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Post by Accountable »

Send an unmistakable message today that we've had enough! We are now going to run over those politicians who don't listen and who vote without regard for public opinion.

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I refuse to look at or listen to Mike Huckabee, so I'm not going to watch the video. If you'd like to sum it up for us and say which law was not read, fine. I just hope you're not talking about the Health Care Law not being read.....It was...It had to be to be written.
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Well, it does seem to be about the health bill.

What a crock.

I like a lot of what the health care bill provides. If they really want to do something about the health Care reform, they would take specific issues, and work on them.

This is just more politico posturing. They won't change a thing, but they will be able to use Congress' "lack of action in the Health care reform" as ammunition against the "Liberals" in 2012.

Wish they would quit with all the saber-rattling and posturing and get to work on things that REALLY need to be fixed.

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"Liberals" you say, I don't think theres much of that left. American Liberalism Died with Paul Wellstone. Though I do like Alan Grayson, too bad he was defeated.
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Ahso!;1345838 wrote: I refuse to look at or listen to Mike Huckabee, so I'm not going to watch the video. If you'd like to sum it up for us and say which law was not read, fine. I just hope you're not talking about the Health Care Law not being read.....It was...It had to be to be written.But by whom? Certainly not by any of the legislators. None of them could say that they'd written or read it, unless I missed something. It was patched together, (my guess) by medical lobbyists, who I think you & I agree shouldn't even be involved.

BTW I know what you mean about Huckabee. I can't listen to him, either. But, the law is unconstitutional and it's over-reach, and it should be repealed.
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Accountable;1345855 wrote: But by whom? Certainly not by any of the legislators. None of them could say that they'd written or read it, unless I missed something. It was patched together, (my guess) by medical lobbyists, who I think you & I agree shouldn't even be involved.

BTW I know what you mean about Huckabee. I can't listen to him, either. But, the law is unconstitutional and it's over-reach, and it should be repealed.What evidence have you seen that makes you believe it wasn't read by any legislators?

So far, according to the courts, its perfectly legal legislation. Also, as yaaarrrgg has pointed out, and I concur, it is constitutional.
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This thanksgiving I went to a friends house and we were sitting around the table talking about health care. One acquaintance told us how she had went for a check to see if she appendacitis. She ended up getting a bill for $7000. No she didn't have appendicitis either.

The system is not working, this woman was a student at the time and had no insurance. The government paid for it anyway so why not a single payer health care system? Just to simplify the process at least. That and stop the vulture corporations who who make profits off of suffering and death.
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Scrat;1345868 wrote: This thanksgiving I went to a friends house and we were sitting around the table talking about health care. One acquaintance told us how she had went for a check to see if she appendacitis. She ended up getting a bill for $7000. No she didn't have appendicitis either.

The system is not working, this woman was a student at the time and had no insurance. The government paid for it anyway so why not a single payer health care system? Just to simplify the process at least. That and stop the vulture corporations who who make profits off of suffering and death.


Like AARP?
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Post by yaaarrrgg »

Ah, health care.

By "nobody," Huckster means the GOP. I sincerely believe most the GOP hasn't read it. Because they have no interest in health care, or reforming it. More reasonable people in the GOP like David Frum have already pointed out the bill is essentially the same one that the GOP proposed back when Clinton wanted a single payer system. Back when the GOP had Gingrich (who by the way is a genius by conservative standards :) ).

Of course, when the Dems decided to go with the compromise, the GOP moves the goal posts again, and doesn't even offer an alternate idea this time. Though they twiddle their thumbs for several months, arguing for the need of more thumb twiddling.
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How do they know whats wrong with the law if they hadn't read it? It amazes me people actually believe the outright contradictions that come from the mouths of GOP politicians and pundits.
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Scrat;1345868 wrote: This thanksgiving I went to a friends house and we were sitting around the table talking about health care. One acquaintance told us how she had went for a check to see if she appendacitis. She ended up getting a bill for $7000. No she didn't have appendicitis either.

