Healthcare Consumers Wake Up-Patient Bill of Rights Now In Effect

The goal of this Bill of Rights is to drive up your premiums so you beg Obama to take over ObamaScare completely and enact a single payer system, i.e., total government run healthcare.

Sounds Like a Quote from Rev Jim Jones

Today marks the start of the ObamaScare’s (I know I changed the spelling) “Patient Bill of “Rights”.  This should be more appropriately be named:  “How to drive health care premiums through the roof so we can blame the insurance companies for increasing premiums so we can get to a single payer system faster…”  

Government ran healthcare is the STATED goal of the President, have no doubt about it.  He hates insurance companies, the State’s ability to regulate the insurance companies, and he wants total control over the system so he can regulate and control every single facet of your life.  Period!  he even has Michelle going around selecting what you are going to eat.  

Below are the main points covered in the new Patient Bill of Rights under what is called the “Affordable Care Act”  Before we begin, let’s get one point on the table.  Insurance companies have to play a game of probability and apply the probable liabilities against their total insured base of clients.   

See if this helps:  

1)       An Insurance Company has 100 clients2)      They charge each client $10/month for current coverage and co-pays before ObamaScare which means they take in $1,000/month or $12,000Year.  3)      Assume that ObamaScare tells the insurance company that they cannot charge a co-pay for an annual physical.  Assume an annual physical’s co-pay is $5.00 per physical.  Assume the probability that 75% of their clients will take advantage of no co-pay for a physical.  This would cost the insurance company, YOU, $375/year since they no longer receive a co-pay for the physical.4)      Net:  The Insurance Company was receiving $12,000/year but now receives $375 less than they were before ObamaScare enacted no co-pays.  This is about a 3% rise in the insurance company costs which YOU WILL HAVE TO SHARE with the others in your policy pool.  THIS IS WHY YOUR PREMIUMS ARE GOING THROUGH THE ROOF.  It is even worse for those poor smucks, the 25% who do not get annual physicals, since their premiums will go up to help cover your cost for your physical.  

The President comes off looking like a great guy while sticking it to you via your insurance company who you now hate! 

Ever heard of Bait and Switch….?

Here is your New Patient Bill of Rights:  

1.  Adult children up to age 26 will be able to receive dependent coverage.

Insurance companies now have to cover “Adult Children”, up to 26 (who came up with that term?  Thought this was just an immature grown-up).  Why not forever? How about 46?  So, regardless of whether those Adult Children are model citizens, drug addicts, drive race cars, go bungee jumping, are in the military and covered by the military or VA, in college and now covered by an inexpensive college health care plan or they wrestle alligators, they are now thrown into your insurance pool of covered clients.  They can have any disease known to man including HIV, stage 4 cancer, or suffer from the Ebola virus and they are now in your insurance pool of covered clients.  Remember the example above; you are paying for those Adult Children even if you don’t have any Adult Children!  The insurance company has to factor these risks into their total potential plan costs and collect from each of us.  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him  

2.  Lifetime limits on the dollar value of insurance coverage are now prohibited.

This is a dandy.  If you are in a plan that has a $1,000,000 lifetime cap on medical care, your plans, and the client pool’s, premium are based on the fact that the insurance company will never have to pay out more than $1,000,000 to any single client in the pool.  THIS MEANS THEY CAN PREDICT THEIR, YOUR, COSTS.  Without the limits, the insurance company now has to analyze what the potential total costs could be for those in your policy pool.  It is certainly more than when they had the $1,000,000 cap.  Therefore, your premiums will go up along with everyone else in your plan, period.   

If you are a health conscious individual, you exercise daily, and you are a non smoker, you are going to be thrown in with the 400 pound, Big Mac gobbling 3 pack a day smoker, and share in the risk of covering Mr. Big Mac!  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him.   

3.  New restrictions are placed on annual limits for coverage and limits will no longer be allowed at all by 2014.

Same issues as with the Lifetime Limits.  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him.  

