices. Instead, Health and Human Services spokeswoman Joanne Peters released a prepared statement saying: "Beginning in October, individuals and small businesses will be able to shop for insurance in the marketplace, where we are already seeing that increased competition and transparency are leading to a range of options for quality, affordable plans."

For the most part, state insurance commissioners are giving insurers the option of canceling existing plans or changing them to comply with new federal requirements. Large employer plans that cover most workers and their families are unlikely to be affected.

Seen as consumer safeguards by the administration, the new requirements limit costs paid by policyholders, and also expand benefits. That includes better preventive care, and also improved prescription coverage in many cases. The most important feature may be protection for your pocketbook if you get really sick: The new plans limit copayments and other out-of-pocket costs to $6,400 a year for individuals.

The National Association of Insurance Commissioners says it is hearing that many carriers will cancel policies and issue new ones because administratively that is easier than changing existing plans.

About 14 million Americans currently purchase their health policies individually, a number expected to more than double eventually because of the new law's subsidies and one-stop insurance markets. But the transition may not be seamless.

"The impending changes ... have the potential to cause policyholder confusion," said a recent memo from Iowa Insurance Commissioner Nick Gerhart to insurers. Though a Republican-led state, Iowa is helping to carry out major portions of the health care law.

Nationally a considerable number of people could be affected by cancellations. Information from insurers is still dribbling in to state regulators.

In Washington state, the changes will affect more than 400,000 people, said Stephanie Marquis, spokeswoman for insurance commissioner Mike Kreidler. Marquis said she expects the premiums for replacement plans to be similar to current ones, but with better coverage.

"Your costs involve more than your premiums," Marquis explained. "It's also what you would have to pay out of pocket if you had actually used your health plan."

Others see an encroaching nanny state.

"You're going to be forcibly upgraded," said Bob Laszewski, a health care industry consultant. "It's like showing up at the airline counter and being told, 'You have no choice, $300 please. You're getting a first-class ticket, why are you complaining?'"

Obama's promise dates back to June of 2009, when Congress was starting to grapple with overhauling the health care system to cover uninsured Americans. Later that summer, public anxieties about changes would erupt at dozens of angry congressional town hall meetings with constituents.

"If you like your health care plan, you'll be able to keep your health care plan, period," the president reassured the American Medical Association. "No one will take it away, no matter what."

At the time, some saw the promise as too broad, given that health plans are constantly being changed by the employers that sponsor them or by insurers directly.

Nonetheless, Democrats in Congress devised a complicated scheme called "grandfathering" to try to deliver on Obama's pledge. It can shield plans from many of the law's requirements, provided the plans themselves change little.

State officials said it has proven impractical in most cases for insurers to "grandfather" plans sold to individuals.

Questions and answers for Virginia insurers provided by state regulators say most carriers are expected to file new policies "given the extensive amount of changes resulting from state and federal laws."

A Washington state insurance department presentation for insurers says plans must mail their discontinuation and replacement notices to consumers by Sept. 15.

State insurance spokeswoman Marquis said, "I don't think it is necessarily a bad thing that they are going to be getting a replacement notice, because they going to be able to go out and shop in this marketplace and they'll be getting better coverage."
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Old 05-29-13, 08:26 PM
  #1296  
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Re: Health Care discussion continues - part 9

The goal is to cover most of the nation's nearly 50 million uninsured, but even Obama says there will be bumps in the road. And discontinued insurance plans could be another bump.
Apparently, Obama hasn't driven on Portland, OR roads.
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Old 05-30-13, 08:36 AM
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Re: Health Care discussion continues - part 9

Originally Posted by CRM114 View Post
Well no shit. Thanks. At least I got you people to open a dictionary.
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Old 05-31-13, 08:27 AM
  #1298  
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Re: Health Care discussion continues - part 9

More details on those CA rates...

http://www.forbes.com/sites/theapoth...ums-by-64-146/
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Old 05-31-13, 08:58 AM
  #1299  
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Re: Health Care discussion continues - part 9

Originally Posted by Artman View Post
Never saw that coming
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Old 05-31-13, 07:50 PM
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Re: Health Care discussion continues - part 9

Originally Posted by Sdallnct View Post
$40 is seriously low. Even for a Catastrophe only plan.

Since we all agree nothing has been done to effect the actual cost of care, the money to pay for that care has to come from somewhere. If he is only playing $40 per month, and that is not enough to cover the cost of the policy, where is the rest coming from?

But wait, reading the rest "...which cover 70% of the cost..." who is going to pay for the other 30%? WTF??? I thought this was one of the big issues against our current system. That even if you have coverage, your out of pocket is often high. Which is why some who claim they had to file for bankruptcy due to medical issues actually had health insurance. My old plan had a 20% co-pay. But this wonderful plan "than anyone can afford" has a 30% co-pay? If he needed help in getting health coverage, what makes anyone think he can afford to pay the 30% co-pay??? Is there also a deductible?

Lets say this young, healthy dude making $45,000 breaks an ankle playing softball. If you include the ER visit after the game, follow up Dr visits, rehab, medication, crutches, etc I don't think unrealistic to say it would be $10,000. He he would have to pay $3,000 + any deductible + plus his premium.

But also...wait another minute. I thought the one great benefit of ObamaCare was no underwriting? That those with pre-existing conditions could not be denied or even charged more? Yet, the quote says "Some young adults, who are less expensive to cover, could pay nothing, depending on how much they earn". So they are going to charge different rates based on underwriting, not just income??? And go strictly by age? Hell physically, I'm in better shape at 49 than my 22 year old son! Or are they looking at it like Life Insurance? I'll be using it "sooner"? At least statistically?

So the old "current" system was bad because private insurance companies would not cover 100% of costs. That there could still be large out of pocket expenses. And those big bad insurance company dared to charge some people more for underwriting reasons.

But under ObamaCare, the government will provide insurance that could have large out of pocket expenses people and will charge more for people based on underwriting reasons.

Hummm....
Originally Posted by BearFan View Post
Never saw that coming
And this answered my question, that I already knew the answer too,

Jon is right that low-income individuals will be protected from these rate increases because of Obamacare’s subsidies, but if you’re not low-income, you face a double-whammy: higher taxes to pay for those subsidies, and higher indvidual-market insurance costs for yourself. A better approach would be to offer everyone access to low-cost consumer-driven health coverage.

If you don't address the cost of the actual care, you can charge less for insurance to cover that care. Well you can, you just now have to pay for that in taxes.
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