This is going to be very embarrassing for big companies that self insure. Companies like Kroger that make more than a quarter of a billion dollars each time they report quarterly earnings, but rob their employees by overcharging for their ever decreasing benefits and ever increasing premiums health insurance. Even their web site says it all. It is www.yourkrogerbenefits.com. That is exactly how employees read it. Your Kroger...benefits.

All good points STexan...in additition, how many companies, rather than try to comply, will now simply decide to opt out of the program because of this onerous regulation. Which of course, is exactly what Obama and his minions desire...one more step closer to single payer.

oh the poor insurance companies, what will they ever do? the big bad government is forcing them to not rip off its costumers.

rather than just being glad that they dodged the public option bullet, or worse, single payer, they kick and scream that they cant overcharge people for something they need.

you guys are missing the bigger picture though...just like the other great socialist takeovers in american history, social security and medicare, in time crazy senile tea baggers will be shouting 'keep your government hands off my obamacare'.

the reality is...progress is going to happen. whether its fast or slow, its going to happen, as surely as the waves crashing on the cliff leave behind sand. conservatism...the only thing sure about it is that it only lasts until people realize the way things are just sucks.

ps. isnt it hilarious that tea baggers all ride their fat asses to their rallies to protest big government on paid by medicare scooters?

Govt is not controlling healthcare - the plan simply specifies that insurers MUST use $.80 of every dollar you pay them on providing health care. This does not mean they won't be making profits - they will continue to make profits and you will continue to get dividends. $.30 of every dollar is to be used for anything they put under 'overhead' and that includes profits. If the insurance companies you are invested in sell to more people, you will be getting INCREASED dividends, not less, than you would have before this provision goes into effect.

ceo- opt out of what program, the Health Insurance shakedown business.

LMAO!!!!

Yea right.

So, let me get this straight, You pay $1200.00 dollars a month for an individual policy ($14,400.00 per year). The insurance company pays $0.00 because you did not meet your $2000.00 deductible which means that you paid $14,400 for nothing in return and if you are healthy for the next 10 years that is $144,000.00 for nothing in return.

CEO takes home $8-$20 mil per year and you think that the healhcare bill is the problem? Either you are the CEO of one of these blood suckers or there is something wrong with your thinking. Tell you what, if you get a rebate check, endorse it and donate it to your insurance company in protest. Spread the word to all of your friends and family.

Heck start an other one of those "grass roots" organization encouraging folks to do the same. I am sure the Insurance companies will make you their "man of the year" for life and you will feel good having done your part for the "free market".

Let me ask you one question. If you went to the supermarket and prepaid for $150.00 worth of food every month just in case you were low on cash and needed food but you had to show proof before you were allowed to buy food with that $150.00and you did this month after month and at the end of each month you would lose your $150.00 would you think that this was the fee market at work, that this was a good deal? Why is it that Americans are so determined to fight against their own interest?

Agreed, government TODAY is not contolling healthcare, however they have taken HUGE steps toward that end and let's not forget Obama has said on many occasions he wants to see single-payer and systems such as that of the French and British. So anyone who thinks this is as far as governement will go towards complete government control is severly mistaken.

If you have such a problem with insurance companies than pay cash for your health care and drop your health insurance. You still have that option for the next year or so.

Mike - I'm curious where you're getting your "facts" from. No, no one is going to have the balls to try and repeal the package as a whole. But, such a system (full blown government ran health care which is where this train is going) can NEVER work in a nation as large and diverse as the US, and I'm sure the only ones who will find it an "improvement" (once fully implemented) will be the ones who are a drain on society, as opposed to those who work, pay taxes and contribute to society and realize they have to sacrifice greatly so that a few can benefit.

Mike - We just had a referendum on Obamacare.... it was called the midterm elections and the American people administered a political bitch slap of historic proportions. With Reid, Pelosi and Urkel still in charge, things don't look much better for the Dems in 2012, in fact it may be even worse...can you say bye, bye Bama?