4.  Insurance companies can no longer exclude children from coverage due to pre-existing conditions.   

This sounds like a tear jerker and it is in many, many cases.  But, the question is, “Should this tragedy be the responsibility of every person who is in an insurance policy pool or should this be taken care of in another manner?”  What ObamaScare is doing, is making this YOUR responsibility and hiding the cost for this in YOUR Premiums then blaming the insurance companies for raising Your Healthcare Costs…  We need a national debate on these types of issues.     a)  In the past, a lot of special care needs for children, adults and the elderly was taken care of by private philanthropic sponsored organizations such as the Shriner’s Hospitals, Catholic Charities, St. Jude’s Hospitals etc.  Is this a better way?     b)  If the government, i.e. “We the People”, believe that these children should be taken care of, and all of us do, should this be a special government or quasi-government program that is funded and can be audited so we can get transparency on the effectiveness of the program?  

The worst way to handle these types of special circumstances is to allow Obama to create yet another hidden, UNFUNDED MANDATE, on you so he can blame the insurance companies for higher premiums so you hate the very people that are really trying to help you manage your healthcare costs.  Remember our example, these cases may have been excluded from your insurance pool before or the policy holder may have been subject to a surcharge for the pre-existing condition.  Now, you are going to pay part of their bills through your premiums.  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him.   

5.  Insurance companies can no longer charge co-pays for preventative care, like annual check ups and immunizations.

Do you think that the $5.00, $10.00 or $20.00 costs that are absorbed by the co-pay merely disappears because the great Obama has eliminated the opportunity of the insurance company to collect a co-pay?  CO-PAYS ARE A SLIGHT OFFSET TO COSTS BASED ON USE.  IF YOU DON’T HAVE AN OFFICE VISIT, THERE IS NO CO-PAY.  IF YOU DO HAVE AN OFFICE VISIT, THERE IS A CO-PAY.    The Czarina of ObamaScare, Catherine Sebelius is still defining the items that will ultimately be included in “Preventative Care”.  The definitions may not only tell you what is included in preventative care but also what is PERMITTED and the FREQUENCY of the Procedure.    Included care:  Could include an annual physical (what is the definition of this procedure?), an “Apple”, an aspirin for heart patients, yoga classes for those requiring a ZEN boost, etc.!  It will be defined by someone you did not elect nor may not agree with at all but you will have no recourse.   Excluded or Regulated care:  This is the scary part!  Annual Mammograms after age 40 may now be included in your insurance plan, with a co-pay, but the Czarina may decide that that you only get one every 5 years after age 60.  If you are in a high risk family, the $5.00 co-pay may be a very good investment for you but the Czarina says you cannot have one…  Remember, Medicare denies a higher percentage of claims than any other “insurance provider”.  Why, the government has to cut costs somewhere.  You are a mere statistic to them unless they can parade you out in front of the Whitehouse as a prop for a press conference.  You may not have a co-pay for a mammogram, but you may get cancer before your next one!  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him.   

6.  Insurance companies cannot cancel coverage, unless the policy holder commits fraud.    

This sounds very innocuous and begs the question why would we not want the mean old insurance companies not to be able to cancel our coverage unless we commit fraud?  As President Clinton said, “depends on what the definition of is is.”  What is the definition of fraud?  It is a legal term and that may not be the same as our day to day use.  The application of this term will be broadened and allow the almost nothing to be construed as fraud so there will be almost no act by the policy holder or applicant that would be considered a cancellable act.  Once again, insurance companies will have to factor in how many people will leave pertinent information off of applications or outright lie about themselves and their lifestyles.  There is a cost for covering this unknown and YOU will pay it via your premiums.  The insurance company will raise, probably already has, your premiums, Obama will tell you they are just gouging you, you will hate the insurance company, and Obama hopes you will love him.                 Over 60% of the American people “get it” when it comes to ObamaScare.  They know it is a sham but what they may not realize that the escalating costs of healthcare in the US has been almost solely due to government meddling over the past 50 years.  They call it reform and regulation.  I call it UNFUNDED MANDATES.

