Health Care 2011

Discussion in 'Politics' started by Industrialsize, Dec 31, 2010.

  1. Industrialsize

    Staff Member Moderator Gold Member

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    • Provisons of the Health Care Law that go into effect at Midnight.
    • Minimum Medical Loss Ratio for Insurers Requires health plans to report the proportion of premium dollars spent on clinical services, quality, and other costs and provide rebates to consumers if the share of the premium spent on clinical services and quality is less than 85% for plans in the large group market and 80% for plans in the individual and small group markets.
      Implementation: Requirement to report medical loss ratio effective for 2010; requirement to provide rebates effective beginningJanuary 1, 2011
    • Closing the Medicare Drug Coverage Gap Requires pharmaceutical manufacturers to provide a 50% discount on brand-name prescriptions filled in the Medicare Part D coverage gap beginning in 2011 and begins phasing-in federal subsidies for generic prescriptions filled in the Medicare Part D coverage gap.
      Implementation: January 1, 2011
    • Medicare Payments for Primary Care Provides a 10% Medicare bonus payment for primary care services; also, provides a 10% Medicare bonus payment to general surgeons practicing in health professional shortage areas.
      Implementation: January 1, 2011 through December 31, 2015
    • Medicare Prevention Benefits Eliminates cost-sharing for Medicare-covered preventive services that are recommended (rated A or B) by the U.S. Preventive Services Task Force and waives the Medicare deductible for colorectal cancer screening tests; authorizes Medicare coverage for a personalized prevention plan, including a comprehensive health risk assessment.
      Implementation: January 1, 2011
    • Center for Medicare and Medicaid Innovation Creates the Center for Medicare and Medicaid Innovation to test new payment and delivery system models that reduce costs while maintaining or improving quality.
      Implementation: Center established by January 1, 2011
    • Medicare Premiums for Higher-Income Beneficiaries Freezes the income threshold for income-related Medicare Part B premiums for 2011 through 2019 at 2010 levels resulting in more people paying income-related premiums, and reduces the Medicare Part D premium subsidy for those with incomes above $85,000/individual and $170,000/couple.
      Implementation: January 1, 2011
    • Medicare Advantage Payment Changes Restructures payments to private Medicare Advantage plans by phasing-in payments set at increasingly smaller percentages of Medicare fee-for-service rates; freezes 2011 payments at 2010 levels; and prohibits Medicare Advantage plans from imposing higher cost-sharing requirements for some Medicare covered benefits than is required under the traditional fee-for-service program.
      Implementation: January 1, 2011
    • Medicaid Health Homes Creates a new Medicaid state option to permit certain Medicaid enrollees to designate a provider as a health home and provides states taking up the option with 90% federal matching payments for two years for health home-related services.
      Implementation: January 1, 2011
    • Chronic Disease Prevention in Medicaid Provides 3-year grants to states to develop programs to provide Medicaid enrollees with incentives to participate in comprehensive health lifestyle programs and meet certain health behavior targets.
      Implementation: January 1, 2011
    • CLASS Program Establishes a national, voluntary insurance program for purchasing community living assistance services and supports (CLASS program).
      Implementation: January 1, 2011
    • National Quality Strategy Requires the Secretary of the federal Department of Health and Human Services to develop and update annually a national quality improvement strategy that includes priorities to improve the delivery of health care services, patient health outcomes, and population health.
      Implementation: Initial strategy due to Congress by January 1, 2011
    • Changes to Tax-Free Savings Accounts Excludes the costs for over-the-counter drugs not prescribed by a doctor from being reimbursed through a Health Reimbursement Account or health Flexible Spending Account and from being reimbursed on a tax-free basis through a Health Savings Account or Archer Medical Savings Account. Increases the tax on distributions from a health savings account or an Archer MSA that are not used for qualified medical expenses to 20% of the amount used.
      Implementation: January 1, 2011
    • Grants to Establish Wellness Programs Provides grants for up to five years to small employers that establish wellness programs.
      Implementation: Funding authorized beginning in fiscal year 2011
    • Teaching Health Centers Establishes Teaching Health Centers and provides payments for primary care residency programs in community-based ambulatory patient care centers.
      Implementation: Funding appropriated for five years beginning in fiscal year 2011
    • Medical Malpractice Grants Authorizes $50 million for five-year demonstration grants to states to develop, implement, and evaluate alternatives to current tort litigations.
      Implementation: Authorizes funding beginning fiscal year 2011
    • Funding for Health Insurance Exchanges Provides grants to states to begin planning for the establishment of American Health Benefit Exchanges and Small Business Health Options Program Exchanges, which facilitate the purchase of insurance by individuals and small employers.
      Implementation: Grants awarded starting March 23, 2011; enrollment in Exchanges begins January 1, 2014
    • Nutritional Labeling Requires disclosure of the nutritional content of standard menu items at chain restaurants and food sold from vending machines.
      Implementation: By March 23, 2011
    • Medicaid Payments for Hospital-Acquired Infections Prohibits federal payments to states for Medicaid services related to certain hospital-acquired infections.
      Implementation: July 1, 2011
    • Graduate Medical Education Increases the number of Graduate Medical Education (GME) training positions by redistributing currently unused slots and promotes training in outpatient settings.
      Implementation: July 1, 2010
    • Medicare Independent Payment Advisory Board Establishes an Independent Advisory Board, comprised of 15 members, to submit legislative proposals containing recommendations to reduce the per capita rate of growth in Medicare spending if spending exceeds targeted growth rates.
      Implementation: Funding available October 1, 2011; first recommendations due January 15, 2014
    • Medicaid Long-Term Care Services
     
