dayman

As a response to someone asserting that the absolute basic system provided no way for insurance companies to not go out of business. Think about that for a minute. If you say something like that...burden is on YOU to at least know what you are talking about.

LOL facade? If you want to look around for answers I pasted some resources I use to make it more manageable. Feel free to use them or not! I could care less. Search around for the word "penalty" would also be my advice that's what they call it in the Bill. Actually a quick search shows it to be in subsection C of 26 USCS § 5000A...so go ahead and google that. You are welcome.

If you want to dig into Title 1 more this may help...bellow is some basic info directing you to certain sections in Title 1 you may want to look at (which as I said is where most of the issues people talk about are) • Sec. 2701. Fair health insurance premiums, limiting rating to age, geographic area, individual or family unit, and tobacco use. (Health insurance issuers for individual and small group market. Also insurers of large groups if offered through exchange.) • Sec. 2702. Guaranteed availability of coverage. (Former sec. 2011). (Health insurance issuers offering individual and group coverage.) • Sec. 2703. Guaranteed renewability of coverage. (former sec 2012) (Health insurance issuers offering individual and group coverage.) • Sec. 2704. (former sec. 2701) Prohibition of preexisting condition exclusions or other discrimination based on health status. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2705. (former sec. 2702) Prohibiting discrimination against individual participants and beneficiaries based on health status. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2706. Non-discrimination in health care. This section both prohibits discrimination by insurers against providers operating within their scope of practice and against individuals in violation of section 1558, which prohibits retaliatory action against employees who complain about actions their employers take in violation of the reform act ( group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2707. Comprehensive health insurance coverage. Requires insurance issuers in the individual and small group market to provide essential benefits under sec. 1302(a) and group health plans to comply with the cost sharing requirements of sec. 1302(a). • Sec. 2708. Prohibition on excessive waiting periods (over 90 days). (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2709, Coverage for individuals participating in approved clinical trials (group plans and insurers in the group and individual market) • Sec. 2709. (Formerly 2733). Disclosure of information by health insurance issuers. • Sec. 2711. No lifetime or annual limits (group health plans and health insurance issuers offering group and individual health insurance coverage, more permissive rules for self-insured and large group plans.) • Sec. 2712. Prohibition on rescissions. (Group health plans and health insurance issuers offering group and individual health insurance coverage. • Sec. 2713. Coverage of preventive health services. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2714. Extension of dependent coverage. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2715. Development and utilization of uniform explanation of coverage documents and standardized definitions. (Secretary to develop standards. To be applied by health insurance issuers and sponsors of self-insured plans. • Sec. 2715A. Reporting of additional information. • Sec. 2716. Prohibition of discrimination based on salary. (Plan sponsors of group health plans other than self-insured plans.) • Sec. 2717. Ensuring the quality of care. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2718. Bringing down the cost of health care coverage. (minimum loss ratios) (Health insurance issuers offering group or individual health insurance coverage. Does not apply to self-insured plans.) • Sec. 2719. Internal and external appeals processes. (Group health plans and health insurance issuers offering group and individual health insurance coverage.) • Sec. 2719A Patient Protections. • Sec. 2722. (Formerly 2721). Exclusion of certain plans (i.e. governmental plans) • Sec. 2723. (Formerly 2722). Enforcement provisions. • Sec. 2724. (Formerly 2723). Preemption, state flexibility, construction. • Sec. 2725. (Formerly 2704) Drive through delivery. (Group health plan and health insurance issuer offering group and individual coverage.) • Sec. 2726. (Formerly 2705). Mental health parity (group health plan and health insurance issuer offering group and individual coverage.) • Sec. 2727. (Formerly 2706). Reconstructive surgery following mastectomies. (Group health plan and health insurance issuer offering group and individual coverage.) • Sec. 2728. (Formerly 2707). Coverage of dependent students during medically-necessary leave of absence. (Group health plan and health insurance issuer offering group and individual coverage.) • Sec. 2731 (Formerly 2711). Section rewritten as a limitation on guaranteed coverage based on network or financial capacity and transferred to 2702 • Sec. 2732. (Formerly 2712). Guaranteed renewability of coverage in small group market. (revised and transferred to section 2703)