-No Denial of Care in Emergency Rooms:  This is a government mandate that is UNFUNDED.  Your local hospital and doctors pick up the tab and pass the costs to you via YOUR INSURANCE and it is not only allowed, but mandated, by your government. Free services also apply to illegal aliens. Government creates the problem then rides in and fixes the problem they created.

-Hate HMOs?:  HMOs were a creation of Ted Kennedy.  These were not thought up by Insurance Companies but by your wonderful government.  All of the referrals, lack of choice of providers (doctors, hospitals, labs) are all part of the regulation.  Government creates the problem then rides in and fixes the problem they created.

-Medicare Reimbursement Model:  When Medicare was first enacted in 1965 via the Social Security Act of 1965, by LBJ, the little people in the regulation closets in Washington DC got to define the system by which a provider, hospital, doctor etc would be reimbursed.  They created fee structures, amortization rules, etc.  These same reimbursement guidelines are also followed to a large degree by insurance companies.  The amount of payment discounts are lower for private insurance versus Medicare, but the overall cost structure is the same.  After Medicare was enacted, HEALTH CARE COSTS WENT UP SIGNIFICANTLY as the government uncovered the true cost of healthcare via their regulatory audits.  In fact, most the increase costs were due to the way capital cost amortization was created.  This allows for rapid write offs for MRI machines that can be passed through in increased fees whereas hospital improvements in administrative systems cannot.  Thus, in the US we have the highest density of MRI machines, not necessarily bad, but some of the worst patient record and hospital administrative systems around.  Government creates the problem then rides in and fixes the problem they created.

-FDA:  The food and drug administration regulates everything in healthcare from pharmaceuticals to the radiation output of MRIs.  They have the right to allow a new product to be used in the US or deny it.  BUT THEY HAVE NO RESPONSIBILITY FOR ANY OF THE PRODUCT LIABILITY.  If they approve of a drug and someone dies using it, there is no limit on the liability of the Drug Company but there is no liability on the government side at.  This raises the cost of every single prescription drug that you buy substantially.  The other mission of the FDA for Medicare today, which will certainly be expanded under ObamaScare, is the denial of the use of a product if it becomes too expensive or it is only used to prolong a patient’s life for a few months at the end of life.  This is not the death panel but a way to steer a lot of medical decisions to the regulators at the FDA.  Congress and the President can, of course, deny any culpability.

     All 4 of the points above created UNFUNDED MANDATES on someone that ultimately ended up being paid by you either directly, through taxes, or most likely through INCREASED INSURANCE PREMIUMS.   

-Emergency room non billable service costs are passed onto those who can pay or have insurance.

-HMOs have spawned the creation of third party administrative support organizations such as Hill Physicians and others to be the go between doctors, hospitals, and labs and the patients and the insurance company.  This has increased the costs of insurance due to mandated layers of bureaucracy.  Medicare billing is a nightmare and the only ones who have figured it out are inmates in prisons who have found Medicare a way to fund their cigarette habits!  (this actually happened)

-Medicare discounted fees to providers are “paid” by the doctors and facilities who are taking it in the shorts by treating Medicare and Medicaid patients (the latter’s discounts are even higher). 

-FDA increases our insurance premiums by forcing outdated testing practices for new drugs, forcing elongated trial periods beyond those in other advanced countries, not having any liability responsibility for any of its actions, denying the use of a pharmaceutical treatment and forcing the use of a less effective and more expensive mechanical (surgical) procedure. 

-These all raise your costs and the costs of healthcare overall.  I am not in love with Insurance Companies but they only average 3-5% annual net profits.  They need to get their story out or the only one you will hear is the one from the ObamaScare story tellers…   

RD Pierini

One thought on “Healthcare Consumers Wake Up-Patient Bill of Rights Now In Effect”

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