APP - Emergency Rooms as Healthcare

PostmodernProphet said:
yes they are....they are spelled out in Section 122, the essential benefits section, which applies to both on and off exchange policies....
Click to expand...

You're the most annoying person in the world.

It sets maximums for deductibles at 5000 and 10000 for families, it doesn't touch copays except to say they have to be copays and not coinsurance.

GEE WHERE CAN THE PRIVATE INSURANCE GO FROM DERRR!??

How about plans with lower insurance deductibles then the government ceiling?
 
Allow me to continue to clarify: Your contention this entire time is that deductibles and copays are defined down to the dollar for private industry plans, which means they have nothing else to offer which means they are selling government insurance. My counter has been that they set minimums that they have to abide by, to which private insurance can exceed to whatever level they want.

What you see in Sec. 122 is the government setting a ceiling for deductibles, but not stratifying them into the different tiers of plans that you have been claiming this entire thread. They also don't set copay levels. (75, 85, 95 percent was what you said they set, but they don't).

So what the fuck can private insurance do beyond that? Basically anything they fucking want. They could lower the deductibles to compete with other insurance carriers, they could offer lower copays, etc. The government doesn't draw it up down to the dollar - which you said they did.

You are supremely ignorant and seriously annoying.
 
ib1yysguy said:
You're the most annoying person in the world.

It sets maximums for deductibles at 5000 and 10000 for families, it doesn't touch copays except to say they have to be copays and not coinsurance.

GEE WHERE CAN THE PRIVATE INSURANCE GO FROM DERRR!??

How about plans with lower insurance deductibles then the government ceiling?
Click to expand...

because changes in the deductible beyond that stage are pretty much a dollar per dollar exchange....if the statistics show that the average person spends a certain amount on medical bills per year, insurance companies are going to charge 100% of that amount in premiums to cover those expenses....until you get up above $5k there isn't much to work with.....
 
ib1yysguy said:
Allow me to continue to clarify: Your contention this entire time is that deductibles and copays are defined down to the dollar for private industry plans, which means they have nothing else to offer which means they are selling government insurance. My counter has been that they set minimums that they have to abide by, to which private insurance can exceed to whatever level they want.

What you see in Sec. 122 is the government setting a ceiling for deductibles, but not stratifying them into the different tiers of plans that you have been claiming this entire thread. They also don't set copay levels. (75, 85, 95 percent was what you said they set, but they don't).

So what the fuck can private insurance do beyond that? Basically anything they fucking want. They could lower the deductibles to compete with other insurance carriers, they could offer lower copays, etc. The government doesn't draw it up down to the dollar - which you said they did.

You are supremely ignorant and seriously annoying.
Click to expand...

the government sets 70%, 85% and 95%....do you think it's enough that a private carrier can offer 87.456% instead?....get real....and the only reason I'm annoying is that I keep showing you to be wrong.....
 
PostmodernProphet said:
the government sets 70%, 85% and 95%....do you think it's enough that a private carrier can offer 87.456% instead?....get real....and the only reason I'm annoying is that I keep showing you to be wrong.....
Click to expand...

No. They. Don't. Not for policies sold off the exchange, and certainly not in Section 122.
 
how many more times must you see the word "minimum" or "least" before you stop saying it isn't true.....you are completely wrong about this, no matter how times you prance around claiming you're right....the words of the bill say you're wrong:

SEC. 121. COVERAGE OF ESSENTIAL BENEFITS PACKAGE.
16 (a) IN GENERAL.—A qualified health benefits plan
17 shall provide coverage that at least meets the benefit
18 standards adopted under section 124 for the essential ben19
efits package described in section 122 for the plan year
20 involved.
Click to expand...

