"If you are happy with your private insurance, you can keep it."

"If you enjoy pounding a 20d spike up your nose, you can keep doing it."

"If you think it fair to pay 1/3 more than its actual value for everything you buy, keep paying it."





Who, exactly, is "happy with their insurance'?

They may like their doc. They may like the hospital that did their last hemorrhoid job. They may like the nurase at their dialysis clinic. They may even love the agent who sold them the policy.

But who the FUCK likes their insurance company?

Anybody?

Beuller?

........

Beuller?

:rofl: you must be a real riot at home. ;)

.... calm down.

I keep yelling that I AM FUCKING CALM. THIS IS CALM

:)

sure as shit, your employer will change it for some reason.

Never a problem with a claim (5 years), they always pay rapidly (unlike Tricare), they have wellness initiatives, huge choice of docs, great on-line presence for tracking stuff, etc. I can't see any circumstance where I would change.

now, they suck. Just don't get too sick that might cost big bucks. They start to find all kinds of excuses not to pay.

Most of our co-workers have Aetna as well, and with no problems (a couple of big illnesses, no problems having everything paid).

it's still Aetna, the plan is different. Need to get referrals now, only certain dr.'s and labs 'in the network'. That wasn't the way it was with his other employer's Aetna plan. Guess I shouldn't bash Aetna as much as the plan selected by his company.

This speaks volumes about his company. Last year, on Christmas Eve. they fired 2 salesmen who were married wtih young children.
:wtf: They couldn't wait a few more days and do it after New Years??

How do you fire someone at Christmas????

Everyone single employee donated money and split it between the two guys.


Can you imagine! My blood was boiling. What bastards.

big money to me, but not to them. It was regarding reimbursement for out of network doctor bills. It would upset me too much to go into details just now, but they lied to me and stonewalled me repeatedly for months and months, had different info on my account depending on who I spoke to on the phone (even on the same day), and seemed generally incompetent and or sleazy.

Good for you and your co-workers, but don't get to feeling too smug about it.

Except for ER (we were on vacation) and they covered it all except for the $100 co-pay, no questions asked.

established an excellent relationship in a field where in-network providers, much less excellent ones, are hard to find.

Try getting an Iraq War veteran who was horribly maimed with life-long problems as a result coverage in the private sector. He will likely be denied coverage because their actuaries would deem him too much of a high risk. In short, he wouldn't be profitable.

I have back problems and I've never had a problem going for MRIs, physical therapy, steroid injections, etc. My mom is on the same plan and she didn't have a problem when she had to get a whole shoulder replacement a couple of years ago. My dad, also on same plan, has had surgery to get his gallbladder removed, also no problems.

:shrug:

Oh yeah, xenophobes and racists.

Obama is talking to them and the people who listen to rush and hannity.

And that select crowd that actually have pretty good company provided insurance like I did ten years ago.

Do I get to keep that?

pay less and less to the company as the value of my HSA has grown.

I don't care anymore about what doctor I see should I need one than I care which person checks out my groceries.

This is all about what they WANT to say, but CAN'T say, because they're too ashamed or COWARDLY to say:

"I'm happuh with mah insurance and don't want Governmunt run helth car!" = "I don't want my tax dollars paying for those fucking lazy (insert racial slurs here)'s and their nine welfare crack babies!!!!"

:eyes: :eyes: Seriously, you probe deep and that's usually what it boils down to. Either that or they think everyone but them is lazy and shiftless because they're supposedly successful and the other person (who may or may not have worked just as hard, but for whatever reason shit didn't pan out or their company closed) isn't. Clowns.

you can keep it until you change jobs or lose your insurance somehow.

Then you may keep your "pre-existing condition".

Something over 70% of the insured.

I don't necessarily think it's good politics to walk around with a large "Kick Me" sign on your back, and running with an insurance plan that replaces what people know, and (think they) like with something they've never seen, is just such a sign.

But what do I know?

In any given year, half the population has NO health care expenses. The healthy majority have nothing to complain about. It's only those useless sick people that have any complaints.

Because I like my health insurance

nt

They can't drop me, but thanks for your concern.

nt

And I would have to go back to using Tricare. It's not great, but it would be better than nothing.

could also be covered?

But why is that mutually exclusive of me liking my insurance?

