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PostPosted: Fri Nov 12, 2010 11:04 am 
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WSJ Article about the stop gap "existing conditions" coverage.

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Democrats think they know how to run the insurance industry better than the insurance industry, and they're getting the chance to prove it under ObamaCare. Consider the early returns on its plan to insure Americans denied coverage for pre-existing conditions.

To judge by President Obama's rhetoric, the insurance industry's victims have been wandering the country like Okies in "The Grapes of Wrath." Thus ObamaCare gave the Health and Human Services Department the power to design and sell its own insurance policies. The $5 billion program started in July and runs through 2014, when ObamaCare's broader regulations kick in.

Mr. Obama declared at the time that "uninsured Americans who've been locked out of the insurance market because of a pre-existing condition will now be able to enroll in a new national insurance pool where they'll finally be able to purchase quality, affordable health care—some for the very first time in their lives."

So far that statement accurately describes a single person in North Dakota. Literally, one person has signed up out of 647,000 state residents. Four people have enrolled in West Virginia. Things are better in Minnesota, where Mr. Obama has rescued 15 out of 5.2 million, and also in Indiana—63 people there. HHS did best among the 24.7 million Texans. Thanks to ObamaCare, 393 of them are now insured.

States had the option of designing their own pre-existing condition insurance with federal dollars in lieu of the HHS plan, and 27 chose to do so. But they haven't had much more success. Combined federal-state enrollment is merely 8,011 nationwide as of November 1, according to HHS.

This isn't what HHS promised in July, when it estimated it would be insuring 375,000 people by now, and as many as 400,000 more every year. HHS even warned that it would bill private carriers for any claims if HHS decided that they had cancelled coverage to dump costs on the government. That outcome would certainly be in keeping with Mr. Obama's caricature of rampant discrimination against the sick.

Yet that hasn't happened. The HHS plan has flopped despite generous benefits and taxpayer subsidies that offset at least 65% of the total cost, sometimes more. Coverage is issued to anyone who has been turned away by even one insurance company or has been uninsured for longer than six months, and premiums vary only by age, not health status. In essence, HHS created a program that is designed to operate at a loss and still can't lure the customers it thought would come streaming its way.

That so few have grabbed this lifeline suggests that the reality of pre-existing conditions isn't nearly as grim as the President continues to claim. A shelf of academic research says the same thing, by the way.

But HHS won't take this for an answer, so this week it said it will cut premiums by 20% and expand benefits for this program in 2011 to encourage more people to enroll. In other words, HHS plans to make its cut-rate insurance even cheaper (and thus more expensive for taxpayers) so it can avoid having to admit that the President's claims about a nation of the indigent sick denied insurance were false. This wouldn't be the first time that one government failure begat another.


Pre-existing conditions sometimes do lead to genuine hardships, and polls show that voters are worried about the relatively rare horror stories. More modest fixes could bring more stability to the individual market, while Republicans support a boost in funding for the high-risk pools that 35 states offer as a safety net. The government didn't need to annex a sixth of the economy and create a multitrillion-dollar entitlement to help 8,011 people.


Bolded sections by me.


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PostPosted: Fri Nov 12, 2010 11:14 am 
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"I told you thusly."

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PostPosted: Fri Nov 12, 2010 11:52 am 
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I'm sure you are aware that the post has some serious bias and misleading information. That said, if those numbers are correct, that's pretty sad.


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PostPosted: Fri Nov 12, 2010 11:53 am 
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Arathain Kelvar wrote:
I'm sure you are aware that the post has some serious bias and misleading information.


Such as?

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PostPosted: Fri Nov 12, 2010 11:56 am 
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The opportunity to acquire health care is not available, but there isn't any mention of the cost.

Going from "not available" to "prohibitively expensive" won't increase the rolls. 65% = what?

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Last edited by Taskiss on Fri Nov 12, 2010 11:58 am, edited 1 time in total.

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PostPosted: Fri Nov 12, 2010 11:58 am 
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DFK! wrote:
Arathain Kelvar wrote:
I'm sure you are aware that the post has some serious bias and misleading information.


Such as?

Seconded. 8011 people are insured under the plan. That's what we call a fact?