Actually next time you say something retarded like "the Bill doesn't even address ____" and the Bill actually does...just admit you are a jackass. It's fine if you want to talk about things you don't know anything about (and admittedly are boring things that are hard to understand)...just know that when you say "it doesn't work b/c of _____" and there's something in there that addresses "_____"...that it's actually on YOU and not the rest of the world to follow up with more. You can still attack things feel free...but you can do so with at least some basic understanding I don't think that is too much to ask. Well a lot of the reform all works together. The basic outline of the Bill is as follows if it would help you look through it: • Title I, Quality, Affordable Health Care for All Americans (health insurance reforms) • Title II, Role of Public Programs (Medicaid and the Children's Health Insurance Program) • Title III, Improving the Quality and Efficiency of Health Care (Medicare amendments, primarily to encourage quality and control cost, but including some benefit enhancements and provider payment reductions) • Title IV, Prevention of Chronic Disease and Improving Public Health (reducing barriers to clinical preventive care and encouraging wellness programs) • Title V, Health Care Workforce (additional support for educating and training health care workers and for community health centers) • Title VI, Transparency and Program Integrity (fraud and abuse and conflict of interest disclosure provisions as well as provision for outcomes research) • Title VII, Improving Access to Innovative Therapies (provision for the approval of biosimilars (generic biologics) and the expansion of the affordable medicines program) • Title VIII, the CLASS Act (a national voluntary insurance program for purchasing community living assistance services and support) • Title IX, Revenue Provisions • Title X, Strengthening Quality, Affordable Health Care for All Americans (the manager's amendment...should read rest of bill w/ this in hand) The "lockout period" once again is just the way I described it so don't fixate on that language...certain insurers controlling their own enrollment...so it's not like some scarlet letter is pinned to you and nobody will touch you for X-amount of time. More importantly to note is this entire concept is still a few years away and there's going to be regulations and private business decisions that continue to shape this concept. Point is under the reform you can absolutely still **** yourself if you choose to be irresponsible. (once again btw the majority of the hot button issues are all in Title 1)

Ok well dig away let me know what ya find I'm interested as well. I'm not trying to fool anyone here. Also just know that if you do go poking around into this bill you have to read the entire thing with Title X in hand (which was added as an amendment but not incorporated...as many of the provisions that appear in the bill are eliminated or substantially changed by Title X). Provisions of the PPACA were also further amended by the reconciliation act. So I'm not saying it's an easy task but ultimately what you are looking at can be found in Title 1 read w/ Title X/reconciliation act in hand....all while browsing regulations.gov and the CFR for proposed and existing rules further addressing the enrollment periods. (In other words your best bet is to find a scholarly synopsis and then check back to the raw material to confirm/better understand what the synopsis says).

zeitgeist from what I saw of the first one is pure sensationalism although it did bring a lot of people basic awareness that there is sure thing a Fed

Actually shouldn't the burden first be on those who make baseless claims that certain obvious things are not given thought in the bill? Am I here to fact check you and just field wild questions and go do research for you? Am I here to educate you? There is a clause that references what will occur. Also the current crop of preexisting injuries we are dealing with are to be dealt with in a variety of ways including the creation of high-risk pools and all this has a 90-day after enactment to 2014ish window...the issue of the abuse you all fixate on is separate from dealing with the current crop...the hypothetical incidents of abuse (which can't occur for years..that's why they are hypothetical at this point) will have problems when they suffer medical bills w/ no insurance same as they do now.