The system is not working, this woman was a student at the time and had no insurance. The government paid for it anyway so why not a single payer health care system? Just to simplify the process at least. That and stop the vulture corporations who who make profits off of suffering and death.


I suppose that if you have no health insurance, and you show up at the ER with a bellyache, thinking it might be appendicitis, you could run up some rather large bills. but 7000 bucks sounds a bit of a reach, unless you ended up in the hospital for a few days.

The people without health insurance get the really big bills.

And the new healtcare bill has provisions for that very problem.
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Ahso!;1345844 wrote: "Liberals" you say, I don't think theres much of that left. American Liberalism Died with Paul Wellstone. Though I do like Alan Grayson, too bad he was defeated.


I was a conservative, once, but the "New Right" has made a "Liberal" of me.
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And the new healtcare bill has provisions for that very problem.


And how does that work? I think we need the system Britain has with stiff penalties for abuse of the system.
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Scrat;1345931 wrote: And how does that work? I think we need the system Britain has with stiff penalties for abuse of the system.
That would never fly here because it would involve passing a judgment on a person's personal behavior, which is forbidden on all except employed white people.

eta: and Juan Williams.
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Accountable;1345938 wrote: That would never fly here because it would involve passing a judgment on a person's personal behavior, which is forbidden on all except employed white people.

eta: and Juan Williams.That's odd, I've never before taken you to play the victim card. Perhaps I've simply never noticed it up to now. You definitely sound like a conservative when you employ tactics such as that.

I'm still waiting for you to tell us what evidence convinced you that no legislators read the health care law.
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Ahso!;1345945 wrote: That's odd, I've never before taken you to play the victim card. Hmm ... I never considered myself a victim, but you're right that that post looks like I do. I don't.

Do you think we we would benefit from a system that has stiff penalties for abuse of the system? I think it would benefit any social program.
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Accountable;1345954 wrote: Hmm ... I never considered myself a victim, but you're right that that post looks like I do. I don't.

Do you think we we would benefit from a system that has stiff penalties for abuse of the system? I think it would benefit any social program.Perhaps a Freudian slip.

I'd need to know the penalties, one's stiff may be equal to another's flaccid. :)
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LarsMac;1345901 wrote: I suppose that if you have no health insurance, and you show up at the ER with a bellyache, thinking it might be appendicitis, you could run up some rather large bills. but 7000 bucks sounds a bit of a reach, unless you ended up in the hospital for a few days.

The people without health insurance get the really big bills.

And the new healtcare bill has provisions for that very problem.


Scrat;1345931 wrote: And how does that work?


Your friend would now have healyh insurance, and would not be subject to such a ridiculous bill.



Scrat;1345931 wrote: I think we need the system Britain has with stiff penalties for abuse of the system.


Ask the Brits around here how well THAT works.
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So, let's try something new, Accountable.

How about telling us exactly which parts of the health Care Reform Bill you and the Right wingers object to, and let's see what we can do to perhaps suggest a resolution.

OR at least tell us why the only option is to take the entire bill and scrap the whole thing.

I believe that anyone who thinks that is the way to go has not read the bill.

They also, IMHO, have little understanding of how the law process actually works.
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posted by larsmac

Ask the Brits around here how well THAT works.


Not sure what you mean about penalties for abusing the system. Our system is not perfect but it's better than yours. You should really stop looking at the faults in other countries system of healthcare you can highlight and just concentrate on what you actually want for yourselves.

It's quite simple.

Do you believe everybody should have access to healthcare when they need it.

Yes or No.

If the answer is no and you don't care then you just let them suffer and die.

If the answer is Yes then how do you provide for it?

If you decide everybody should pay their way then how do you cater for those who simply can't afford it? If you think they should not recieve ab-ny help then just let them suffer and die. Also accept the reality that if for any reason you lose your healthcare you will be one of those left in the ****. That is the reality of what seems to happen in the states. It always amuses me that those right wingers that think welfare a nonsense never seem to believe they might become unemployed or lose their wealth for any reason. That people are poor because they choose to be doesn't really stand much examination.



