Health care loophole would allow coverage limits

[FUZO]

TweetHe truly is a scum bag



WASHINGTON – A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.
The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.
As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.
Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."
The 2,074-page bill would carry out President Barack Obama's plan to revamp the health care system, expanding coverage to millions now uninsured and trying to slow budget-busting cost increases. A tentative deal among Senate Democrats to back away from creating a new government program to compete with private insurers appears to have overcome a major obstacle to the bill's passage.
Officials of the American Cancer Society Cancer Action Network said they were taken by surprise when the earlier ban on annual coverage limits was undercut, adding that they have not been able to get a satisfactory explanation.
"We don't know who put it in, or why it was put in," said Stephen Finan, a policy expert with the cancer society's advocacy affiliate.
Democratic officials of the Senate Health, Education, Labor and Pensions Committee would not comment publicly but said the bill contains numerous provisions that will benefit patients with cancer and other life-threatening illnesses, not to mention improvements in preventive care.
Advocates for patients say they're concerned the language will stay in the bill all the way to Obama's desk.
"The primary purpose of insurance is to protect people against catastrophic loss," Finan said. "If you put a limit on benefits, by definition it's going to affect people who are dealing with catastrophic loss." The cost of cancer treatment can exceed $100,000 a year.
Under the health care bills in Congress, the major expansion of health insurance coverage won't take place until three to four years after enactment. Democrats have touted a series of consumer protections as immediate benefits Americans will secure through the legislation. Both the Senate and House bills, for example, ban lifetime limits on the dollar value of coverage.
But Finan said the change in the Senate bill essentially invalidates the legislation's ban on lifetime limits.
"If you can have annual limits, saying there's no lifetime limits becomes meaningless," he said. A patient battling aggressive disease in its later stages could conceivably exhaust insurance benefits in the course of a year.
It's unclear how widespread such coverage limits are in the current insurance marketplace. Large employers have moved away from coverage limits, but insurers have wide discretion in designing plans for small businesses and individual customers.
In the House bill, neither annual nor lifetime limits would be allowable under an essential benefits package intended to provide comprehensive coverage

[deepsouth]

Tweetyou know, the more I study this Obamacare and find myself trying to find what good its supposed to do. The problem is, it doesn't even accomplish what its original intension was-give everyone coverage. Can someone point out one good thing it does???

[Michelle Hayden]

TweetI already have limits on my BCBS and i pay for mine being i am self employed, and i pay dearly for it. Like over 10k per yr and this is without prescription coverage, so if someone without coverage is getting it for much less then what is the complaint? I understand the political cover ups, but still it would provide med coverage to ppl that dont have it..I just wish at some point mine would go down. Ppl that get it from their work imo shouldnt complain a bit.

[Michelle Hayden]

Tweetthis is for 2 ppl. Me and my cousin and i believe it to be more like 11-12k. It goes up like 15% every yr. I think there should be some kind of regulation or cap on how much they can charge. Ever see how much the hospitals charge to simple procedures and utensils?? My insurer was billed like 30. for latex gloves, to put a cath in like 400. for a dr visiting that isnt even your dr 185. etc...i can go on and on..They are using the system to their advantage and we pay for it.

[JsJs24]

TweetThis bill is pathetic, period! You do not want the government running our health care. The quality of care will go down, taxes will go up, costs will go up, and freedom of choice will be gone. Why is it so hard for people that support this to take a look at the countries that do have government run health care. It is a damn joke. Go to Canada or England if you want government run health care, but please leave our system alone. If politicians want to help they can do two things and two things only..............

1. Allow people to cross state lines to get coverage
2. Establish tort reform limits

I don't know why so many people are brain dead when it comes to understanding the the government can not run anything efficiently.

[Michelle Hayden]

TweetWell mine never goes down..always up. I dont have a choice. Sure ppl that have full employer paid healthcare are targets, but ppl like me are screwed. I think it is Italy that has the best healthcare in the world i heard. Doesnt matter anyways, the gov will do what they want no matter what any of us thinks huh.

[JsJs24]

Tweet

Well mine never goes down..always up. I dont have a choice. Sure ppl that have full employer paid healthcare are targets, but ppl like me are screwed. I think it is Italy that has the best healthcare in the world i heard. Doesnt matter anyways, the gov will do what they want no matter what any of us thinks huh.

