Defining Essential Health Benefits
http://thedianerehmshow.org/shows/2012-01-03/defining-essential-health-benefits
Under the new health care law, private insurance companies must offer a package of “essential health benefits” to consumers by 2014. Facing strong Republican opposition to the new law, the Obama administration said last month it would give states the power to decide which essential benefits are covered. Consumer advocates worry that states will select plans that don’t cover enough basic services while business groups fear the states will pick the most expensive plans. Diane and guests will explore what the latest decision means for consumer choice and health care quality.
Guests
Joseph Antos
Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute
Judy Feder
Urban Institute fellow; professor and former dean, Georgetown Public Policy Institute
Julie Appleby
senior correspondent, Kaiser Health News
Joy Johnson Wilson
Health Policy Director and Senior Federal Affairs Counsel,
National Conference of State Legislatures
Comments
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To all the folks who insist that they won't pay for insurance mandated by this new plan and will cover all of their med costs out of pocket, I say, please think a bit. Last year, I too was healthy, until I got what I thought was the flu that was circulating in our area. Unfortunately, it wasn't the flu, but appendicitis; while I was taking aspirin, drinking fluids and resting, my appendix was getting worse and worse until it ruptured. After 8 days of round-the-clock treatment, several cat scans, and surgery, my bills came to almost $70,000. I was fortunate to have decent medical insurance and we still had to pay $6,500 out of pocket. Without this care, I would have died. I was 49 at the time. If you think that you're somehow exempt from needing major medical care because you haven't needed it in the past, are you really willing to bet you're life on that? Please recognize that life-threatening health issues can strike any of us, and we should all have access to life saving care if needed. Obama's health plan as is exists now is far from perfect, but we have to start somewhere.
bathberne: Thanks for taking your time to report the unvarnished truth, and you were a lucky one this time. Good luck and good health.
Unfortunately I only caught a bit of this show, the part where an uninsured man was called a freeloader. I am also uninsured, I live on about $12,000/yr but don't qualify for medicaid because I own my home. Nonetheless, I am unwilling to buy into a system that does not take into account that most medical problems are life style related. I keep myself healthy and would prefer not to pay for my fat neighbor's 3rd bypass operation. I am also reluctant to pay for a system with huge administrative costs as well as paying for lots of unneccesary treatments and tests as well as therapies with no proven value. So after I pay for fat Bud's bypass, I can pay for Marsha's reiki, David's chiropractor and Susan's psychotherapy, not to mention Bud's blood pressure meds and statins that he wouldn't need if he was willing to eat a healthy diet and get a little excercise.
We can make contributions to a government pool or we can pay exorbitant fees charged by corporations. Take your pick. Back when there were community (public) hospitals, before privatization, people received good care without being bankrupted by their illnesses. Hospitals didn't throw people out on the streets because they couldn't pay. Doctors didn't perform CAT scans and MRIs for every headache, just so they could get their cut of the payout for every procedure.
Many of us would be happy to pay our share to the government if we knew we would be taken care of when it was our turn to be sick, rather than having our money funneled up to a CEO bonus or out to greedy shareholders.
The following interview is very enlightening:
http://www.pbs.org/moyers/journal/07102009/watch2.html
Hey Diane. Why is it so terribly aggregious to you for people to not purchase mandated health insurance and then possibly receive health care anyway, possibly at the expense of others, if they lose their gamble to stay healthy; but it's perfectly acceptable to you for healthy people to have to bear the cost of unhealthy people by being forced to pay for health insurance that they don't want or need in spite of being healthy and not actually utilizing the health care products and services they're force to pay for?
The act of purchasing insurance--for anything, not just health insurance--is a matter of evaluating the risk of incurring a loss and deciding how much you're willing to pay someone else--an insurance company--to assume that risk in exchange for being relieved of bearing the loss yourself in the event the loss occurs. Insurance companies have to pay for the insured losses out of the premiums they collect for the insurance.
Contrary to what so many people seem to believe, insurance companies don't have endless resources that make them able to assume any and all costs that may be foisted upon them. Insurance is by definition a matter of balancing risks, premiums, and payouts. Everything that increases the payouts must be offset by increased premiums. The money to cover the increased payouts doesn't somehow just magically appear.
No, I'm not affiliated with any insurance company or the insurance industry in any way. Yes, I do utilize the health care system. I don't expect anyone else to pay for my utilization and I don't think anyone else should expect me to pay for theirs--other than through the pooled risks and premiums offered through freely chosen and purchased insurance.
Becstebo, that's what happens when you take personal choice, responsibility, and consequences out of consumer transactions. The attitude becomes, "Why should I care how much it costs? Someone else is paying for it." Universal health care coverage with no personal responsibility or personal consequences in the equation only exacerbates the problem.
Amen, JamieT!