If you do care then you need to have some kind of provision that takes no account of a person wealth when allocating treatment. You need kind of non judgemental aid system, charity doesn't work you need government to help finance and organise it, not run just provide the means. Having a healthy population is fundamental to a successful capitalist economy it's enlightened self interest to care for the nations health and was being advocated long before the term socialist was even coined. Go read up on it if you don't believe me. Just have a look at the effect on the economy the lack of healthcare is actually having. It's not the cost of something so much as the value of it that really matters.

What really started social reform in the UK was the realisation during the boer war that 40-60% of males in the cites were not actually fit enough for military service. when it got started our long trail to the welfare state had bugger all to do with socialism.

I don't know why you have such a debate about this in the states. If you don't care about the well-being of society as a whole or think it doesn't actually matter come right out and just say so and then see how the voting goes.

Your constitution originally didn't give the vote to people without property, women or slaves. It's not idea of changing the constitution with the times that is the problem is it?
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Post by Accountable »

I posted this just before going to bed, and this morning it's not there. I spose I didn't hit submit.

LarsMac;1345959 wrote: So, let's try something new, Accountable.

How about telling us exactly which parts of the health Care Reform Bill you and the Right wingers object to, and let's see what we can do to perhaps suggest a resolution. I can only speak for myself; I object to the federal part.

LarsMac wrote: OR at least tell us why the only option is to take the entire bill and scrap the whole thing.
Sure thing.

Accountable;974666 wrote: Still, we're a big country. A blanket one-size-fits-all program would never be able to adequately serve all Americans, no matter what problem it addresses. Everyone talks about national this and national that, pointing at European countries as a benchmark. Well those countries are smaller than many of our states. If their programs are truly the best way to go, then doesn't it make sense to do it on a similar scale? Let the states create whatever programs they want, or none at all. The natural competition and benchmarking will create continuous improvement. A national program has no reason to change or improve.


Accountable;969073 wrote: But a federal program is neither necessary nor constitutional. That's the purview of state governments. By leaving it with them, they can benchmark of each other's programs and improve on your idea far surpassing a blanket one-size-fits-all federal program.

[...]



But for the rest: YES!! Life, Liberty, and the Pursuit of Happiness. The US federal government's job is to protect us from those outside forces that would prevent us from chasing our own dreams ... on our own. It's job is not to pick up the tab for the consequences if we should fail. That's our responsibility.


Accountable;843642 wrote: Centralized one-size-fits-all big government mandates are not the answer. The LAST thing I want to hear from my president is how the federal government is going to "fix" the education system. We're in enough of a "fix" as it is. Let each state handle things and benchmark off each other.


I also mention my opinion from time to time on another forum:

Accountable wrote: I base it on the constitution, of course. If it's not there, it's not up to the federal gov't. The states can take it on if they choose. In fact, that would be the ideal way. Fifty programs, each tailored to it's state citizens - each looking to the others for ideas on how to be "better", however they may define that word. The federal gov't could provide nationwide statistics to show what's working and what's not. Isn't that better than a one-size-fits-all approach?

But the federal politicians want the power and guard it jealously. It will be challenged in court, and in the meantime the program will go on as flawed, as rushed through, with thought only for political favors owed. When it is declared unconstitutional, the debate will not be whether to or not. The debate will be on how to change what's already in place. The foot's in the door. The camel's nose is under the tent. Pick your metaphor.


Accountable;1567083 wrote: Really, go back and read my post. I did not say "we" shouldn't, I said the federal gov't shouldn't, then I went on to say that that's the job of state and local gov't. I would hope that would make the rest of the questions moot, but just in case:

Our federal government, which is so unique and different from any European national government that it really should have another name, was never designed to take care of the individual citizen or any of the micro-governance of day-to-day life, only macro - those issues that are truly interstate or international in nature. The whole system was originally designed to keep the political power as close to home as possible.