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PostPosted: Fri Nov 12, 2010 11:59 am 
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DFK! wrote:
Arathain Kelvar wrote:
I'm sure you are aware that the post has some serious bias and misleading information.


Such as?


/sigh. No problem, I can provide examples, give me a few. But first, can I assume, then, that you find the post above to be free of bias and, to the best of your knowledge, perfectly accurate?


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PostPosted: Fri Nov 12, 2010 12:03 pm 
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Arathain Kelvar wrote:
DFK! wrote:
Arathain Kelvar wrote:
I'm sure you are aware that the post has some serious bias and misleading information.


Such as?


/sigh. No problem, I can provide examples, give me a few. But first, can I assume, then, that you find the post above to be free of bias and, to the best of your knowledge, perfectly accurate?


With the caveat that I've done no independent verification of their numbers, yes. I state that caveat because it does not appear to be the numbers you're challenging but the other information.


Edit: I do have to say I find it surprising you have to dig though, as the nature of your post seemed to indicate that these biases and misleading pieces of information were self-evident, given your prompt response.

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PostPosted: Fri Nov 12, 2010 12:16 pm 
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Quote:
Democrats think they know how to run the insurance industry better than the insurance industry


Misleading/inaccurate statement. They've said no such thing. Attempt to bias the reader.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
To judge by President Obama's rhetoric, the insurance industry's victims have been wandering the country like Okies in "The Grapes of Wrath."


Bias.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
ObamaCare's


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
A shelf of academic research says the same thing, by the way.


Neither obviously inaccurate nor biased, but unsubstantiated and unreferenced. Suspect.

Quote:
President's claims about a nation of the indigent sick denied insurance


Bias, and if I may say so, laying it on a little thick.

Quote:
This wouldn't be the first time that one government failure begat another.


Bias. If he were reporting facts, rather than trying to convey an opinion, this statement would have no place.

Quote:
annex a sixth of the economy


Quote:
The government didn't need to annex a sixth of the economy and create a multitrillion-dollar entitlement to help 8,011 people.


Misleading and inaccurate. This is not the goal of the entire bill. It is a component of it. In fact, according to whomever wrote this article, this portion of the bill is worth $5 billion. This is not 1/6 of the economy.


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PostPosted: Fri Nov 12, 2010 12:17 pm 
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DFK! wrote:
Edit: I do have to say I find it surprising you have to dig though, as the nature of your post seemed to indicate that these biases and misleading pieces of information were self-evident, given your prompt response.


No, it took time not to dig, but to highlight the vast number of them.

You are correct, numbers are (once verified) generally unbiased. I'm not taking issue with the numbers (yet).


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PostPosted: Fri Nov 12, 2010 12:30 pm 
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Taskiss wrote:
The opportunity to acquire health care is not available, but there isn't any mention of the cost.

Going from "not available" to "prohibitively expensive" won't increase the rolls. 65% = what?

When people talk about "the total cost" of an insurance program, one expects that the total cost of underwriting people is whatever the number-crunching formulae anticipate its outlays will be annually, given the (anticipated) insured pool, etc.

In the actual insurance *business,* premiums are then determined by taking the anticipated costs, divinding by anticipated enrollment (coming out with some kind of average per customer expenditure), and then tacking on a margin.

So I read that as "the premiums are 45% of what a sane insurance industry would assess the risk for this pool of pre-existing conditioned people to be."

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PostPosted: Fri Nov 12, 2010 12:46 pm 
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NPR article with some additional information

Quote:
Here's a no-brainer: Charge lower rates for health insurance and more people will buy it.

That's one of the lessons gleaned from early enrollment figures in the new federally subsidized program for uninsured people with pre-existing conditions. These high-risk pools, established under the health law, began signing up enrollees in August and September.

As of Nov. 1, Pennsylvania has enrolled 1,657 people — 1,000 more than any other state, according to figures released Friday by the Department of Health and Human Services. The Keystone state charges a $283 monthly premium — one of the lowest rates in the country. Pennsylvania is also the only state to charge the same rate regardless of age. Other states have higher rates for older people.