I need to get referrals, but in the cases when I've failed to do so getting a referral after the fact was possible.

Otherwise, no problem. I need to go to the hospital, 30 minutes later it's approved and the hospital admissions folk are waiting for me. I need a cardiologist, I see a cardiologist. I need hand surgery, on Tuesday I see the GP; the following Wednesday I see the all-purpose orthopedics guy; the following Thursday I'm operated on by a hand specialist.

It's self-serving, but they have a prescriptions-by-mail option--instead of going to Walgreen's, you can have them mail you a 3-month supply of whatever it is you need.

They also have a routine check-up provision, and an annual 'well-child' preventive checkup/inoculation provision. Kid's born on 1/1, he sees the doc within a week or two of his birthday, gets his shots, gets checked up physically, cognitively, and psychology, and off he goes until the next year.

It's an HMO policy, so some doctors are out of network. However, their network is big enough, and I have few doctors that I strongly prefer, that it's never been a problem. Moreover, if there's a really good reason for seeing a doctor that's out of network, that's fine, too; they'll make an exception.

And, yes. My insurance covers stuff that Medicare does not, and since it reimburses at levels higher than Medicare/Medicaid, doctors don't refuse to accept it.

disclosure: i support the public option and healthcare reform.

but my insurance is WONDERFUL. i *used* to have pacificare. they were OK. not great. not terrible. i currently have aetna. they are great.

first, the benefits: i get 60 massages a year (with prescription, which i have) and 30 chiropractic sessions. i also get 60 physical therapy appointments (with referrals).

all of the above are FREE. technically, my insurance has a 90% coverage on the above, but once i paid out $400 in a year on copays, after that, ALL coverage goes to 100%. so, my max outlay per year is $400.

the aetna website is awesome. i can quickly look up ALL my medical history/claims.

i have called them for questions about coverage etc. and have minimal waits on the phone, and get fast, responsive customer service. a THOUSAND times better than any software technical support, ill tell you

here's my recent story:
i am a competitive athlete. on july 18, i seriously hurt my shoulder.

that was a saturday.

sunday my primary care office is closed, so I went to urgent care. sat down and within 20 minutes i was already seeing a doctor. they ordered an X-ray (came back negative), gave me a prescription, and urged me to see my primary care on monday (next day) to get an MRI referral.

on Monday i called the dr's office at 10 am and was able to get a 2pm appointment. by 2:45 i was done and had an MRI referral. I called the MRI facility and got an appointment to get my MRI at 3:15. how good is that???

i was out of the MRI by a little after 4 pm.

by 6 pm that evening, i got a call from my primary care doctor with the results of the MRI analysis1!! major muscle tear. surgery going to be required.

the next day i called the orthopedic surgeon (this was now tuesday), and got an appointment for THURSDAY. this is one of the most respected surgeons around, and i know he does excellent work because he worked on my sister in law. also, *i* was able to choose him because he's an aetna provider. i was able to go to the AETNA website and do this search and could have chosen ANY surgeon that was aetna certified (as most are).

within 10 days of seeing the surgeon, i was on the operating table. that was August 3.
my TOTAL cost for all this medical care? ZERO dollars. 100% coverage.

my only expenses are the prescriptions (5-7 dollars per refill).

i have seen him since the surgery and will continue to follow up again in about a month. i am getting physical therapy twice a week (free), as well as continuing my 2X a week massages ( which greatly speeds recovery imo. it was also a huge part of my sports training regimen).

due to the fact my injury will keep me out of work for several months, I am starting disability next week. this is a different insurance company (disability), and my premium has been paid as part of my union dues.

my employer pays 100% of my medical insurance premium, btw. it;'s a phenomenal benefit.

so, all the wanking aside, i *know* that insurance coverage can be awesome. mine is. these are expensive things (MRI's, surgery, etc.)_ and they have all been covered 100% no muss no fuss.

i support the public option and reform but i do not think for a second that any public option will provide benefits and speed of care NEARLY as good as my private insurance provides. i have yet to hear from any canadian or brit, but i suspect such quick response, minimal wait times, etc. that i have gotten here w.my insurance are as good (or more likely better) than most jurisdictions.

In general, only 30% of claims against any insurer are denied.

my point was simply that i LOVE my insurance and i have had great experiences with my insurance company

i support the PO as a matter of policy not because it would benefit me.