One-size-fits-all cannot possibly be effective in this country. We're too large and diverse. Two people, one in southern California and one in rural Louisiana, both earning the same income, pay the same federal income tax. Because the cost of living in southern CA is tremendously higher than it is in LA, the Californian has the higher tax burden even though the dollar amounts are the same. Similarly, giving each of them the same amount of money from some federal program or other is also unfair to the Californian because the money won't go as far.

One nationwide program for everyone also squelches innovation. Take healthcare, for instance. A single program is too cumbersome to cover everyone, and limits the number of ideas that they can try to make improvements. Fifty programs is better. One state may find a more streamlined approach of record-keeping that other states can adopt. States with smaller populations would almost certainly have better programs. Poorer states would likely be the leaders in efficiency. Some states might decide that a government program is ideal for them while others might devise a contractor system.

And if a state decides not to have a government healthcare program, then that's their decision. Individuals would be free to move to the area that best suits their needs.

A federal system is never the way to go unless it is purely international or interstate in nature. That's why we don't have federal high schools, fire fighters, or garbage services.
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Accountable;1345984 wrote: I can only speak for myself; I object to the federal part.So if the same law was enacted as a state initiative in Texas, you'd be okay with it?
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Post by littleCJelkton »

I think the state only thing is one of the things that inhibit low health care. The state lines should be abolished so we can have competing companies asking me "Can Geico save you 15% or more on your health insurance? Does Sally really sell sea shells by the sea shore?" followed by some clip of sally selling sea shells by the sea shore maybe in San Fransico or some other beach in a town that starts with S to keep the aliteration.
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LarsMac;1345959 wrote: So, let's try something new, Accountable.

How about telling us exactly which parts of the health Care Reform Bill you and the Right wingers object to, and let's see what we can do to perhaps suggest a resolution.

OR at least tell us why the only option is to take the entire bill and scrap the whole thing.

I believe that anyone who thinks that is the way to go has not read the bill.

They also, IMHO, have little understanding of how the law process actually works.


New Reform

Are you aware that if my doctor submits a bill and classifies it as wellness visit, it gets covered at 100% - that's it. No questioning. And not subject to my deductible.

That's ridiculous! How can anyone possibly think that this won't be abused?
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LarsMac;1345841 wrote: Well, it does seem to be about the health bill.

What a crock. I like a lot of what the health care bill provides.


Yeah, me too. I've had to wait for up to eight hours at an emergency room before while the uninsured get their colds taken care of because they have no insurance. Then, since they can't pay their hospital bill it's written off as "indigent." Then that's added to my health care insurance premiums and costs.
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flopstock;1346001 wrote: New Reform

Are you aware that if my doctor submits a bill and classifies it as wellness visit, it gets covered at 100% - that's it. No questioning. And not subject to my deductible.

That's ridiculous! How can anyone possibly think that this won't be abused?First, I'd like to see the provision that states that. Can you provide it?

Second, the problem with your assertion is that your medical record can be reviewed to ensure abuse is not occurring. For example, if your physician classifies your visit as wellness and your medical record for that visit states your visit was due to a broken bone, the doctor is in trouble. Do you honestly believe many doctors would take that chance?

Sure abuse will occur, but it won't be rampant like conservatives like to scare everyone into thinking.
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Saint_;1346003 wrote: Yeah, me too. I've had to wait for up to eight hours at an emergency room before while the uninsured get their colds taken care of because they have no insurance. Then, since they can't pay their hospital bill it's written off as "indigent." Then that's added to my health care insurance premiums and costs.Not quite. Where did you get that from, the insurance industry propaganda machine? Insurance premiums increase because of medical cost increases and profit motives.
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Ahso!;1346004 wrote: First, I'd like to see the provision that states that. Can you provide it?

Second, the problem with your assertion is that your medical record can be reviewed to ensure abuse is not occurring. For example, if your physician classifies your visit as wellness and your medical record for that visit states your visit was due to a broken bone, the doctor is in trouble. Do you honestly believe many doctors would take that chance?

Sure abuse will occur, but it won't be rampant like conservatives like to scare everyone into thinking.


