Senate proposal--Insurers to cover as little as 65% of enrollees bills

[nightrain]

http://www.latimes.com/news/nationworld/nation/la-na-healthcare-insurers24-2009aug24,0,2392720.story



Healthcare insurers get upper hand



"In May, the Senate Finance Committee discussed requiring that insurers reimburse at least 76% of policyholders' medical costs under their most affordable plans. Now the committee is considering setting that rate as low as 65%, meaning insurers would be required to cover just about two-thirds of patients' healthcare bills. According to a committee aide, the change was being considered so that companies could hold down premiums for the policies.

Most group health plans cover 80% to 90% or more of a policyholder's medical bills, according to a report by the Congressional Research Service. Industry officials urged that the government set the floor lower so insurers could provide flexible, more affordable plans."


------------------------

Senate Finance Committee = insurance protection racket

This is what you get for about $6K/year for 1 person or about $14K/year for a family of 4. Oh, plus any deductible and co-pays (to make it more affordable!)

[OHdem10]

1. This is reform. Bleed the American People and fill Insurance Company

Coffers.

I hate to say it, but the Republicans could do this well.(Sarcasm)

[nightrain]

4. yes. That 35% goes to "overhead"--including obscene exec salaries. No change there!

And Medicare runs on about 3-4% overhead.

[dsc]

19. you are mixing up percentages

I agree this sounds like a scam but they aren't saying that for every one dollar collected from the public only $.65 is spend on health care. They are saying that for every $1.00 their customers are billed they will only pay $.65. Still a scam but not what you are saying.

[nightrain]

24. I read it differently than you. Usually the "loss ratio" is around

the high 70s. This reduces that ratio apparently.

[dsc]

27. those are two different things

The loss ratio is the percent of premiums that go to medical bills. So if I pay a dollar in premium and the insurance company pays a dollar in medical bills the loss ratio would be 1. What the OP refers to is the percent of the medical bills I get which are paid by insurance. So if I am billed a dollar and insurance pays a dollar that ratio would be 1.

[snappyturtle]

2. Great!

:sarcasm:

Why can't we have the same options (and premiums) that governmental workers have? The above plan does allow for the insurers to continue to heap high profits and screw the policy holder. imho

[Statistical]

5. The insurance companies reap huge profits on govt worker plans.

The true cost is simply hidden by the fact that premiums & deductibles are low. So you and I (via taxes) pay more of it.

[snappyturtle]

9. Yes! True. But WHY do govt workers have this and we can't?

I would think that by adding millions more insured would help lower the taxpayer contribution. Wonder how much 'we' could save if we got out of the ME in toto?

[Statistical]

11. Because they are special.

Seriously there is no good reason.

What people forget about the "cost of healthcare" is that single payer would replace EXISTING programs (govt worker private plans, Veteran Affairs, tri-care (for active & retire military), Congressional plans, existing Medicare, Medicaid.

People act like Single payer $1T would be $1 trillion more but it would be replace all these existing programs.

Govt workers would no longer be more equal than those working without healthcare.

[Orangepeel]

21. the government pays the employer part of the contribution for people who work for the government

like most other large employers.

It isn't single payer and paying the employer part of the premium for everybody would be much more expensive than a single payer system. But it works well for federal employees. So, if one doesn't mind giving a lot more money in subsidies to private insurance companies, that would be a way to provide everyone with insurance that doesn't discriminate based on health status or pre-existing conditions.

[Statistical]

22. I agree I wasn't saying that fed = single payer.

I was saying:

a) single payer is cheaper than it looks because it replaces other costly programs that only cover a portion of people.

AND

b) designing any universal system that only pays 65% while fed employees very good coverage is hypocritical. If 65% is "enough coverage" and will save money then imagine how much money we will save if ALL federal employees coverage was dropped to 65%. Starting with Congress of course.

[SammyWinstonJack]

3. K&R

x(

[kentuck]

6. A windfall for the insurance companies?

That's sounds just great!

[nightrain]

7. yep, a windfall, just as many of us have been saying for months!

[joeycola]

8. Yes, and there have been previous articles these past weeks saying the same.

[Phoebe Loosinhouse]

10. So we can maintain our "uniquely American" tradition of going bankrupt due to medical bills.

Excellent job, you wankers!

I hope everyone reads the entire article, there's enough in there to move my disgust level to 10 on a scale of 10.

What people need to realize is that The Finance Committee has been used as an arm of the White House for many of these negoitations. So don't just think it's only the Finance Committee.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x8605684

The LA Times story references Daschle's association with United Health. How's that for a warm and fuzzy?

Here's more about Daschle's role behind the scenes.
http://www.nytimes.com/2009/08/23/health/policy/23daschle.html?_r=1&hpw

[nightrain]

18. yeah, what a pile of crap. I think that's code for "we don't really

intend to stop the insurance scamming of US citizens".

[Altoid_Cyclist]

12. When is this B.S. going to stop?

My wife & I already have medical bills in the 5 figure range due to some chronic problems. As it is, we just joke that they'll get the money when I die and my wife gets the payout from my life insurance. I can't imagine what it must be like for people who are worse off then we are.
I really thought that once the Democrats had the majority in the house and senate that things would change. I am too naive I guess.

[joeycola]

13. Perhaps when the Dems and the WH get some balls?

[nightrain]

15. more likely to happen if they had ovaries.

[joeycola]

17. You are right. Good one.

[nightrain]

14. I think many of us thought that once the Dems had both the House and Senate, and

the Presidency, that things would change. (That favorite word!).

Perhaps we didn't count on the HUGE impact of the bribes...

So, election reform is needed....

I've been wondering why corporations are legally treated as individuals, yet get to "donate" in amounts much larger than individuals can.

(Very sorry to hear about your medical bills, that's horrid)

[Altoid_Cyclist]

16. At least I'm not the only one that hoped for change.

It's small comfort, but I just never realized how many tentacles the Insurance companies had in so many pockets on both sides of the aisle.
Thank you for the concern, but as I said, we really have no right to complain when there are so many people in much worse condition. I'm to the point now that I can't even watch the news without yelling at least once or twice because I know that the Corporate Media is such a willing partner to this.

[Laelth]

26. Welcome to DU.

I am beginning to share your pessimism.

:dem:

-Laelth

[scheming daemons]

20. Pass something... then clean it up in committee for the final bill

What is in the Senate proposal right now LITERALLY does not matter.

All that matters is what is in the final bill that goes before both houses after committees merge the house and senate bill.

[nightrain]

23. we'll see how that works out....

[kenny blankenship]

25. I BLAME THE LEFT111!!

Obviously, this is more of their doing.