I feel for you, I really do, but I listed the two things the government needs to do to fix our costs. Insurance companies do not have to compete across state lines because it is not allowed for people to go to another state for coverage, however auto insurance companies do compete across state lines and look how competitive the rates are. The same would happen if health insurers could compete across state lines. Also, tort reform, doctors have to pay huge insurance premiums due to the insane amounts they can be sued for. Tort reform would fix this by placing caps on the amount people can sue for.

As for Italy having the best health care system, that is a joke. First off, the U.S. has the best quality care in the world and that is a fact. The prime minister of Italy came to the U.S. to have a heart surgery a few years ago, thus if their health care is so wonderful then why did he come here for his surgery. Also, why do Canadians come to the U.S. if they can afford to? Because our health care is better and they don't have to wait forever to be seen. Washington state has a hospital that built and entire extra wing on it to support Canadians that come their for Health Care. I promise you other nations health care is horrible. England is a joke too by the way. Did you know that if you have a liver failure due to drinking alcohol in England then you cannot get a new liver and have to die? This is a fact. Also, if you want a good idea of how our health care will be with a government run system then check out Romney care in Massachusetts. Their health care debt doubled in one year and the average wait to see a family doctor is 60 some days. That is pathetic and the program is a known failure, so how will it work in America. Most Americans sadly do not understand the national debt and the Federal Reserve and how money is created. The larger that debt becomes the higher our taxes will go and the closer we come to a national bankruptcy. If you think that isn't possible then wait and see because we are almost there now. This president is ruining our country financially and the price to pay is fatal.

[JsJs24]

Tweet

Well mine never goes down..always up. I dont have a choice. Sure ppl that have full employer paid healthcare are targets, but ppl like me are screwed. I think it is Italy that has the best healthcare in the world i heard. Doesnt matter anyways, the gov will do what they want no matter what any of us thinks huh.

By the way, I do have a good health care plan with my company but it is going up every year also, everyone's is. I am single with no children and my bi-weekly coverage was $42 per check this year and next year it will be $54 per paycheck. I know that is still cheap compared to most people's but still the increase is roughly 30%.

Also, I do not mind to pay for may health care as long as it is my personal choice and I get to choose the provider. When I started my own company last year for a short time and had no insurance I simply elected to keep coverage from my former employer under the Cobra option for $220 for medical and $40 for dental. That was well worth it to me. Also, I priced a policy with a private insurer and coverage could have been obtained for about $200 which would have covered up to around $2 million in coverage, however I would have had about a $2000 out of pocked to reach but it would be worth it if I had a major medical problem and for little things I could pay out of pocket. Most people do not want to pay for insurance and complain that a few hundred dollars is too much, yet they will spend the money on a nicer car or truck, a new motorcycle, an expensive cell phone plan, etc. Why do people not care about insuring themselves in case they are hurt. Why do people expect the government to do that for them. The constitution does not guarantee health insurance so why should we start now. We need to stop asking for everything to be paid for by the federal government which is taxpayers. Another things I don't understand is why insurance has to cover physicals and other preventative maintenance. Does your car insurance cover oil changes? No. Some things we should have to take care of on our own. Its our body which is the most important property we own so why not spend a little money and take care of it.

I am just tired of everyone expecting the government to take care of us and especially with their record of failure. These clowns wrote a 2 thousand page health care bill over a few weekends and claim they have solved the problem, yet no tort reform. This is a power grab, they care nothing about any of us. They simple do not care!

[FUZO]

Tweet

I am just tired of everyone expecting the government to take care of us

JSJS TRUST ME BUDDY THIS BILL WONT GET PASSED MAYBE A WATER DOWN BILL BUT NO WORRIES BECUSE LIKE I'LL KEEP SAYING WE WILL TAKE OVER IN 2010 HOUSE AND SENATE AND IN 2012 THE SCUM BAG IS OUT

[Michelle Hayden]

Tweet

By the way, I do have a good health care plan with my company but it is going up every year also, everyone's is. I am single with no children and my bi-weekly coverage was $42 per check this year and next year it will be $54 per paycheck. I know that is still cheap compared to most people's but still the increase is roughly 30%.