You look it up. It got handed to me this morning at 9:15 in my insurance meeting. Effective 1/1/11 Adult Wellness and Well Child visits are mandated under the Reform act to be covered 100%. We were actually encouraged to group all of our bloodwork and tests into these wellness visits, by the insurance rep.

Needless to say, the owners were not in this meeting.
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flopstock;1346009 wrote: You look it up. It got handed to me this morning at 9:15 in my insurance meeting. Effective 1/1/11 Adult Wellness and Well Child visits are mandated under the Reform act to be covered 100%. We were actually encouraged to group all of our bloodwork and tests into these wellness visits, by the insurance rep.

Needless to say, the owners were not in this meeting.No comment on the second part of my post?

Blood workup and tests as part of a wellness visit seems reasonable to me, though I'm figuring that the law itself states what does and does not fall under the definition of "wellness".

As I said, the problem with conservative arguments is they insist extreme examples are commonplace. They employ that tactic constantly, you can see and hear it in interviews in newspaper articles and on television news shows, and they do it so fluently, like they practice the behavior. It's called exaggerating, or also known in the business world by the name of marketing.
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flopstock;1346009 wrote: You look it up. It got handed to me this morning at 9:15 in my insurance meeting. Effective 1/1/11 Adult Wellness and Well Child visits are mandated under the Reform act to be covered 100%. We were actually encouraged to group all of our bloodwork and tests into these wellness visits, by the insurance rep.

Needless to say, the owners were not in this meeting.


Look it up, youself.

The labs, bloodwork, and such are not, by nature covered under the umbrella of "wllness"

You may be able to apply the doctor visit to wellness clause, and in in-house labwork your doctor can do at the time, (such as standard Blood sugar, A1C, BP, and such, might be covered, but the out-of office labs and such that are ordered will be covered by separate billing, unless your insurance compny is run by real idiots.

I know this because I just went through the insurance docmentation for my company.
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I don't have to worry about any of it for myself because I finally have my medical benefits through the VA. No monthly payments, $15.00 copays for regular visits and (get this) $50.00 deductible for anything else, including all potential major problems. Everything is covered except dental. Thanks everybody!
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LarsMac;1346022 wrote: Look it up, youself.

The labs, bloodwork, and such are not, by nature covered under the umbrella of "wllness"

You may be able to apply the doctor visit to wellness clause, and in in-house labwork your doctor can do at the time, (such as standard Blood sugar, A1C, BP, and such, might be covered, but the out-of office labs and such that are ordered will be covered by separate billing, unless your insurance compny is run by real idiots.

I know this because I just went through the insurance docmentation for my company.Well, to be fair, all insurance companies are run by real idiots, jut not the stupid kind. :)

floppy's insurance company may be trying to sabotage the system, but I can't see why they'd want to do that since its a complete windfall for the insurance industry. Money is going to be literally shoveled onto their laps.

They probably haven't read the god damned thing. :wah:
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By the way, there is not one mention in the Health Care bill about "Adult Wellness"

or "well child" or "Child Wellness"
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Post by LarsMac »

There is section 4206:

SEC. 4206. DEMONSTRATION PROJECT CONCERNING INDIVIDUALIZED

WELLNESS PLAN.

Section 330 of the Public Health Service Act (42 U.S.C. 245b)

is amended by adding at the end the following:

‘‘(s) DEMONSTRATION PROGRAM FOR INDIVIDUALIZED WELLNESS

PLANS.—

‘‘(1) IN GENERAL.—The Secretary shall establish a pilot

program to test the impact of providing at-risk populations

who utilize community health centers funded under this section

an individualized wellness plan that is designed to reduce risk

factors for preventable conditions as identified by a comprehensive

risk-factor assessment.

‘‘(2) AGREEMENTS.—The Secretary shall enter into agreements

with not more than 10 community health centers funded

under this section to conduct activities under the pilot program

under paragraph (1).