The rhetoric has already softened on the side of the Republicans. Give it 6 more months and it will be a non issue.

its great how republicans always want to do 'what the american people want'. except for when, you know, a democrat president is elected by an emphatic majority and does EXACTLY the things he ran on.

in that case, to hell with what they want. they will just stick their fingers in their ears and shout 'i cant hear you'.

If I remember correctly in 1994 President Clinton lost both House and Senate and in 2006 so did George W Bush. What were the people saying then? How come 2006 did not prompt Pres. Bush to come clean with the American people about the bogus wars etc. Then in 2008 what were the people saying still.

The one thing I really do admire about Republicans is their ability to re-write history and it is taking place with no shame what so ever.

I am going to sit back and see what happens in the house over the next two years. It should be entertaining

As someone who supports real health care reform I am sorry to disappoint you but Obamacare will fail.

Obamacare is essentially the same as the failing Romneycare system we have in MA. MA has shown that you can’t provide universal health care by forcing people to buy regular health insurance polices. Costs are off the wall and the state is thinking of returning to capitation, which failed miserably in the 90s, to try to cut costs. Our politicians were even thinking of taxing non-profit hospitals to bankroll the insurance industry, The only difference is we don’t have a huge regressive middle class tax hike (The Cadillac tax going into effect in 2014) designed to lower the quality and increase the cost of health care of people with insurance.

CEO... if you care to go back and read the election news and the exit polls you will see that 'Obamacare' was NOT one of the reasons people voted Rethuglicans in. More than 60% of all voters said they were HAPPY with the healthcare plan and wished it did MORE.

I mean I know rightwingers have really small brains and are in the red when it comes to intellect but man....you guys just can't debate on ANY topic without putting some MAJOR spin on it.

If you believe the leftist polls you are right. The last independent poll show 68% want it completely repealed. That has actually increased since it's passage. People would rather have nothing than Obamacare.

That's why Boehner made such a big deal about it before the election, it was a sure vote getter. Almost all republicans supported full repeal and it sure didn't hurt them Nov 2. On the other hand, democrats were scampering away from their votes and still got hammered.

They already laid off a ton of folks and shipped jobs to India. Believe me, they operate with a skeleton staff now.

This is an important point. This will be a big win for them for the insurers while patients and providers will loose.

Almost every test or procedure your doctor orders have to be preapproved by your insurance company. This usually involves someone at the doctor’s office spending hours on the phone, trying to plow through poorly written voice recognition software to speak whit a human. A single test can take an hour or more to get approved. If the request doesn’t exactly meet the algorithm the clerk at the insurance company works off of it gets denied. This usually means that a nurse at the office needs to call and speak to an insurance company nurse. If it is denied again the doctor needs to speak with an insurance company doctor. The large for profit insurers can drag this process out for weeks for diagnostic tests and months for surgery

If the insurance company defines the staff that handles this as an administrative then they can cut back on them. It is really a win- win situation for them. They lower staff costs and create delays in patient care expenditures while being able to claim they were forced to do it.

Of course this will have a negative impact on patient care and drive up already high provider administrative costs.

That is why Obamacare and the entire notion of reducing insurance premiums and consumer healthcare costs via government mandate does not work. Private companies and their decision-makers will always shift their costs onto the consumer to protect their margins and shareholder value. If they don't they cease to exist; or at the minimum cease to manage the company. We've already got a boat load of government regulation of health insurance and where has it gotten us? More of the same ala Obamacare is only making it more expensive, not less.

Welcome to the law of unintended consequences. With all the big companies opting out, the small businesses will be the ones squeezed. Obamacare strikes again.

Starve it to death till 2012 then drive a stake in it.

Valhalla. What on earth are you talking about. Big companies opting out of what? You folks are so determined to demonize President Obama that you end up making no sense at all. How is making sure that your premiums are spend keeping you well a bad thing?

If you think that big insurers will get out of that business then good. There are thousands of smaller decent companies that will get the chance provide healthcare not profits for shareholders.

Hey STexan, what do you think of the above post? The problem with the capitalistic health care model is illustated by the above post. Whenever a capitalistic system is used, somebody at the bottom of the food chain gets eaten. That's OK when your selling cars or clothes, not so good when your providing quality of life services. In a perfect capitalistic health care system, efficient, quality care is rewarded by the consumer due to competitive pressure. What we have now is a noncompetitive business environment in which even the most inefficient, poorest care providers can still do well.