    #1 Industrialsize, Dec 31, 2010
    Last edited: Dec 31, 2010
  2. Speculator

    Speculator New Member

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    yawn. You'll still have crap healthcare.
     
  3. houtx48

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    It's better than before, which was none.
     
  4. B_Marius567

    B_Marius567 New Member

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    I have healthcare at work takes 15.00 a week out of my pay check for it and it may go up this year with new healthcare laws :(
     
    #4 B_Marius567, Jan 1, 2011
    Last edited: Jan 1, 2011
  5. Industrialsize

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    You've got to be kidding if you're looking for sympathy that you pay n60 dollars a month for health insurance. I have to BUY my health insurance and pay 820 dollars a month plus a 25 dollar copay for doctor's visits, 500 dollar copay for an ER visit and 1000 dollar copay for and in patient hospital stay. PLUS I pay 160 dollars a month in copays for prescription meds that I take.
     
  6. Who_Dun_It

    Who_Dun_It New Member

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    At least you guys have people willing to sell you insurance.
     
  7. Industrialsize

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    It's because I live in Massachusetts. It is against the law in this State to deny coverage because of pre-existing conditions. They can't even ask if you have them. This provision will kick in on a National basis for everyone in 2014.
     
  8. houtx48

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    back when i could still buy it it was 800 a month........ have not priced it now but need to now that I can not be denied coverage........ I have a thing about it being called insurance. Insurance is something you are not suppose to use where as everybody uses the health care system.
     
  9. nudeyorker

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    Thanks for posting, I'll read the new laws more carefully when I have more time. This post made me take a step back and look at my own plan with a new perspective. My health insurance is $6,000.00 a year for medical and dental and I have a $10.00 copay for office visits and $15.00 for prescriptions, everything else is covered 100%. I was just bitching that it went up to $7,000.00 for 2011... I'm going to shut up and count my blessings.
     
  10. JTalbain

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    This reminds me of trying to talk about the high cost of healthcare with my parents. It was quite frustrating, because my Dad is ex-military so they both have TriCare Prime, which is retarded good health coverage. He didn't understand that most people don't have anywhere near that good. Wasn't until I pointed out that my friend's son had troubles that would have cost my father about 5000 dollars total, but put my friend in debt over 200k AFTER his insurance that he started to get the picture.
     
  11. midlifebear

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    Again, the whole reason (well, most of it) why I can not afford to live in the USA. Recently had a lesion removed from my right butt cheek that, with pre lab, the cost of the operation, and the looming possibility of needing both chemo and radiation therapy for 6 to 8 weeks -- all costing me less than US2,000 of which the Government of Spain will eventually reimburse for most of when I file taxes. I'm having all this work done in Argentina where health care is not exactly free, but it does not remotely cost what a doctor's visit costs in the USA. It's just much easier climbing aboard and Iberia flight to and from Spain and ignoring the USA altogether. Thank the powers of the universe that fell into place allowing me to have Spanish Residency!

    Industrialsize should not have to pay so much money for insurance. It's a rip off. I'm sure, even though he does live in Mass., the minute he really needs to use his insurance his insurance company will find many creative ways to create hell in his life and refuse benefits.
     
    #11 midlifebear, Jan 1, 2011
    Last edited: Jan 1, 2011
  12. Speculator

    Speculator New Member

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    That is not an insurance issue, it's to do with the cost of healthcare. If the health industry is able to charge $200k after basic cover has been exhausted then something is going seriously wrong in the sector. They shouldn't be able to charge those sorts of sums; it's frankly disgusting. But that's what happens in highly regulated government licenced industries, they hinder the competition that would reduce prices.
     
  13. Speculator

    Speculator New Member

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    As you say, surely it's cheaper to just hop on a plane and travel the globe for quite a few surgical procedures. This may not be suitable for everything, but if you're paying $200k plus it's worth considering all your options. That's a lifetime's investment for most people.
     