1. Abortion: Pro-death 2. Gay Marriage: The state of Texas should recognize my Massachusetts marriage to my tree 3. Prayers in school: Student led speech about things I like may be permissible... 4. Death Penalty: More death and victims should do it game of thrones style 5. Guns: in every house 6. Health Care: Scientology 7. War on drugs: keep the prisons packed 8. Taxes: tax everyone but me 9. Immigration: optional compliance 10. Illegal Immigrants: pro-death 11. Free trade: i like coffee 12. Military Spending: probably need more stuff all the time... 13. Foreign Policy: comply or die earth

If you choose not to buy, you are penalized by getting locked out for a period of time. You cannot simply choose to stay out despite the mandate and then take advantage of the preexisting injury deal at your leisure. Insurance companies are not worried about what you describe bankrupting them. It's just not one of the issues that is concerning everyone. Of course that isn't what I'm saying. Ok well first off I haven't read the damn thing. But that was the way it was explained to me by someone who worked with the creation of it (directly with members of congress and the white house) and who I know is qualified to speak on it (although certainly is not the God of all things related to the Bill). Anyway I did go ahead and tool around looking for somewhere in there I could reference. Obviously you can pick apart the specifics of what I said before but the idea is insurance companies still have some control over their enrollment. ‘‘SEC. 2702 ø42 U.S.C. 300gg–1¿. GUARANTEED AVAILABILITY OF COVERAGE. ‘‘(a) GUARANTEED ISSUANCE OF COVERAGE IN THE INDIVIDUAL AND GROUP MARKET.—Subject to subsections (b) through (e), eachhealth insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual in the State that applies for such coverage. ‘‘(b) ENROLLMENT.— ‘‘(1) RESTRICTION.—A health insurance issuer described in subsection (a) may restrict enrollment in coverage described in such subsection to open or special enrollment periods. ‘‘(2) ESTABLISHMENT.—A health insurance issuer described in subsection (a) shall, in accordance with the regulations promulgated under paragraph (3), establish special enrollment periods for qualifying events (under section 603 of the Employee Retirement Income Security Act of 1974). ‘‘(3) REGULATIONS.—The Secretary shall promulgate regulations with respect to enrollment periods under paragraphs (1) and (2). The plaintiff and the spill incident. The plaintiff, a 79-year-old grandmother named Stella Liebeck, was not driving, nor was the vehicle moving when the injury occurred. While the car was stopped, Mrs. Liebeck, who was sitting in the passenger seat, tried to hold the coffee cup between her knees as she removed the lid. The cup tipped over, spilling the contents into her lap. The injury. Mrs. Liebeck’s injury was anything but trivial. The scalding-hot coffee caused third-degree burns over 16% of her body, including her genital area. She had to be hospitalized for eight days. She required extensive skin grafts and was permanently scarred. She was disabled for a period of two years. During the ensuing trial, Mrs. Liebeck’s physician testified that her injury was one of the worst cases of scalding he’d ever seen. The coffee. At the time, McDonalds’ corporate specifications explicitly called for coffee to be served at a temperature between 180 and 190 degrees Fahrenheit. An expert witness testified that liquids at this temperature will cause third degree burns of human skin in two to seven seconds. (Coffee served at home is typically 135 to 140 degrees.) McDonalds’ culpability. During discovery, McDonald’s was required to produce corporate documents of similar cases. More than 700(!) claims had been made against McDonald’s, and many of the victims had suffered third-degree burns similar to Mrs. Liebeck’s. Yet the company had refused to change its policy, supposedly because a consultant had recommended the high temperature as a way to maintain optimum taste. Some have speculated that the real reason for the high temperature was to slow down consumption of the coffee, reducing the demand for free refills. Greed? Despite the pain caused by her injury, and the lengthy and expensive treatments she required, Mrs. Liebeck originally offered to settle with McDonald’s for $20,000. The corporation offered her a mere $800, so the case went to trial. The settlement. The jury awarded $200,000 in compensatory damages to Mrs. Liebeck, which was reduced to $160,000 because the jury felt that only 80% of the fault lay with McDonald’s, and 20% with her. They also awarded $2.7 million in punitive damages, essentially as punishment of McDonald’s for its callous treatment of Mrs. Liebeck, and its years of ignoring hundreds of similar injuries. This amount was held to be reasonable given that it represented only two days’ worth of McDonalds’ revenue from coffee sales alone. The trial judge reduced the punitive damages, however, to $480,000. After further negotiation, Mrs. Liebeck ultimately received $640,000. When the first assertion is so broad and based w/ no "logic" of it's own how do you expect me to combat it with reasoned analysis? "The way the bill is written" will put insurance companies out of business? ok...