As a result, I pay out about $900 a month in health insurance premiums for my wife and son, that also includes about $125 a month towards my employer provided plan. I gross 3k a month. I've got a 2K per person ded. and it pays 80% of "covered" charges. Doesn't strike me as a very efficient, cost effective system.

What a load of crap. Europeans can't just walk in like Mexicans. I know people from Canada, the EU, etc. and it is almost impossible to get in here legally without a ton of effort. Most give up and go home.

Health care here is the best in the world. Have you already forgotten the Premiere of Nova Scotia coming here for his care? Both Canada and Britain have publicly stated their system is not sustainable and cuts will have to be made. You probably ignored that news as well.

Survival rates for cancer, heart disease, etc. are all much higher here. How does that spell inferior?

The problems with our system is too much meddling and not enough competition. Each state sets up it's own little fiefdom and and that kills competition and cost controls. People wanted reform not Obamacare.

The best in the world when there are millions die every year for lack of this wonderful service. When before your doctor could send you for an x-ray or start treatment it must be approved by the insurance companies. When being a woman and having had a pregnancy is a "pre existing condition"

You have got to be kidding.

gee...sounds to me like every one of those issues would be solved if only they passed a public option or single payer system!

Jason (may I call you Jay). ACOs are not being run by the Government, they are being run by your "free market" Insurance companies. Isn't that what you want, no government run health-care (aka the public option) just your friendly free market "have your best interest at heart" insurance company?

Allmill2: We are currently so far from a "free-market" healthcare system that to argue against it based on today's landscape and what Obamacare proposes is akin to arguing for more of the same, not for something different. The current system is a mountainous mess of insurance regulation and government mandates that vary from State to State, region to region and that have NOT lowered our overall healthcare costs or insurance premiums one stinkin' penny over the last 40 years -- post Medicare. Today, as a result of countless insurance boards, Medicare and Medicaid finaggling, and government involvement, we've got less competition, minimal portability, variable coverage rules, and millions and millions more consumers who assume that they are entitled to whatever healthcare they demand when they want it and at minimal to no cost to them personally. Yes, Obamacare only represents yet another lovely attempt at government fixing something that they caused in the first place. Please, no more. I can't afford it.

So what do you suggest, not have any laws or regulations? That worked well for Wall Street. If you think that is a the way to go then I guess that you also believe that tax cuts for the rich create jobs like the 1.2 million created under Bush after two tax cuts and the 23+ million crearted under Clinton with higher taxes for the rich (and he had his zipper down )

I assume you read the bill and that is your source of enthusiasm.

You must be some of the ones who get everything for free. If not you are all fools for thinking this is good for the people. It is severely damaging to my family.

Which part is damaging?

*Letting your kids remain on your policy until age 26?

*The unlimited lifetime limits on claims?

*Insurance companies not being allowed to cancel you if you become sick?

*trying to stop price gouging by making them spend 80% on health care?

Do tell which part is so damaging because my individual insurance company (
Anthem) is charging me $1700 a month for a $5000 deductible. Goes up 35% every year. We started out at $464 a month. I certainly feel sorry for that poor Anthem/wellpoint making millions/billions in profits. Not.

I do not think that the health care bill is perfect, but it is certainly a place to start. If something does not happen soon, my family is going to join the ranks of the uninsured.

Angie,
What is damaging? Let's see...

Keeping "kids" on policies until 26 will mean greater payouts by insurance companies...who will then have to raise our premiums to pay those costs. Damaging.

Unlimited lifetime claims? Hmmm...sort of speaks for itself. That's a whole lot costs and payouts borne by insurance companies. Who will pay for that? Yes, you and I. Damaging.

Mandating coverage for pre-existing illness is telling a private company that they must begin paying someone's known healthcare costs (which could be massive) immediately and always, right from the start. No real risk taking there...just government mandated payouts. Again, who pays? You and I do. Damaging.