‘‘(3) WELLNESS PLANS.—

‘‘(A) IN GENERAL.—An individualized wellness plan prepared

under the pilot program under this subsection may

include one or more of the following as appropriate to

the individual’s identified risk factors:

‘‘(i) Nutritional counseling.

‘‘(ii) A physical activity plan.

‘‘(iii) Alcohol and smoking cessation counseling and

services.

‘‘(iv) Stress management.

‘‘(v) Dietary supplements that have health claims

approved by the Secretary.

‘‘(vi) Compliance assistance provided by a community

health center employee.

‘‘(B) RISK FACTORS.—Wellness plan risk factors shall

include—

‘‘(i) weight;

‘‘(ii) tobacco and alcohol use;

‘‘(iii) exercise rates;

‘‘(iv) nutritional status; and

‘‘(v) blood pressure.

‘‘(C) COMPARISONS.—Individualized wellness plans

shall make comparisons between the individual involved

and a control group of individuals with respect to the

risk factors described in subparagraph (B).

‘‘(4) AUTHORIZATION OF APPROPRIATIONS.—There is authorized

to be appropriated to carry out this subsection, such sums

as may be necessary.’’.

Control is an illusion. The Chaos is all part of the fun.
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Accountable
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Post by Accountable »

Ahso!;1345985 wrote: So if the same law was enacted as a state initiative in Texas, you'd be okay with it?It's unlikely that an identical law would see the light of day in Texas. If a trend developed among the States to provide some kind of health service, I'd definitely give the Texas version a friendlier look than I would any federal one.
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Post by Ahso! »

Accountable;1346038 wrote: It's unlikely that an identical law would see the light of day in Texas. If a trend developed among the States to provide some kind of health service, I'd definitely give the Texas version a friendlier look than I would any federal one.So you've read it? It's not like you to dismiss something out of hand.
“Those who can make you believe absurdities can make you commit atrocities,”

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Post by flopstock »

LarsMac;1346022 wrote: Look it up, youself.

The labs, bloodwork, and such are not, by nature covered under the umbrella of "wllness"

You may be able to apply the doctor visit to wellness clause, and in in-house labwork your doctor can do at the time, (such as standard Blood sugar, A1C, BP, and such, might be covered, but the out-of office labs and such that are ordered will be covered by separate billing, unless your insurance compny is run by real idiots.

I know this because I just went through the insurance docmentation for my company.


Adult wellness and Well Child were split out in our discussion because we actually already had the coverage. This year, the visits are covered after the deductible is met, next year it's a free pass(bull- we'll be paying with next years rates!).

And what we were told specifically is that if our doctors order the tests using the codes for wellness, that insurance can't question it.
I expressly forbid the use of any of my posts anywhere outside of FG (with the exception of the incredibly witty 'get a room already' )posted recently.

Folks who'd like to copy my intellectual work should expect to pay me for it.:-6

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Post by Ahso! »

flopstock;1346040 wrote: Adult wellness and Well Child were split out in our discussion because we actually already had the coverage. This year, the visits are covered after the deductible is met, next year it's a free pass(bull- we'll be paying with next years rates!).

And what we were told specifically is that if our doctors order the tests using the codes for wellness, that insurance can't question it.Doctors don't code, office personnel do, and their work is closely scrutinized.
“Those who can make you believe absurdities can make you commit atrocities,”

Voltaire



I have only one thing to do and that's

Be the wave that I am and then

Sink back into the ocean

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Post by flopstock »

Ahso!;1346025 wrote: Well, to be fair, all insurance companies are run by real idiots, jut not the stupid kind. :)

floppy's insurance company may be trying to sabotage the system, but I can't see why they'd want to do that since its a complete windfall for the insurance industry. Money is going to be literally shoveled onto their laps.

They probably haven't read the god damned thing. :wah:


No. What's going to happen is that this asinine law is going to force rates through the roof and company owners who have tried, over the years to offer something to their employees will be forced to drop coverage all together. That's what the real goal is.
I expressly forbid the use of any of my posts anywhere outside of FG (with the exception of the incredibly witty 'get a room already' )posted recently.