    #13 Speculator, Jan 1, 2011
    Last edited: Jan 1, 2011
  14. midlifebear

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    Dear Chuckles . . . er, Speculator:

    Insurance isn't as "heavily" regulated in the USA as you imagine. In fact, health insurers have usually written their own ticket in that country, with few exceptions. I think you're confusing Humana, Blue Cross/Blue Shield, Kaiser, and the rest with your heavily regulated national health care in the UK. At least in the UK you don't have to file for bankruptcy after having been treated for breast cancer, lymphoma, lupus, or a bunch of chronic conditions that have nothing to do with one's life-style choices.

    If you think deregulation is such a swell idea and the free market competition is best and doesn't hinder businesses for underbidding one another, come to the USA and be sure to fly here on only USA-based airlines. I'm sure you'll be thrilled with the delays, problems with aviation safety, and being treated as less than human by employees that use to say silly things such as "I'm United. Fly me!" And be sure that you stand only 5'9" (max) and weigh less than 150 lbs, otherwise you'll find the seats on those planes a bit small. LOL!

    Oh, and in the spirit of economic competition, you'll need to have lots of cash or credit cards to pay for your luggage, which may or may not make it along with you on any given flight. LMAO! :biggrin1:
     
  15. Speculator

    Speculator New Member

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    It's a shame the socialist paradises you admire have a tendency to collapse into tyranny and chaos, the EU and the U.S are suffering the same fate the more government nationalises and get's its tentacles into every aspect of our lives.

    I really don't understand the mentality of people that want to be told what to do by central government, are you a sadomasochist? If you are then fine, but don't try and drag me down into your warped world view.
     
    #15 Speculator, Jan 1, 2011
    Last edited: Jan 1, 2011
  16. B_VinylBoy

    B_VinylBoy New Member

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    Wow... equating some form of government regulation with seeking out sexual pleasure through the infliction or submission of physical or emotional abuse. What a way to start the New Year. :rolleyes:
     
  17. Speculator

    Speculator New Member

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    Pretty much the same thing, you want other people to make up the rules and tell you how you can live your life.

    I feel a bit like Jesus around here sometimes, my message is one of peace, tolerance and freedom - just do your own thing as long as you're not harming others - and the reaction towards me is often violent.

    I don't think I'll ever really understand human nature.
     
  18. B_VinylBoy

    B_VinylBoy New Member

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    Bullshit. Because even in a "free market" someone with more capital and control is making the rules and are dictating how you live your life. Unless you plan to be your own doctor, self diagnose and administer your own health care (and procedures) out of your own pocket, you're always playing by someone else's rules. At least a government can invoke a standard that can protect certain kinds of consumers that really need the assistance. With a truly "free market", the people with the money can dream up any form of test, based on actual medical science or not, to grant or deny you treatment. I don't know about you, but I don't think having an insurance company deny you health care because some overweight, heart-attack prone guy who sits on a chair made up of $100 bills thinks you look healthy enough to stand is an ideal system. Nor would I ever want to see an undeserving person suffer while a doctor sits by idle with the tools necessary to save their life, all because someone's debit or credit card doesn't process a payment due to a faulty magnetic stripe.

    You're too caught up on false images that can be easily conjured up by mere buzzword terminology (ooooh, it's "free"... that MUST mean it's better), and place a staggering amount of overvalue on the money that exist in your own pockets.

    There are many other things you clearly don't understand either... sadly, you're too caught up in your image of self-imposed divinity to figure it out. BTW, when you're implying to others who are clearly more versed on these issues as uneducated and gets off on torture, the last thing you're trying to spread is "peace, tolerance and freedom". I'd advise you keep your day job because you don't wear the title of "Messiah" too well. :rolleyes:
     
    #18 B_VinylBoy, Jan 1, 2011
    Last edited: Jan 1, 2011
  19. Speculator

    Speculator New Member

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    Within a system of all encompassing government monopoly if for one reason or another you don't get the treatment/resources you need (yes it happens!) you're totally screwed, there was one option available and it's been shut in your face.

    A free market removes this unnecessary restriction and allows a plurality to thrive, if one provider doesn't want to treat you for any reason they'll be a number of others ready and willing to take his place.

    These are basic concepts, I don't understand why you have such a hard time grasping them; the threat of being replaced by somebody else encourages capitalists to keep their prices in check. This is how a free market works and why it's so successful at delivering people with the goods and services they need.

    btw, this isn't about the public sector vs the private sector; it's about the removal of coercive monopolies. In some situations I believe that public ownership may be the least worst option, but that doesn't apply to healthcare which is an industry ideal for free market competition.
     
    #19 Speculator, Jan 1, 2011
    Last edited: Jan 1, 2011
  20. sargon20

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    And where has that worked out?
     
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