Trying to stop them "price gouging" by capping admin costs will only have them shift the unpaid admin costs and profit margins on to premium costs. Again, we lose. Damaging.

Angie, we cannot "government cap" ourselves out of this cost nightmare. It has never worked; ever...in any industry. Medicare and Medicaid is a prime, case-study of how government involvement has driven our healthcare costs, not lowered them.

So, liberty you really think that health insurance companies should be able to drop those that are sick and stop covering them when they reach a certain limit??? That would be after they paid their premiums when they were healthy, and the company took their money. That is absolutely sick.

I know by your comment you have never had a sick child and worried that he would meet his lifetime limits at 6 years old. Easy for you to have such opinions when you are not sick. Hope you never need any insurance coverage, because it will cut into the health ins. companies profit. I guess we all should hope we die quick to save that poor CEO his bonus.

Liberty keeps missing the point by a mile, Insurance companies can raise rates if they want to but if 80% if that money is NOT SPENT on my care, I get the difference back soooo... what's the problem here? Lib, stop pawing the ground blowing steam out of your ears and actually read what the new law says.

Making a profit is fine and I do believe the versatility and agility of capitalism makes it the best system by far. BUT unregulated, monopolistic, corporate exploitation of captive consumors is not capitalism and not an environment supportive of democracy. Most insurance companies pay out 80% and keep 20% for operating and profit, but because of the lack of regulation and near monopolies in many markets, health insurers have only paid out 60% and kept 40% - by refusing claims, finding preexisting conditions and charging outragous prices. This has left them with plenty of money to buy our politicians (repubs are cheap) and manipulate our elections with massive advertising to keep the gravy train going, or is it the 'blood flowing'. Healthcare is the ultimate addiction, most all of us will need it and in the end will pay anything for it. Insurance companies have reduced it to the street corner laze-fair capitalism of the drug pusher. It must be regulated to protect us all.

Making a profit in healthcare is the problem??? Just what do you think motivates everybody that works within healthcare? Are we all just saints who wish for only a roof over our heads? Take the profit away and you'll have nothing more than under-staffed and under qualified respite clinics with mile long lines out the door. And who will pay for this socialized medicine? The government? with its already 14 trillion dollar debt? How's that going to work? "Essential service?" Really? Is it essential then for me to demand that everyone live healthier? Put down those doughnuts? Cause, if I'm paying for everyone to have this "essential service" I assume I have some say in the matter? Where will all the Canadians go for when they wish top-notch surgery within a few days?

To argue against profit is to fail utterly at seeing the most basic human motivator...the one that has spurred the greatest of inventions, the greatest of medical breakthroughs, and the one motivator that keeps the very economic engine of any country going. Take away that and you may as well live in Cuba.

I find it difficult to always understand the logic of people that want our government to regulate and reform something in order to improve or repair what may be wrong with it. Question: Why do you assume and believe that Governmental empowerment will always be used for "good" when there are so many historical examples that demonstrate otherwise?

Government Regulation that creates more oversight and control can be used for the disadvantage of the "captive consumors" just as eaily as it can be used to their advantage, and sooner or later will. The "monopolistic corporate" Health Insurance and Medical Care Providers are in the best position to influence the government. Out of their own self-interest, they inevitably seek to control the mantle of power.

Power and Control comes from the people, the individual citizens, you; and is obtained generally by the use of three (3) methods: 1. given freely and voluntarily, 2. through coersion and deciet, 3. by duress and dictate. Whenever you listen to someone's persuasive argument, consider which of these methods they are suggesting.

Centralization of Power IS the problem; regardless if it is with a corporation or a government or an individual. It is self-evident: a government that can give you everything you want, can and will take everything you have. If not today (when "your" political party is in power) then tomorrow (when the other guy's has taken control). The person or party that advocates that they can "reform" or "correct" the problems if they were just given the authority and power to do so, is not only a fool, but quite reasonably a danger to the freedom of his fellow citizens.

There is nothing wrong with making a profit but when you lay hardworking Americans off and send their jobs to India and other countries and then jack up the rates for no real reason then pay out millions in bonuses, we have a problem, it is called greed.

