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	<title>Comments on: A Private Health Insurance Death Spiral Will Begin on September 23</title>
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	<description>Health Care Policy and Reform Insights &#124; NCPA</description>
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		<title>By: John R. Graham</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-59205</link>
		<dc:creator>John R. Graham</dc:creator>
		<pubDate>Thu, 08 Apr 2010 21:08:07 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-59205</guid>
		<description>Joe S.:

Insurers have accepted the proposal of government-dictated comparative effectiveness because it will allow them to escape responsibility of deciding what treatments to pay for and all the hassle of appeals and other mechanisms of consumer protection.  Much easier to simply process claims according to a government template and avoid any liability.  So, I think you are right.

Whether this will protect them a few years down the road when the single-payer extremists point out that they are adding no value in exchange for skimming their percentage off the top of ObamaCare, I highly doubt.  Look at the evolution of the government&#039;s student-loan take-over.

Bart Ingles:

The video didn&#039;t tell us a lot about Mr. Effington, but it was clear that he was a dependent on his parents&#039; employer-based group coverage.  Therefore he had HIPAA protection.

Paul:

The Secretary will have the power to fix premiums.  If she decides to drive all insurers out of business she can do it with the stroke of a pen, using her entirely arbitrary and unaccountable power under this law.</description>
		<content:encoded><![CDATA[<p>Joe S.:</p>
<p>Insurers have accepted the proposal of government-dictated comparative effectiveness because it will allow them to escape responsibility of deciding what treatments to pay for and all the hassle of appeals and other mechanisms of consumer protection.  Much easier to simply process claims according to a government template and avoid any liability.  So, I think you are right.</p>
<p>Whether this will protect them a few years down the road when the single-payer extremists point out that they are adding no value in exchange for skimming their percentage off the top of ObamaCare, I highly doubt.  Look at the evolution of the government&#8217;s student-loan take-over.</p>
<p>Bart Ingles:</p>
<p>The video didn&#8217;t tell us a lot about Mr. Effington, but it was clear that he was a dependent on his parents&#8217; employer-based group coverage.  Therefore he had HIPAA protection.</p>
<p>Paul:</p>
<p>The Secretary will have the power to fix premiums.  If she decides to drive all insurers out of business she can do it with the stroke of a pen, using her entirely arbitrary and unaccountable power under this law.</p>
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		<title>By: Virginia</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58808</link>
		<dc:creator>Virginia</dc:creator>
		<pubDate>Thu, 08 Apr 2010 02:43:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58808</guid>
		<description>I agree with Devon.  In ten years, we&#039;ll be rallying to &quot;fix the system&quot; again.</description>
		<content:encoded><![CDATA[<p>I agree with Devon.  In ten years, we&#8217;ll be rallying to &#8220;fix the system&#8221; again.</p>
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		<title>By: paul</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58781</link>
		<dc:creator>paul</dc:creator>
		<pubDate>Thu, 08 Apr 2010 00:41:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58781</guid>
		<description>Will employers be able to charge for adult dependents on the plan?

says &#039;The legislation leaves it to the U.S. Health and Human Services Department to define what “dependent” means, as well as whether and how employers can charge extra for the benefit, Abbott said.&#039;

Have they defined this yet?</description>
		<content:encoded><![CDATA[<p>Will employers be able to charge for adult dependents on the plan?</p>
<p>says &#8216;The legislation leaves it to the U.S. Health and Human Services Department to define what “dependent” means, as well as whether and how employers can charge extra for the benefit, Abbott said.&#8217;</p>
<p>Have they defined this yet?</p>
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		<title>By: Bart Ingles</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58661</link>
		<dc:creator>Bart Ingles</dc:creator>
		<pubDate>Wed, 07 Apr 2010 19:58:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58661</guid>
		<description>Correct me if I&#039;m wrong, but it was my understanding that to be eligible for HIPAA coverage, the creditable coverage must be with a qualified group plan.  If young Mr. Effington(?) had been on an individual plan, he wouldn&#039;t have qualified for HIPAA coverage but presumably could have stayed with his existing individual plan.

A couple of alternatives to reality-by-fiat might have been to extend the existing child mandate limit one year at a time until it equals 26.  Or, failing that, to at least set an enrollment window, say from September 23 to November 23, after which creditable coverage requirements begin to apply.</description>
		<content:encoded><![CDATA[<p>Correct me if I&#8217;m wrong, but it was my understanding that to be eligible for HIPAA coverage, the creditable coverage must be with a qualified group plan.  If young Mr. Effington(?) had been on an individual plan, he wouldn&#8217;t have qualified for HIPAA coverage but presumably could have stayed with his existing individual plan.</p>
<p>A couple of alternatives to reality-by-fiat might have been to extend the existing child mandate limit one year at a time until it equals 26.  Or, failing that, to at least set an enrollment window, say from September 23 to November 23, after which creditable coverage requirements begin to apply.</p>
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		<title>By: Elsie</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58546</link>
		<dc:creator>Elsie</dc:creator>
		<pubDate>Wed, 07 Apr 2010 15:43:18 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58546</guid>
		<description>Obama Care is complicated and unworkable.  It is going to have an avalanch of unintended consequences that will create choas.  Repeal it now.  Our present system has flaws.  Let the companies get together and take care of the truly just health care features requested in Obama care...but let the companies do it....not the government.  Then have a Commission supported by all the health care companies to which anyone with a problem with any of the companies can go to get an unbiased and fair solution to the problem.  Sometimes it is the error of companies not taking responsibility and sometimes it is the error of individual not being responsible that causes the problem.  With open competiton, the private sector will meet the needs of its customers....if not....they go out of business!! 

