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Blogcritics Comments on Healthcare Reform: Our Most Likely Future Is Now
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• Comment by Clavos on Healthcare Reform: Our Most Likely Future Is Now
  "Fewer people are covered by employer group plans every year. And many of those covered are trapped with an employer, e.g., an employee with a severely disabled child may never be able to change jobs." Fewer people are covered by employer paid group plans, true. However, the plans are still offered; the employers (some of them) just don't pay the premiums anymore. That's my family's case; the plan is available, and we're in it, but must pay the entire premium without employer participating, other than to provide a "cafeteria" of plans. If, in your example, the employee with the disabled child changes jobs to an employer that offers health insurance, BY FEDERAL LAW, they cannot be refused, if they were covered in the previous job. There CAN be a "waiting period" of up to nine months in some states, but most states have passed state legislation prohibiting waiting periods.
• Comment by bliffle on Healthcare Reform: Our Most Likely Future Is Now
  Fewer people are covered by employer group plans every year. And many of those covered are trapped with an employer, e.g., an employee with a severely disabled child may never be able to change jobs."See a lawyer". Small comfort to a person already crushed by financial distress. Indeed, the strategy of the insurance company is to refuse to pay and force the patient to undertake disproportionate legal expense.
• Comment by Zedd on Healthcare Reform: Our Most Likely Future Is Now
  Clavos, I'll look into it. I've nearly used up my retainer and don't want to lay eyes on my advocate. It seems to cost me a google per word.
• Comment by Clavos on Healthcare Reform: Our Most Likely Future Is Now
  If the condition existed before you were insured, it CAN be excluded. If you were being treated for it under one employer's plan, and it was excluded by your next employer's plan when you changed jobs, and if you had no break in coverage longer than 60 days between jobs, you need to see a lawyer.
• Comment by Zedd on Healthcare Reform: Our Most Likely Future Is Now
  Clav That is my very real personal experience.
• Comment by Zedd on Healthcare Reform: Our Most Likely Future Is Now
  Clav I had a condition that was diagnosed 8yrs ago. I wasn't serious and was told that it may resolve itself. I had moved two jobs and two different providers. It wasn't, ISN'T covered. It is the condition that nearly took my life 6mos ago. I have always been healthy. This condition has had all sorts of complications which have dominoed, not covered. Finding and affordable way to resolve it extended my illness (and discomfort due to extreme pain).
• Comment by Clavos on Healthcare Reform: Our Most Likely Future Is Now
  "But they don't insure everyone, just the clients they deem (in their sole discretion) to yield a profit. The others, those with previous conditions and many others, are simply abandoned by the private system and thrown onto the public system. At great cost." Not true. First of all, insurance obtained through an employer (whether paid for by the employer, the employee or both) is group insurance, for which all employees, regardless of health status, are eligible. By law, the only instances wherein an insurance company can refuse insurance to some one with a pre-existing condition are: 1. Individual customers (as opposed to those eligible for group plans, as outlined above). 2. Those with who change jobs having let their insurance lapse between jobs, which is the reason for COBRA, which allows you to retain your group insurance for a premium of no more than 102% of the TOTAL premium previously paid by you AND your employer, for a period of 18 to 36 months, depending on the circumstances of the covered employee. Most people qualify for the 18 months only. If you move from a group plan to another group plan with a pre-existing condition, you (and your dependents) cannot be cut off. I know this from personal experience.
• Comment by bliffle on Healthcare Reform: Our Most Likely Future Is Now
  Clavos: "You left out the fact that the insurance company is charging the $100/mo. premium to everyone it insures, " Yablosi: " I think the problem here is that you'r looking at single cases rather than the aggregate portfolio of insured individuals. Some people that receive insurance would use it more while others would use it less. That's why insurers don't cover only one person...they aggregate risk across a very large portfolio so that the average level of risk is low enough to make them profitable." But they don't insure everyone, just the clients they deem (in their sole discretion) to yield a profit. The others, those with previous conditions and many others, are simply abandoned by the private system and thrown onto the public system. At great cost.
• Comment by Lumpy on Healthcare Reform: Our Most Likely Future Is Now
  Re: #26. Didn't we see figures earlier showing that illegals played a pretty trivial role in using up healthcare resources? Think about it. Most illegals are young working people and they only make up about 4 percent of the population. Some of the figures people are throwing out for healthcare costs just don't seem believable.
• Comment by Zedd on Healthcare Reform: Our Most Likely Future Is Now
  Yabosi Thanks for the pardon :o) I am posing these questions not to make an attack but to explore the issue further. I ended up in the emergency room a few months back (unavoidable choice between living and a bill) and ended up spending one night in the hospital. My first bill was $60000 I was shocked and assumed that that was the entire sum. I got another $3000 bill another $2000 bill and lastly a $650 bill. I laid in emergency near death for several hours. They had forgotten about me. I was supposed to get an emergency transfusion, this was 11am. I got it at 9pm after my doctor showed up and made a huge fuss, barely conscious. This particular hospital was NOT a county hospital. Not a social service situation. Still full of bumbling yet costly! I went to a county hospital 4mos ago had to pay $70, stayed over night, had an invasive procedure, and several diagnostics of which I paid $70 for also. YES the clientele was interesting to say the VERY least but the care was top notch. Much better than the private hospital and cheaper be legions. I am not sure if I am comfortable with your proposal hedging on a MAYBE. People are greedy. The incentives will not work unless there is a specific directive. We cant hedge people's access to health on the goodwill of capital focused entities. WE JUST CANT.
• Comment by Brooklynbrenda on Healthcare Reform: Our Most Likely Future Is Now
  How can you be advocating MORE OF THE SAME? The current arrangement (it certainly ISNT a SYSTEM)is barbaric. There is something wrong when having insurance still leads to bankrupcy. It is a pathetic shame that the United States is the ONLY great state on the face of the planet that does not practice those hallowed republican family values...affordable housing, healthcare and education.
• Comment by Yabosi on Healthcare Reform: Our Most Likely Future Is Now
  "Doesn't figure. The government subsidy would have to be much bigger than the premiums. For example, to subsidize an insurance company to provide insurance at a premium cost of $100/mo. for an illness that costs $1000/mo. would cost $900/mo. More, actually, since they operate at a margin of about 30-40% it would cost more like $1500. Not a good economic model." I think the problem here is that you'r looking at single cases rather than the aggregate portfolio of insured individuals. Some people that receive insurance would use it more while others would use it less. That's why insurers don't cover only one person...they aggregate risk across a very large portfolio so that the average level of risk is low enough to make them profitable. So here's the math. The margin between health care costs and premiums for a typical health insurer is around 20%. This doesn't include operating expenses or other income sources which pretty much cancel one another. Suppose that a company that pays $1B in corporate income tax on healthcare premium revenue of $20B provides $500M worth of insurance subsidies so that more people can afford policies, and the Fed matches them 1-1 on tax credits. Typically the cost of healthcare for these would be 80% or $4