Folks who'd like to copy my intellectual work should expect to pay me for it.:-6

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LarsMac
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Post by LarsMac »

flopstock;1346040 wrote: Adult wellness and Well Child were split out in our discussion because we actually already had the coverage. This year, the visits are covered after the deductible is met, next year it's a free pass(bull- we'll be paying with next years rates!).

And what we were told specifically is that if our doctors order the tests using the codes for wellness, that insurance can't question it.


I believe they are correct that the insurance cannot question the doctor's order for tests, but I think you will find that tests done outside of the actual visit will come with their own bill, and I even suspect that in some instances they will come with a deductible/co-pay.

That all depends upon the specific insurance program, though, and is not "mandated" by anything in the Health Care Reform Bill as passed by Congress, and signed into law by the President.



By the way, insurance companies have learned, even without federal "mandates" that preventative maintenance (Wellness) programs save them money in the long run.

If you go see the doc more often because you don't have to shell out money each time, the doc can catch stuff earlier, and get you on preventative treatment a lot sooner, ultimately perhaps even keeping you healthier, and working longer, so you pay more insurance premiums, and they don't have to shell out a lot for catastrophic failures from preventable conditions.
Control is an illusion. The Chaos is all part of the fun.
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Post by flopstock »

Ahso!;1346041 wrote: Doctors don't code, office personnel do, and their work is closely scrutinized.


You don't have any idea what you are talking about, do you? I've gone to have lab work done and they've had to call the doctors office because they can't read his order. They want to know what it is for. See, he scribbles on this form and they use that to code the work. And I've had to wait while they get another fax that is legible.

That's how they bill it. I spent a year getting blood work with him using weight related codes and it wasn't covered at all. Once they found out I was diabetic - ta dah! covered after I met my deductible.

And the doctor codes what the tests are for.

But I'm not gonna debate the issue with you. It goes into affect 1/1. We'll find out next year and I really hope to hell you guys are right and the folks trying to keep our insurance business are as stupid as the politicians in washington.:thinking:
I expressly forbid the use of any of my posts anywhere outside of FG (with the exception of the incredibly witty 'get a room already' )posted recently.

Folks who'd like to copy my intellectual work should expect to pay me for it.:-6

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Post by flopstock »

LarsMac;1346043 wrote: I believe they are correct that the insurance cannot question the doctor's order for tests, but I think you will find that tests done outside of the actual visit will come with their own bill, and I even suspect that in some instances they will come with a deductible/co-pay.

That all depends upon the specific insurance program, though, and is not "mandated" by anything in the Health Care Reform Bill as passed by Congress, and signed into law by the President.



By the way, insurance companies have learned, even without federal "mandates" that preventative maintenance (Wellness) programs save them money in the long run.

If you go see the doc more often because you don't have to shell out money each time, the doc can catch stuff earlier, and get you on preventative treatment a lot sooner, ultimately perhaps even keeping you healthier, and working longer, so you pay more insurance premiums, and they don't have to shell out a lot for catastrophic failures from preventable conditions.


Once again, sure hope you guys are smarter than the companies that competed for our business.
I expressly forbid the use of any of my posts anywhere outside of FG (with the exception of the incredibly witty 'get a room already' )posted recently.

Folks who'd like to copy my intellectual work should expect to pay me for it.:-6

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Post by LarsMac »

I hope you found a smarter doctor.
Control is an illusion. The Chaos is all part of the fun.
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flopstock
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Post by flopstock »

LarsMac;1346048 wrote: I hope you found a smarter doctor.


Separate thread, but yeah...lol
I expressly forbid the use of any of my posts anywhere outside of FG (with the exception of the incredibly witty 'get a room already' )posted recently.

Folks who'd like to copy my intellectual work should expect to pay me for it.:-6

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Post by Ahso! »

flopstock;1346042 wrote: No. What's going to happen is that this asinine law is going to force rates through the roof and company owners who have tried, over the years to offer something to their employees will be forced to drop coverage all together. That's what the real goal is.Rates were going through the roof without the law, remember the 30% increases the insurance industry was threatening during the debate of the law? Those increases disappeared after this law went into effect. Coincidence? You tell me.