(b) CHOICE OF COVERAGE.—
22 (1) NON-EXCHANGE-PARTICIPATING HEALTH
23 BENEFITS PLANS.—In the case of a qualified health
24 benefits plan that is not an Exchange-participating
25 health benefits plan, such plan may offer such coverage in addition to the essential benefits package as2 the QHBP offering entity may specify.
3
Click to expand...

section 122()

(b) MINIMUM SERVICES TO BE COVERED
Click to expand...

emphasis in original
 
still nobody has been able to tell me what there is 'in addition" to the essential benefits.....whoop te do....they can offer me 2.5% less copay......get real.....

the solution is simple.....just let private companies offer whatever they want....if nobody wants to buy it, they won't sell it.....
 
Last edited:
PostmodernProphet said:
still nobody has been able to tell me what there is 'in addition" to the essential benefits.....whoop te do....they can offer me 2.5% less copay......get real.....
Click to expand...

anything they want to offer.....:pke:

face it....you're wrong, plans do not have to offer ONLY the government minimums....now all you can do is make stupid comments like whoopie....because you've once again been shown that they can offer additional benefits other than the MINIMUMs...
 
PostmodernProphet said:
the BC/BS are not "owned" by a parent company, most are individual non-profits set up in a particular state....this was done so that each company could comply with the laws of a state without it interfering with their ability to comply with another state's laws.....
Click to expand...

Wellpoint Corp., a for-profit company owns BC/BS in 14 states. Would you like to say a for profit company is in this out of the goodness of their hearts or is it because they now hold a for-profit monopoly in each of those states?
 
belme1201 said:
Wellpoint Corp., a for-profit company owns BC/BS in 14 states. Would you like to say a for profit company is in this out of the goodness of their hearts of is it because they now hold a for-profit monopoly in each of those states?
Click to expand...

a couple of pages back I provided YOU with a list of the BC/BS companies and which were NPCs and which weren't.....don't think you've just come up with some major revelation.......
 
Yurt said:
because you've once again been shown that they can offer additional benefits other than the MINIMUMs...
Click to expand...

whoopie!....I found a company that will give me a 29.999999999% copay, while you're stuck with 30%......I could have gone with one that would give me 29.999998, but mine threw in a free set of Pyrex baking dishes.....sweet!......
 
PostmodernProphet said:
the BC/BS are not "owned" by a parent company, most are individual non-profits set up in a particular state....this was done so that each company could comply with the laws of a state without it interfering with their ability to comply with another state's laws.....
Click to expand...




What were you trying to say in the above post? The BCBS "are not owned by a parent company"? I know of no other term for Wellpoint's or any other BC/BS owner's role. Once they convert, how does it differ from a monopoly with a state franchise, and for what purpose would a for-profit company want them if not to make even more money?


Re: Your question in reply. I was replying to the BS of your above post.
 
belme1201 said:
What were you trying to say in the above post? The BCBS "are not owned by a parent company"? I know of no other term for Wellpoint's or any other BC/BS owner's role. Once they convert, how does it differ from a monopoly with a state franchise, and for what purpose would a for-profit company want them if not to make even more money?


Re: Your question in reply. I was replying to the BS of your above post.
Click to expand...

did you miss the "most are individual non-profits set up in a particular state"?.....I believe it was around 30....that qualifies as "most" in my math text....again, I had already provided the list of which were privately owned and which were NPC.....you can't play "gotcha", when I was the one that provided the evidence....
 
PostmodernProphet said:
whoopie!....I found a company that will give me a 29.999999999% copay, while you're stuck with 30%......I could have gone with one that would give me 29.999998, but mine threw in a free set of Pyrex baking dishes.....sweet!......
Click to expand...

Why can't a company give you a 0 percent copay?
 
PostmodernProphet said:
lol.....I have given you five chances and you still can't come up with a thing that isn't included in the essential benefits.....so stick that little stick in your ear.....
Click to expand...

i cannot believe you think everything relating to healthcare is included in the essentials....you have lost it on this issue...i don't know if it is pride or stupidity....you claim people are lying, yet you keep getting shown direct language from the bill that clearly shows that you are wrong
 
You must log in or register to reply here.
Back
Top