<>The Pennsylvania home health care company Linda Bettinazzi runs is
charged about $6,800 per worker for health insurance â€“ $2,000 more than
the national average for single coverage. One reason: nearly every one
of her 175 employees is a woman.
Insurers say women under the
age of 55 cost more to cover because they use more health services, and
not just for maternal and infant care. . . . .
Gender rating is the norm today . . . But advocacy groups for women argue
that charging more for women than men is discriminatory and should be
illegal . . . .
The battle is playing out on Capitol Hill through the debate on health
overhaul legislation. If a new law results in nearly all Americans
having to carry insurance, the industry has said it would agree to end
rating based on gender and health status in sales of policies to
individuals and small groups. But the leading industry trade group and
some of its legislative allies have balked at ending such rating in the
group market where larger employers purchase coverage. . .
Emails of questionable origins are generally not reliable sources of information about health care reform.
As far as members of Congress, they purchase "private" health insurance through the Federal Employees Health Benefits Program, which also covers federal employees, retirees and their families. They can chose from several private plans from different insurers. Employees have the option to switch plans during the annual open enrollment period. There is plenty of competition; FEHP is the largest employer sponsored health plan in the U.S.
I think private insurance companies would object to a requirement that Congress and federal employees go on a public plan -- private insurers would lose 8 million customers. Members of Congress are however required to go onto a public plan when they turn 65 -- they must sign up for Medicare. And members of Congress, that are retired military are eligible for lifetime coverage through TRICARE, the government health care program for active and retired military and their families.
Regarding Medicare beneficiaries access to doctors, has been a complaint in some regions. Whether a region is classified as urban or rural, will determine reimbursement rates. If a region is designated rural, access could be restricted due to a shortage of doctors because of the lower Medicare reimbursement rate; physicians would opt to work in higher reimbursed urban areas.
Access, however was not a problem with my parents nor with my siblings and their spouses -- they were/are able to choose their own doctors. Since Medicare pays about 80% of some medical costs, my family members also had private Medigap plans that covered costs not covered by Medicare.
I think there is a lot of misinformation about a public plan option. It would be a government run plan, but individuals would still be able to choose their own doctor. And it would be "one" option in the insurance exchange that would also include several private insurance plans -- no one would be forced to enroll in the public plan. And, only the uninsured would be allowed to purchase insurance -- private or public -- in the exchange.
As far as being able to choose one's doctor, that could be a problem with private health insurance. One sees a doctor that contracts with the insurance company that contracts with one's employer. If your employer no longer offers that insurance plan, you might lose your doctor.
We have a fragmented health care system, that is becoming more difficult to navigate and becoming more and more expensive. A single payer system with private doctors and hospitals seems like a more efficient, equitable and sustainable system -- but that wasn't considered by Congress.
I received it as an email, thought I'd throw it out there to see what people think. I probably should have spent more time looking it up as it was an email. I'll go back and check out the source. I don't post emails ever, big mistake. Congress and government workers are already on a public option, they have no complaints. I don't think they get other options..maybe they do. I've never heard a government employee complain about their health coverage. A choice is not warranted. But if they want a choice, certainly. What I'm saying is the public plan should be as good as medicare(as far as coverage goes) and no one should be afraid of being on it and it should not be looked down upon to be on a public plan. Medicaid patients should not be looked down upon either (but they are, there is a stigma, trust me).Medicaid provider choices are more limited every day as many doctors are refusing to take on new medicaid patients. My question...why are bills being introduced where people are acting afraid to be on a public plan...and why would members of congress not be more than willing to go on a public plan? You know why congress has a problem with the public option for themselves? I'll tell you why. I was talking to a primary care physician at work on Friday. I told her that I had heard that her office was no longer taking medicare patients...she said, yes unfortunately, that is true. I asked her why...she stated. We cannot afford medicare patients, we go in the hole everytime we see a medicare patient. She thought the reimbursement rate was around 85 percent, while third party payers are around 135 percent, she was not sure but thought she was close to the figures. So, her office has had to limit medicare patients so they can pay their bills. This is the problem with government insurance plans such as medicare, medicaid, etc. also the patient is limited on his/her choice of providers. Personally Joie, I would not want that. I want to pick my provider. Members of congress know these facts. I am all for a public option, but it must be able to compete with insurance companies. No one should have to go to a doctor that they hate, that does not listen to them, that they just cannot connect to. Part of staying well and getting better is having a provider that you can work with, not one you can work against. Personally, I'm all for single payer. I believe that is the way we are going to cut health care costs.
Health care reform would require insurance plans sold in the health insurance exchange to provide basic coverage. There would also be plans to choose from that would have additional coverage at higher premiums. Most group or employer provided health insurance already provides coverage at this level.
Nongroup insurance or individual insurance plans often do not provide adequate affordable coverage or access. The insurance exchange would provide people now locked out of the individual insurance market an affordable option. For the low-income uninsured, there would be subsidies, financial assistance. But they would still have their choice among the private insurance plans and the public plan, if that is part of the final bill.
Lor, do you feel that Congress, all gov workers -- which would be fed, state, county and city workers -- should not have a choice of plans, but be required to enroll in the public plan? Consider, everyone 65 and over is on Medicare, the poor are on Medicaid, military are on TRICARE or VA care, low income kids on SCHIPS -- if you feel all gov workers should be on a public plan, then given the number of all these populations on a government health program, perhaps, rather than have all these different programs, would it be more efficient to have a single payer system or Medicare for all?
Linncn. I guess what I'm taking from this HR 615 is that the public feels the public policy will be inferior to what employers offer. I'm not sure this is true. The public option will ensure competition. I feel that all of congress should be put on the public option. All government workers should be on a public option. If they are against this, then I'm a bit suspicious.
But don't they already have taxpayer funded insurance? I mean, who pays their salary and benefits if not the taxpayers? Why should they not take the same as they are offering us? The tab's on us anyway, right?
Opponents of health care reform, have
proposed congress members who support/vote for a public plan option, be required
to enroll in the public plan. Opponents to HCR say proposed legislation exempts Congress.
Actually, members of Congress or any federal employee
or anyone with employer provided health insurance, would not be allowed to
purchase insurance in the health insurance exchange. The exchange would only be
available to those uninsured -- i.e., employees of small businesses, the
self-employed, early retirees not yet eligible for Medicare. These uninsured would choose from private plans
in the exchange, that would range in price and coverage, and, if included in
final legislation, they would also have the option of the public plan. The
consumer, however, would have the choice -- no one would be forced to take the
The purpose of the exchange is to offer a choice from
several plans to that group of uninsured that have difficulty finding access to
affordable health insurance. Most large group employers, like public employee
systems, offer several plans for their employees to choose from -- from HMOs to
PPOs, that range in premiums.
Senator Ron Wyden of Oregon, however, points out that not
all workers are satisfied with the insurance plans selected and offered by their
employer. He has therefore proposed that workers be allowed to purchase
insurance in the exchange with a voucher, the employer's premium contribution.
Wyden believes that without multiple policy choices and competition, health care
costs will continue to go up. Few support Wyden's proposal and thus it is not a part of current health care reform
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