Well what is so unfair about that? And that McDonald's case is basically the face of propaganda for tort-reform.

Have good lawyers, pick a good jury, have an orderly presentation of evidence and clear experts. That's all you can do.

wise words from 3rdlng of all posters

If you choose not to buy, you are penalized by getting locked out for a period of time. You cannot simply choose to stay out despite the mandate and then take advantage of the preexisting injury deal at your leisure. Insurance companies are not worried about what you describe bankrupting them. It's just not one of the issues that is concerning everyone.

If everyone has a policy they aren't worried about it. Fact. And it's Mr. Dumbass. Pronounced due-moss.

There is nothing about everyone having insurance the insurance companies don't like trust me.

LOL. Classic.

Take your small victories, small minded one.

3rdnling I've interacting with you before. I know better than to try and slip one by you.

I would actually like to know a bit more about what exactly Mitt accomplished in business. The good and the bad. Any suggestions on where to go? A good neutral article I can find it all in?

haha c'mon now rich folk pay a lot of taxes...to say only poor people pay taxes is hurting my ability to be taken seriously here MDP...haha...

Well like I said above, this isn't a reform that will happen with a piece of legislation IMO (generated by either side) outside of a single payer system in which case I guess you could accelerate the process but it still couldn't be overnight (and either way I'm not here to advocate a single payer system). Obviously the government is a huge purchaser but this change will still start in the private sector and it is moving that way slowly. Your insurance company and your doctor developing a more outcome based payment system and then (necessarily) you driving down the cost of your own care by shopping for the services you do need in a way that more resembles a free market, thus driving down the cost of care (and coincidentally driving up the demand for general practitioner services relative to specialists). As for why I'm fine with ACA? Because of all the good things it does bring. Yes you could argue that maybe it would be better to continue to put off the issues effecting the uninsured for 10 or so years until we can work out what we are dealing with...but to me that is not acceptable morally b/c really this is something that needs to be addressed yesterday. And yes I know everyone ultimately receives the care they absolutely need but as has been repeated over and over in discussions like this there's the shifting of costs issue (and explosion of emergency costs issue) which does go to the underline cost of healthcare. Things like the 80/20 rule, the mandate/preexisting injury system, the extension of the age the child can stay on and other plan-related reform...it should theoretically encourage competition among plans it does try and address fraud...etc...I'm not ready to trash it. I call it progress.

Well from what I can tell Romney, the GOP, and a lot of voters around America

1. Agreed but let's be real... 2. Agreed 3. Disagree but you acknowledge that the cost is negligible so whatever..but just know tort reform is evil. 4. THIS IS THE ENTIRE DEAL! This IS how you reform healthcare. You change the pay structure, and then you make sure that those making the purchasing decision have enough skin in the game so that the industry actually works like a free market. 5. Agreed but let's be real...what this is really saying is the mandate is necessary...which I agree with just tell this to the GOP and remind them it was their idea please... ...anyway the point of my post was to just make sure everyone knew my feeling on the subject (lol)...point 4 is where it is at and that's serious talk....

You think it's impossible to raise it without contributing to further decline? Direct cause and effect? Don't you think this issue is overblown?

LOL. Anyway...on this issue there just is no polite way to categorize anyone that is actively trying to prevent gay people from obtaining a marriage. And saying "I have a traditional view on the matter" is a cop out and means nothing.