There was no need to destroy a good system to which 80% of the people were satisfied.  Medicaid was working fine as the safety net for those who could not afford health insurance. The government must stop using the &quot;emotional element&quot; to replace rational clear solutions to peoples problems when dealing with the health insurance companies and responsibility issues. Government, get out of the way and let private industry attract customers by the services they offer for a price.  Competition will determine which are good for the people and which are not.</description>
		<content:encoded><![CDATA[<p>Obama Care is complicated and unworkable.  It is going to have an avalanch of unintended consequences that will create choas.  Repeal it now.  Our present system has flaws.  Let the companies get together and take care of the truly just health care features requested in Obama care&#8230;but let the companies do it&#8230;.not the government.  Then have a Commission supported by all the health care companies to which anyone with a problem with any of the companies can go to get an unbiased and fair solution to the problem.  Sometimes it is the error of companies not taking responsibility and sometimes it is the error of individual not being responsible that causes the problem.  With open competiton, the private sector will meet the needs of its customers&#8230;.if not&#8230;.they go out of business!! </p>
<p>There was no need to destroy a good system to which 80% of the people were satisfied.  Medicaid was working fine as the safety net for those who could not afford health insurance. The government must stop using the &#8220;emotional element&#8221; to replace rational clear solutions to peoples problems when dealing with the health insurance companies and responsibility issues. Government, get out of the way and let private industry attract customers by the services they offer for a price.  Competition will determine which are good for the people and which are not.</p>
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		<title>By: Tom H.</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58525</link>
		<dc:creator>Tom H.</dc:creator>
		<pubDate>Wed, 07 Apr 2010 14:42:36 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58525</guid>
		<description>The IRS claimed yesterday that they are not really planning to enforce the mandate. That will virtually guarantee a death spiral.</description>
		<content:encoded><![CDATA[<p>The IRS claimed yesterday that they are not really planning to enforce the mandate. That will virtually guarantee a death spiral.</p>
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		<title>By: Joe S.</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58504</link>
		<dc:creator>Joe S.</dc:creator>
		<pubDate>Wed, 07 Apr 2010 14:01:03 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58504</guid>
		<description>One thing you may be overlooking, John. Will insurers be able to ration care, under cover of comparative effectivenees or with really low provider payment rates?

If so, they may try to stop the death spiral that way.</description>
		<content:encoded><![CDATA[<p>One thing you may be overlooking, John. Will insurers be able to ration care, under cover of comparative effectivenees or with really low provider payment rates?</p>
<p>If so, they may try to stop the death spiral that way.</p>
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		<title>By: Devon Herrick</title>
		<link>http://healthblog.ncpa.org/a-private-health-insurance-death-spiral-will-begin-on-september-23/comment-page-1/#comment-58503</link>
		<dc:creator>Devon Herrick</dc:creator>
		<pubDate>Wed, 07 Apr 2010 13:59:41 +0000</pubDate>
		<guid isPermaLink="false">http://www.john-goodman-blog.com/?p=9897#comment-58503</guid>
		<description>ObamaCare will only last for a limited duration before it collapses under the weight of inappropriate incentives.  A decade from now history will repeat itself when pundits (again) begin to clamor for reform. Next time the &quot;public plan option&quot; (e.g. a single-payer plan such as Medicare for All) could get more traction after liberals claim they tried private coverage options but it didn&#039;t work. 

The government current funds about half of health expenditure (60% if you include the tax expenditure from employee health plans).  New public subsidies will put government health care spending care on par with countries that are recognized as having socialized medicine.

Assertions that the reform legislation amounts to a government takeover of health care is not  rhetoric.  ObamaCare is another step towards a system like they have in Britain where the wealthy have private coverage and everyone else makes due with a substandard public plan.</description>
		<content:encoded><![CDATA[<p>ObamaCare will only last for a limited duration before it collapses under the weight of inappropriate incentives.  A decade from now history will repeat itself when pundits (again) begin to clamor for reform. Next time the &#8220;public plan option&#8221; (e.g. a single-payer plan such as Medicare for All) could get more traction after liberals claim they tried private coverage options but it didn&#8217;t work. </p>
<p>The government current funds about half of health expenditure (60% if you include the tax expenditure from employee health plans).  New public subsidies will put government health care spending care on par with countries that are recognized as having socialized medicine.</p>
<p>Assertions that the reform legislation amounts to a government takeover of health care is not  rhetoric.  ObamaCare is another step towards a system like they have in Britain where the wealthy have private coverage and everyone else makes due with a substandard public plan.</p>
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