Unfortunately the poor and middle class people who are most negatively impacted by these greedy bastards are the ones fighting to let them continue their unfair criminal practices because we have been told that anyone no matter how poor can reach great heights and we hear all of those stories of a CEO who was so poor that eating dirt was a luxury and that his mother could only afford one pair of shoes so he and he bother took turns wearing it (bring on the violins)etc. So in our little minds we think that by supporting these pigs we are safeguarding our own very rich futures.

You could not be more wrong, you are not safeguarding anything, the greedy rich we have created have one goal and one goal only, creating a serving class to clean up after. That is you and me and all of us that use to belong to the now almost extinct middle class.

Did you see the report that kids coming out of MIT and Harvard are moving to India where they are getting well paying jobs? The European brain drain in the 19,20 centries that made this country great is now the American brain drain that will make India and Chaina super powers as America fades away and you continue to bitch about a President trying to help those that don't have any get healthcare, a basic human need and see that as the problem we are facing.

"There is none so blind as those who will not see".

There in the bussines to make a profit? So is the mafia!

They ran on it, and won the biggest victory in 70 years. We were promised health care reform, we got Obamacare instead. That is unacceptable. The people have spoken, get over it.

What people? Let's see how the Republicans are going to repeal it. lol

Welcome to Obamacare! Isn't all it was cracked up to be, is it.

Make that upwards to $1million for some cancers. What people ought to be looking at the cost drivers to the system, not the offensive executive pay (however obnoxious it is, it still represents a tiny portion of why we're paying so damn much). Government caps, taxes, fees, and mountains of healthcare and health insurance regulation (yes, mountains of often non-sensical existing regulation from state to state) only drive up costs by adding costs that will be ultimately passed on to consumers by way of increased medical costs and insurance premiums. We enroll more and more people, demand more and more coverage, then try and mandate or cap the resulting costs has NEVER worked and will not suddenly start working under Obamacare.

That 's just it, they don't

It is 80% of premiums collected on paying for healthcare for the people who have policies with said company. It is a aggregate amount, let me try to explain this:

I have car insurance with a NJ Manufacturers, one of the best in the State of NJ. At the end of the year they add up all they paid out to their insured to their administrative costs (salaries bonuses, recurring costs etc.) and they subtract that from the premiums collected. They then return that money to policy holders, what you get is based on how much you paid in premiums.

With health care, the company will add up all they paid out talking care of the healthcare needs of ALL their policy holders. If that amount is less than 80% of all of the premiums collected, they will have to return the difference. That payment will be based on utilization and the cost of your premium, it will not be the return of the difference between what they spend on ME and what I paid, it will be calculated based on the aggregate amount (what was spend on everybody).

By the way, NJM is also one of the best companies to work for and have one of the lowest premiums and do not refuse to pay for repairs if you do get in an accident AND your premium never increases because as a result of one.

BTW, it would also do us all a world of good if we turned off the TV and read to gain knowledge.

Clinton only won because he made a hard right turn after he lost congress to the republicans. Remember welfare reform and NAFTA? The republican congress also made him look better than he was.

Add to that, the fact that Dole was a dinosaur and it wasn't hard to beat him.

When the government gives you 50 cents with one hand, you can bet they are stealing $1 from you with the other. Do you really think those 109 new bureaucracy's come for free?

Insurance companies are already one middleman skimming their percentage, now Obama has added a whole new one on top. At least insurance companies have a profit motive to keep costs down, government always goes the other direction and gets more expensive over time.

It's amazing how many idiots still believe in something for nothing.

I second that!

Funny how the congress fails to think that their government funded health plan is socialist.

Last I heard, they have a choice of private insurers, just like you and I. Because we pay for it does not make it socialist.

So using your argument what makes Medicare and healthcare for all funded by tax payers dollars socialist? They all will have a choice of private insurers.

Tom,

Move to India, you will find your job.

Obamacare is not health care reform. That's why dems lost so big. If you keep this crap up 2012 will be even worse. That would make my day of course.