That is the basic problem trying to get anything accomplished. Most people are not now and will never be expensively sick, so they basically don't care one way or another.

you VILL keep it.

twice even worse.

Pay your ever rising taxes to pay for this dumb government health care then pay your ever rising premiums to the insurance company to pay for the better care that you won't get through the government plan.

Looks like a lose lose to me. Doesn't the government have enough stuff to mess up?

So while you may not find many people who are genuinely happy with their insurance and who will be allowed to keep it, there will definitely be many millions of people who will be stuck with insurance they don't like. If their employer offers it, they will HAVE to buy it whether they think it's a rip off or not.

The first class may be mythical, but the second class will be typical.

That's the whole point of the exchange, to give you the chance to change insurance if you want to.

"Eligibility"
SEC. 202. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.

(a) Access to Coverage- In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage.

"acceptable coverage" could be Medicare or Medicaid, but it could also be employer based insurance. Call it a pre-existing condition.

Under the HR3200 bill, if your employer offers an approved insurance plan you are not eligible to buy into the public option (should it even exist) or anything else on the Exchange. Only if your employer does not offer what is deemed an acceptable insurance plan can you buy for yourself on the Exchange. For example, you work for a small business and there's no plan, or you've been thrown off your insurance plan, or never had one because your employer is a fly-by-night who contracted with a fly-by-night insurer and the plan doesn't qualify. There is a 5 year grace period for the employer provided plan to meet Federal regs. (Sec 102,b,1) If your employer has a plan that meets Federal requirements, no choice for you.

And that is the "good" bill. The Senate HELP bill actually grandfathers in bad company insurance plans like Walmart's, which is so bad that hourly employees often take Medicaid instead. Employees that now resort to Medicaid would be forced to buy the company plan, which they've already determined they can't afford or rely on.

Why does President Obama say that if you like your insurance you can keep it, but if you don't, you can buy from the exchanage?

he can duck behind a smooth sounding generic platitude and not take responsibility for the detailed language in the bill. None of the plans are "his" plan, and none of them have been passed yet. How can he be held responsible for details of the plan or things he said about it as if it were already finalized, signed, and implemented? You sure do want a lot of specifics from a guy about a plan that's not even his. Say, what do you think he is - a lawyer? And if it turns out to be slightly different in practice from what he said - well it will still be true that if you LIKE your plan you can keep it. You can't say he lied.

Maybe he is assuming that if the employer based plan you have meets federal qualifications, you would have no right or reason to prefer a different one. I doubt that, but who knows? Maybe he's forgetting that HR3200 has sections and subsections about who is eligible to purchase insurance from the exchange. I'm not a mind reader and can't say. Maybe he is being vague and recklessly optimistic in his choice of words since HR3200 is a bill, not yet passed by Congress, and so he need not trouble himself with reading out a 13 paragraph answer outlining what exact conditions will govern whether you keep or don't keep your existing insurance. Maybe he's conveniently conflating the case of the self-insured individual who just as he says, may keep or ditch their insurance as they prefer, with the universal case, forgetting how many people buy their insurance through their employer. Maybe he's selling his preferred vision of what a country with health care reform would be "like". Maybe he prefers to think happy thoughts. I just can't answer for him.

force you to keep insurance if you choose to buy from the exchange rather than via the employer?

For years I paid for health insurance without using it.
They took their fee directly out of my paycheck like a tax.
When my mother pressured me to get a regular check up I finally went in to get one.
I gave the doctors office my insurance card .....
Sometime later I got a letter and a bill...
The insurance company refused payment for a basic check up.
So, I wrote a check to the Doctor myself.
The amount owed was less than I paid monthly to the insurance companies.

Fuck this.... I'm paying cash, and dropping out of the system.

For years I paid for health insurance without using it.
They took their fee directly out of my paycheck like a tax.
When my mother pressured me to get a regular check up I finally went in to get one.
I gave the doctors office my insurance card .....
Sometime later I got a letter and a bill...
The insurance company refused payment for a basic check up.
So, I wrote a check to the Doctor myself.
The amount owed was less than I paid monthly to the insurance companies

.... I'm paying cash, and dropping out of the system.

they said the first one wasn't posted