What is driving rates up is the ever increasing costs associated with health care. Three years ago when I lost my finger tip the hospital wanted to treat me in the operating room. When I asked how much that would cost, I was told $12,000.00 for the use of the operating room itself, at which point I told them (since I was uninsured at that time) if they didn't fix me up in the room I was in, I would walk out and take care of it myself. They took care of me outside the operating room and it all still cost me somewhere in the neighborhood of $4,000.00, which was reduced from $7,000.00 since I paid cash.
“Those who can make you believe absurdities can make you commit atrocities,”

Voltaire



I have only one thing to do and that's

Be the wave that I am and then

Sink back into the ocean

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Post by Ahso! »

flopstock;1346044 wrote: You don't have any idea what you are talking about, do you? I've gone to have lab work done and they've had to call the doctors office because they can't read his order. They want to know what it is for. See, he scribbles on this form and they use that to code the work. And I've had to wait while they get another fax that is legible.

That's how they bill it. I spent a year getting blood work with him using weight related codes and it wasn't covered at all. Once they found out I was diabetic - ta dah! covered after I met my deductible.

And the doctor codes what the tests are for.

But I'm not gonna debate the issue with you. It goes into affect 1/1. We'll find out next year and I really hope to hell you guys are right and the folks trying to keep our insurance business are as stupid as the politicians in washington.:thinking:Sorry to hear about your mishap, but the fact is that medical coding has become a specialized profession (I've looked into it for addl income and my wife's sister-in-law does it). As LarsMac said, outside lab work will come back with a bill attached to it and the doctors office will have to pay that bill, so mis-coding will cost them money - it would be financially irresponsible to code improperly, saving the patient a few bucks would cost the practice profit - that ain't gonna happen often.
“Those who can make you believe absurdities can make you commit atrocities,”

Voltaire



I have only one thing to do and that's

Be the wave that I am and then

Sink back into the ocean

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Post by Accountable »

flopstock;1346042 wrote: No. What's going to happen is that this asinine law is going to force rates through the roof and company owners who have tried, over the years to offer something to their employees will be forced to drop coverage all together. That's what the real goal is.
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Post by Accountable »

Ahso!;1346039 wrote: So you've read it? It's not like you to dismiss something out of hand.
No, I didn't read it. I'd dismiss any omnibus bill thousands of pages long. But even more importantly, I have a rule of thumb: "Washington should only be allowed to do that which only Washington can do." It's my sig in another forum. That means international issues and interstate issues, not issues that can fit the definition if you tilt your head just-so and squint, but real, actual, indisputably international and interstate issues.

Unemployment compensation does not fit that rule.

Subsidizing retirement income does not fit that rule.

Meddling in an individual's healthcare does not fit that rule.

Regulating what a farmer grows that is only for his own consumption does not fit that rule.

Mandating what a child is taught in school does not fit that rule.

Providing economic safety nets for individuals & families does not fit that rule.

These and many other things Washington does can be handled at the state or local level, and therefore should be handled there.

There are many things that do fit that rule of thumb that Washington does that I believe they should not, as well, but that's another thread.
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Post by Ahso! »

Accountable;1346078 wrote: No, I didn't read it. So, if in fact a bill like it was to make its way to the Texas state legislator, you wouldn't know it.
“Those who can make you believe absurdities can make you commit atrocities,”

Voltaire



I have only one thing to do and that's

Be the wave that I am and then

Sink back into the ocean

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Post by Accountable »

Ahso!;1346081 wrote: So, if in fact a bill like it was to make its way to the Texas state legislator, you wouldn't know it.Y'know, when you snip something, it doesn't make the original post go away as if you'd interrupted me in conversation. Anyone can read my post to get the context.

A bill like it would not make its way to the Texas state legislature because it is a national healthcare program. As I said earlier, that objection alone is enough for me to dismiss it.

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