D. You keep talking about the damage to your family. What exactly has happened to you? What has Obama done that has had such a negative impact on you?

Excuse me d, but I don't see how "they tap" your paycheck if you are unemployed.

lol

@gave up: Please re-read post #5 above, thoughtfully posted by akgirl. (Thank you akgirl.) It should answer all of your concerns. If not, please explain the discrepency. You cannot argue with facts, and calling the President a monster and a dictator is not a legitmate debate tactic. In fact, it's very childish.

For the poster who is upset about having to have a prescription card, if you really are unemployed there is a provision for financial assistance in obtaining the benefits. If you were to become ill, you may be very glad that you now have the coverage that you didn't think you needed or wanted.

He is one and done. Three weeks ago proved that.

Democrats have controlled congress for four years and the white house for two. Who has made out? Unions, government workers, banks, and wall street; lots of rich white people. Who has suffered? Lower and middle class. Black unemployment is 3x white unemployment.

Yet you idiots still worship him and thank him for his incompetence. Go figure.

You have completely ignored what dealing with the insurance industry costs providers in your administrative costs.

Recently we treated 2 oncology patients with the same disease. 1 with conventional Medicare and one with a Medicare “Advantage” plan run by a large for profit insurance company. We were able to confirm a diagnosis and begin treatment on the conventional (government run) Medicare patient in 2 weeks. We had to fight the large for profit insurer every step of the way dealing with denial of care and appeals. It took us 3 months to begin treatment. These delays may cost a patient their life. (A win for the insurance company)

It is also quite expensive as providers have to dedicate staff and time to deal with the appeals and peer to peer calls. You can add at least 10% to your somewhat low 10% to see the overall administrative costs.

What you are talking about are not administrative costs to the health insurance company, but costs to the providers I think (that would be under the MLR).

Do you always generalize when it comes to any issue? I would guess not. If I did, I could name several times when a doctor's treatment killed people because they were just trying to perform procedures to get the higher reimbursement or make a buck.

Does that make all doctors greedy and ineffective? No. And your one experience shouldn't cloud every experience with health insurance companies.

Good points, Kelly; well stated. The mindset of capping and/or taxing insurance companies as a means to lower our premiums and lowering our healthcare costs is void of economic merit. Insurance companies will and do simply pass on increased taxes or fees on the consumer. Profit and operations margins will always be protected to protect shareholder value -- else they cease to exist. Mandating them to spend 80% of their premiums on healthcare will only cause them to shift their adminstrative costs to the consumer via increased premiums. Make companies assume greater financial risk, they will spread the risk to the consumer accordingly.

libertyfirst ... good points. Someone will always have to pay, and it is usually the consumer.

soliberty, How much should the health insurance companies be allowed to make. Should they be a totally free "business" that can charge anything they want, with soaring profits until they price themselves out of business. How much can the back of the american worker bear? We cannot continue to pay outrageous health care costs while insurance executive make millions and fly around on their corporate jets.

The system will collapse...and sooner than we think.

They should be forced to compete so costs can be contained. The flaw now is there is no competition. That's why republicans want competition across state lines.

Medicare may seem like a great program until you are reminded that it is broke. It is in far worse shape than SS and you can see how hard that is to fix. Obama stole $500,000,000,000 from Medicare to fund is abomination so it is now in even worse financial shape.

Medicare reimbursements will continue to fall as the well runs dry so don't expect the above scenario to hold in the future.

Also, in one province in Canada, the goal waiting time for chemo is nine weeks and they are missing it by four. So your utopia socialist system is already at 13 weeks delay. Add to that the fact that they've said their system is not sustainable and you can see where that number will be going in the future.

They also issued a report on the estimates of preventable deaths due to lack of access to the latest expensive cancer drugs. If I remember, the number was 23,000 dead, due to government cost controls.

As usual, there is no free lunch, there is no such thing as something for nothing, you get what you pay for.

valhalla phil, how many people do you think die here in the US because they could not afford the Chemo drugs???

There was not just a "delay" in care, they were told to come back when they either had the money to pay or had insurance. (oh right, they could not get insurance because they had a pre-existing cancer. )

DEAD!