"Making it a little more affordable was in the thought process for us," said Melissa Fox, spokeswoman for the Pennsylvania Insurance Department.

Premiums vary in the program nationally to reflect partially differences in medical costs nationwide. Missouri, for example, has one of the highest monthly premiums – ranging from $423 to $972 a month. Only 101 Missouri residents have enrolled.

Many states were worried about not being able to meet the demand for coverage with limited federal funding. So 23 states and the District of Columbia opted to have HHS run the plan for them. HHS officials announced today that they will lower premiums by about 20 percent in 2011 and offer different cost/benefit options. HHS asked the other states to consider lowering their rates as well.

“We expect enrollment to grow and escalate,” said Richard Popper, director for the Office of Insurance Programs in HHS’ Office of Consumer Information and Insurance Oversight.

“There’s no question that lower prices make some difference,” said Michael Keough, executive director of the North Carolina Health Insurance Risk Pool. North Carolina, where rates start at $183 a month, has enrolled 513 people, tied with California for fourth highest in the nation.

Overall, the new federal Pre-existing Condition Insurance Plan has attracted far fewer uninsured people than anyone expected. About 8,000 people have enrolled nationally even though the Congressional Budget Office has estimated that as many as 4 million uninsured Americans would be eligible and that 200,000 would be enrolled by 2013.

To be eligible for the new program, you must have been uninsured for at least six months and have a pre-existing condition. Most states require applicants to show proof that they've been rejected for coverage by a private insurer within the past six months or been denied coverage for certain benefits.

The federal government is subsidizing the program with $5 billion until 2014 when the program ends. At that time insurers will no longer be able to discriminate based on a person's health status.


Keep in mind, these are rates for pre-existing conditions, which by default means a higher annual medical cost to whoever is footing the bill. These aren't plans for healthy 20-30 yr olds.


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PostPosted: Fri Nov 12, 2010 12:51 pm 
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Yeah, and add this as something to consider - the people that have been denied coverage are obviously very sick ... or at least the ones still alive are ... or they'd not be denied. I'm not sure how cost estimates will necessarily apply to their enrollment numbers. They could be totally broke for all I know. Or, they could have alternative assistance that might be compromised if they enrolled. I don't think the authors of this article are anxious to find out the answers to those questions though, given the premise of this piece.

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Last edited by Taskiss on Fri Nov 12, 2010 12:54 pm, edited 1 time in total.

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PostPosted: Fri Nov 12, 2010 12:52 pm 
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To add to what Ladas is saying, remember, those numbers don't include your employer paying part of it the way most of our plans' advertised rates probably account for.

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PostPosted: Fri Nov 12, 2010 12:54 pm 
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Taskiss wrote:
the people that have been denied coverage are obviously very sick

No.


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PostPosted: Fri Nov 12, 2010 12:57 pm 
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Ladas wrote:
Taskiss wrote:
the people that have been denied coverage are obviously very sick

No.

Uh huh, people who are totally healthy are being denied coverage for preexisting conditions.

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PostPosted: Fri Nov 12, 2010 1:04 pm 
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You can also be denied coverage for relatively minor complications that don't develop into more serious issues.

For example, the degree of issues with something such as spina bifida can range from severe to almost nothing. Yet, that simple diagnosis on the medical charts is sufficient to qualify for pre-existing conditions and impact ability to obtain life insurance and health insurance.

So, there is nothing "obvious" about it, nor does being denied coverage mean that someone is "very sick".


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PostPosted: Fri Nov 12, 2010 1:20 pm 
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Ladas wrote:
You can also be denied coverage for relatively minor complications that don't develop into more serious issues.

For example, the degree of issues with something such as spina bifida can range from severe to almost nothing. Yet, that simple diagnosis on the medical charts is sufficient to qualify for pre-existing conditions and impact ability to obtain life insurance and health insurance.

So, there is nothing "obvious" about it, nor does being denied coverage mean that someone is "very sick".

I'd call someone with spina bifida very sick in comparison to myself - someone who has had insignificant medical issues throughout his life. They're going to need regular visits to the doctor at any rate, from what I can tell.

