The national HIPAA law contains a provision of portability which means that as long as you have had 12 months of continuous coverage either through your employer, COBRA or individual and you change to new insurance you will receive credit for the time you have had prior ins. Therefore if you had 12 months of coverage no pre-ex for changing ins. I would however, before changing check into the cost you will be expected to pay. Most small companies expect the employees to pay a portion of the premium especially for their dependents (if not all).

I thought the conservatives said that the corporations were going to solve the health care problems?

Rustyboy, I cant tell you any others, yet I can tell you mine because working with insurance companies at the hospital is part of my job and I normally keep silent because I feel very strongly but don't want to seem like I know so much, ...I don't. This below though, is what I do know. I had NO clue until I got into the industry near to ten years ago.

By far, the worst ones to deny, delay or limit services are medicare and medicaid - including humana, freedom blue, unicare, carelink ...all of the government ones. Huge rolling deductibles for the elderly on their medicare a and b, everything has to be coded ridiculously, and denials are common. I can't tell you how many times I have to page doctors to get fixed orders because this patient is deathly ill but medicare doesn't see the test as medically necessary.

It is just common sense that people miss in regards to one thing: Government, regardless of which party is in office, is quite fond of red tape and hoops when they are in your life - try to renew your drivers license, lol. Bad thing is, when it comes to healthcare, LIVES are entrenched in that red tape. This is what I cannot stand.

I cant tell you how many times I have warned someone near to twice my age "before you sign this paper called an ABN, let me explain what your signature means..." that if they sign it, medicare says they won't cover this test and they pay out of pocket.

Just like any other insurance, having coverage is not going to mean you get every test that you want, nor even every test that you need. Some stuffed shirt somewhere has veto power and its your life or your family member's on the line. THAT is horrible. The government insurance will not give you a free pass, its still coders telling you no, they just have a federal badge instead of a privately owned company and they are in the mindset to save money, not spend it.

I don't mind the idea of universal healthcare for everyone, but I dont want it to mean that my job means that I have to universally hassle or deny or delay everyone universally either. Its bad enough as it is.

Also, I wonder, will this mean the end of the overdue hospital bills because the government can garnish your money from you out of your check for what you owe for your out of pocket maximum every year - forget payment arrangements. (wondering aloud, but I guess it would be plausible.) I think many are under the opinion that federal equals free, but for once I don't think at all that it will. It does for medicaid but not medicare.

Anyway, like I said, this is only what I know from my job. Im playing wait and see for this to be broken down and see just how it goes. But I would hope after what I wrote, you can see why Im honestly terrified.

Thank you Calmprice for your informative position.

What would be your suggestion to get us out of this mess?

Why does it work in many other industrialized countries?

Is a one-payer system really that bad?

You are most welcome sir :). I don't want to "change anyone's mind" or make them see my way, ...I just think I need to change to a different department. LOL

I just want everyone to see a full and broken down version of this thing and everyone get proactive for changes that may need implemented before they need them fixed. For the better or for the worse, we are all in this together now.

As far as single payer, I do worry because if the only system around denies you, you're in a dire situation with no alternative other than appeal endlessly. For example, one horrible facility and its the only one. But one payer, if the deductible is too formidable and the out of pocket as well, you're still out of luck. Many facilities offer charity apps, but you have to ask, they have discounts, etc, ... those would go away, you would just be stuck with what they say.

What I think would be a good thought (totally clueless as to the how, lol, but others might) is possibly a ?five? company national system, overseen by a third independent party. Competition for cost effectiveness and quality, and culpability for all of these held accountable by a governing agency, etc. Does it need quality control? absolutely! Does it all need to fit under the same system? I don't, personally, believe that is a good idea. Any time I have ever faced a single option, it seems they feel "why bother with being innovative, caring, compassionate or forthright... you'll still be here next time."

I see what you are saying, calmprice. But the problem is those that do not have insurance at all do not have to worry about their claims being denied, as they have no coverage at all. So if those people have medicaid or medicare vs. no coverage, that is still an improvment.

actually bobb, I can NOT speak for other facilities yet I can mine, you can fill out charity apps, make payment arrangements, take agreements, etc if you have no insurance at all. I know that all facilities may not have this exact program but they offer many options if people ask. that unfortunately is the key. Why, I dont know, but it is so.

So true!

My company stopped providing it before Obama was even a candidate! What IS the problem with everyone having health care? We already pay FAR MORE than any other country in the world, we also ALREADY pay an incredible amount because of BANKRUPTCIES! It really would be much cheaper to have national healthcare....but the DEATH PANELS I mean INSURANCE COMPANIES would go out of business! Best health care in the world?

This is good. We need to get rid of employer based healthcare insurance. Only a single payer system (financed by a low tax) will work. I can't even get health insurance, because I am self employed and have a pre-existing condition. How dare the bastard Republicans fight healthcare reform, so I can't get insurance. Republicans are attempting to murder me and I am not Ok with their immoral disgusting un-Christian devil loving behavior.

I Agree Tim but that is not what we will get. Our political system is hopelessly corrupt and politicians will not do the right thing. They will just allow the insurance industry to feed on more citizens while driving the cost of care up and the quality down.