Also, I do not mind to pay for may health care as long as it is my personal choice and I get to choose the provider. When I started my own company last year for a short time and had no insurance I simply elected to keep coverage from my former employer under the Cobra option for $220 for medical and $40 for dental. That was well worth it to me. Also, I priced a policy with a private insurer and coverage could have been obtained for about $200 which would have covered up to around $2 million in coverage, however I would have had about a $2000 out of pocked to reach but it would be worth it if I had a major medical problem and for little things I could pay out of pocket. Most people do not want to pay for insurance and complain that a few hundred dollars is too much, yet they will spend the money on a nicer car or truck, a new motorcycle, an expensive cell phone plan, etc. Why do people not care about insuring themselves in case they are hurt. Why do people expect the government to do that for them. The constitution does not guarantee health insurance so why should we start now. We need to stop asking for everything to be paid for by the federal government which is taxpayers. Another things I don't understand is why insurance has to cover physicals and other preventative maintenance. Does your car insurance cover oil changes? No. Some things we should have to take care of on our own. Its our body which is the most important property we own so why not spend a little money and take care of it.

I am just tired of everyone expecting the government to take care of us and especially with their record of failure. These clowns wrote a 2 thousand page health care bill over a few weekends and claim they have solved the problem, yet no tort reform. This is a power grab, they care nothing about any of us. They simple do not care!

Just to give you an idea Jsjs, I pay over 3,000. per quarter for I and my cousin for BCBS and that is without prescription coverage. I also have a $500. deductable i have to meet per yr b4 my insurance will kick in for labs and x-rays. So 54. is like nothing, lol! Not that it is any less a burden. It is small businesses that are getting screwed left and right with all the costs and taxes rising. My brother in-laws family business had to be sold this yr that his father started out over 30yrs ago, because of this economy. They did trucking for hazardous waste and other materials for the big 3 (owned a fleet of semis not counting office, maintainence equiptment etc and now hes left trying to find something that will be comparable in pay, but where is a 50 something going to find that kind of income in the east coast? He has a family and it you can tell is eating at him.

[3sweeties]

TweetMichele, I feel for you. We are also self-employed and for our family of 5 we pay $425 a month and have a $5200 deductible. If you are relatively healthy, I would look into a Health Savings account and a high deductible with bcbs.

I don't want the government involved in my healthcare but I sure would love to have affordable healthcare and be able to shop around for the best policy. Once you have any type of health problem with private insurance you're screwed with trying to go from one company to another looking for competitive rates with out running into riders and non coverage for any preexisting.

[Michelle Hayden]

TweetI already did look into raising my deductible to 1000. instead of 100., but the lowered cost is about the same as what id be paying out in deductibles, because of my testing and surgeries. I dont want to sound complacent, but it seem like it is always ppl with the good healthcare that is paid for that complain, lol! I wish some could see how much a small independent business owner gets screwed by the gov. I dont ever complain, but ive talked to BCBS admin for years and they always give me the same song and dance, about how they are working on it and there will be change, but it never happens. I am not for gov ran health care, but there needs to be some kind of regulation on the cost of insurance for independent coverage.. Oh, and btw i am in a group plan, lol What a joke!

[Michelle Hayden]

TweetNot to change the subject, but what gets me too is how my insurance (which i think is about the largest in US) doesnt cover hrt procedures, but it will pay for abortions..what is up with that? Ive considered HMO's but they (at least HAP) is more expensive than BCBS and with mine i dont have to get a referral from a primary care dr for every specialist i go to. I dont think this bill will pass either..as too many ppl would be affected and it would included ppl in power, so it wont pass for sure. I sure hope tho something changes with healthcare. Too many ppl arent covered at all and its the children of these families that suffer as well. I have heard many children that are suffering from chronic diseases like cancers etc and the parents have to set up funds to help raise money so they can pay their insurer's. Very sad..

[FUZO]

TweetWell in Illinois all children are covered no matter what. Its called "all kids" the one of the good things x Gov Blojobavitch signed and passed

[JsJs24]

Tweet

JSJS TRUST ME BUDDY THIS BILL WONT GET PASSED MAYBE A WATER DOWN BILL BUT NO WORRIES BECUSE LIKE I'LL KEEP SAYING WE WILL TAKE OVER IN 2010 HOUSE AND SENATE AND IN 2012 THE SCUM BAG IS OUT

Fuzo I do not doubt that, however my fear is that once anything is passed it will grow and grow until one day we have a single payer system. Yes the republicans will put this on hold if they win back the house and senate, which would be great, but if ever the dems take it back, look out. Obama spoke about this several years ago in a televised speech he gave about health care. He told people that we must be patient becuase we can't install a single payer system too fast, instead we take it slowly and eventually will be there. That is their plan. But I am with you on the fact that a watered down version will get passed and not the extreme one.