People being denied coverage are done so because of the financial risk they pose to the medical insurance companies. Those companies are betting that if they're not sick, they will be, and they'll cost more than they are worth to them. That's what insurance is - I bet I will get sick, they bet I won't, and when they don't want to take that bet, they've typically canceled policies if they can.

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PostPosted: Fri Nov 12, 2010 1:41 pm 
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And you still haven't supported the most obvious meaning of your first comment.

Those being denied are not necessarily "obviously very sick". They might have a higher probability of developing costly medical issues, but its not guaranteed. There are plenty of conditions which might or might not make the individual very sick, but regardless of the specific diagnosis, the general category is sufficient to cause denial. For the specific ailment I used, your information is inadequate, unless you consider a yearly check up as part of a normal routine excessive, or out of the ordinary.

However, since you got closer to the truth with the second paragraph of that post, I'll drop it.


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PostPosted: Fri Nov 12, 2010 1:53 pm 
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In comparison to someone who's non-traumatic medical history is uneventful, I consider the average person who has a preexisting medical condition extensive enough to cause insurance companies to refuse to insure them an indication that they're "obviously very sick".

The "not very sick as far as anyone can tell" fall off one edge of that category, the "dead", the other.

Assuming the traditional bell curve such things usually follow, I'm good with the generalization. I'm even good with assuming a bell curve.

Now, if the premise of the issue being discussed was something specific I'd absolutely avoid generalizations, but that's not where this discussion originates.

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PostPosted: Fri Nov 12, 2010 2:13 pm 
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Arathain Kelvar wrote:
Quote:
Democrats think they know how to run the insurance industry better than the insurance industry


Misleading/inaccurate statement. They've said no such thing. Attempt to bias the reader.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
To judge by President Obama's rhetoric, the insurance industry's victims have been wandering the country like Okies in "The Grapes of Wrath."


Bias.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
ObamaCare's


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
ObamaCare


Bias. That is not the name of the bill. Misleading/inaccurate statement.

Quote:
A shelf of academic research says the same thing, by the way.


Neither obviously inaccurate nor biased, but unsubstantiated and unreferenced. Suspect.

Quote:
President's claims about a nation of the indigent sick denied insurance


Bias, and if I may say so, laying it on a little thick.

Quote:
This wouldn't be the first time that one government failure begat another.


Bias. If he were reporting facts, rather than trying to convey an opinion, this statement would have no place.

Quote:
annex a sixth of the economy


Quote:
The government didn't need to annex a sixth of the economy and create a multitrillion-dollar entitlement to help 8,011 people.


Misleading and inaccurate. This is not the goal of the entire bill. It is a component of it. In fact, according to whomever wrote this article, this portion of the bill is worth $5 billion. This is not 1/6 of the economy.


I disagree with most of your assessments here, but am choosing to not try to go through them item by item and explain why (I can if you so prefer).

Obamacare is accepted verbiage for this bill, the initial statement is a clear inference from the stated intentions of the bill, and "suspect" items being discounted is itself suspect without evidence.

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PostPosted: Fri Nov 12, 2010 2:40 pm 
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DFK! wrote:
Obamacare is accepted verbiage for this bill


Only by people who absolutely hate it.


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PostPosted: Fri Nov 12, 2010 2:41 pm 
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NPR calls it Obamacare all the time.

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PostPosted: Fri Nov 12, 2010 2:44 pm 
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Khross wrote:
NPR calls it Obamacare all the time.


I've never heard that. Some of their guests have, but I don't recall hearing any of their news personalities refer to it that way.


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PostPosted: Fri Nov 12, 2010 2:47 pm 
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DFK! wrote:
Obamacare is accepted verbiage for this bill, the initial statement is a clear inference from the stated intentions of the bill, and "suspect" items being discounted is itself suspect without evidence.


It's not "accepted". It's a loaded term.

Regardless, the big one is this one:

Quote:
Quote:
The government didn't need to annex a sixth of the economy and create a multitrillion-dollar entitlement to help 8,011 people.

Misleading and inaccurate. This is not the goal of the entire bill. It is a component of it. In fact, according to whomever wrote this article, this portion of the bill is worth $5 billion. This is not 1/6 of the economy.


Are you going to argue that this is not misleading and is perfectly accurate?


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