Dumping everyone into the individual market is the dirty little secret of Obamacare wth Gruber's "Cadillac Tax". Gruber, an economics professor from MIT, is the author of much of RomneyCare. We learning here in MA that Gruber's theories are not surviving real world tests.

Have you ever looked at what it actually costs to provide that employer sponsored health care? I'm not saying that what you mentioned aren't huge problems, but you're blaming the wrong people.

The problem is health care costs that are a direct result of the industry itself, not the decisions businesses are being forced to make in order to simply stay in business.

Don't worry Obamacare will take care of yor medical bills and now your employer can increase your wages!

The only thing "destroying this country" is people that think like YOU!

How so, grouch?

You disagree with hard work, and taking care of your own? With all due respect, do I need the Government making me pay for your poor life decisions? Whats destroying this country is that too many people rely on the Government for daily sustenance, instead of using every day common sence. This isn't Europe, not yet anyway.

There was a time when employers did not cover health care and health costs were much lower. Costs will trend downward when the health care industry discovers that it'll have to trim costs to survive.

Terry (and Rape boy), you are fools. I can't get health insurance thru your GOP garbage health insurance no regulation crap. At least Obama will force insurance companies to insure someone who is self employed (no group policy) with a pre-existring condition. i bet that I am far heatheir than you are (Terry or Rape boy), but you are lucky enought to have employer based healthcare. Republicans don't care if I die. and your attitude is slime.

That's true also!

You are bang on, Brenda. When a 3rd party pays the bills there is no market force controlling costs, so prices rise. When a 3rd party pays, there is no incentive for a health consumer to shop for the lowest cost health care. Providers also know that patients won't leave simply because they are charged too much, because the patients don't pay, a 3rd party does. Eliminating employer paid insurance, as long as it isn't replaced with government paid insurance, is the first step to reining in medical costs.

Brion, do you have any idea how much health issurance costs? If you're over 50, it's about $1500 a months for a bad policy. If you make $50K a year, that's a 36% healthcare FEE and that's in addition to your income tax. I'd be glad to pay 35% if it covered my healthcare plus taxes. You must be very bad at math.

Single payer healthcare would be FAR cheaper than the crap we get now in America.

So self-insure Tim. $1500 a month is a nice chunk of change. Hang onto it and invest it. Pretty quickly you'll have a nice cushion against any medical emergency.

No, you are wrong JohnCarter. If I had not had insurance last year, I would have come out of pocket about $18,000. And all of that was for Dr. ordered diagnostics that only confirmed nothing was wrong with me or my wife.

Sounds like you are not a very smart medical consumer. If the tests were unnecessary, why did you let them do them?

http://www.heritage.org/research/factsheets/obamacare-top-10-reasons-its-wrong-for-america

bobb- diagnostic tests are considered elective when done on an outpatient basis. And any insurance, even when issuing a precertification (medical necessity) will tell you that its not a guarantee of payment. This time, it will be the government telling you that disclaimer. It already does to those already under government insurance.

I worry that this is what so many people are misguided on: that if you have it, you wont pay anything. OF COURSE we are going to have to pay something, services can and will be denied, and you could still even then and larger amounts. It is health insurance, period, not a voucher. Did you ever think that if they aren't making enough money that they could raise your deductible or your out of pocket maximum? If the program isnt workable the way they wrote it, and there arent any companies left offering alternatives, could they tax you to fund the differences?

Government healthcare for 80% of us is not going to be free, that's medicaid. They pay a pittance against what the test normally costs and the commercial insured make up the rest to cover the loss. But medicare a & b pays the same larger amount and it is government healthcare as well. To keep payments to the hospital up so that they do not lose the ability to purchase new machines that we all need and want, to have facilities that don't have broken beds, faulty surgical machines, etc, they are going to be making money off of you, and if you don't follow the program rules, you will be paying huge sums again, just to the government. And the worst part is that if the others go, even if you DO want an alternative carrier, there will be none.

It is going to have compliance (coding your diagnosis for your test wanted), it is going to have a deductible and an out of pocket maximum (which could be rolling, like medicare instead of year to year like commercial), it is going to have precertification requirements just like medicare, humana, freedom blue, medicaid, and it WILL have denials. The program has to make money and its going to be making money off of us.

Im not saying that the idea is a bad thing, but the thing that people need to think of is: its a great thing if it WORKS for you. If it does not, it is a nightmare for you! I just want people to get the stars out of their eyes.

They need to write out, for any person who deals in insurance, exactly what the "coordination of benefits" will be and let healthcare professionals agree or disagree and start the amendment process. We are not all so easily broadbrushed as that we can all fit under the same plan without dire risks.

Tell (some of) that to all the Senators that voted against Sen. Enzi's amendment to allow, I repeat allow, small business to pool together across State lines in order to negotiate for less expensive insurance premiums for their employees. That was six maybe seven years ago. In regards to Govt. medical exchanges see my post below. Keep in mind the program I refer to below has been MS law for twenty years...

But yet many would have us believe the private health care model in the US provides the best product in the world.