Friday, April 02, 2010

More of that good, old *CYCB*I, Health-Care Reform Edition


Pres. Febreez H. Shamwow has sold us people the FUCK out...

Here's a short compendium of the 10 most obvious loophioles and exceptions of which the Heal Insurance Parasites hope to avail themselves over the next TWELVE (12) fucking years, while the Obamination Health Insurance Reform comes, slowly, painfully, erratically, unevenly, probably incompletely into being.

Via Kos, and from Froomkin (HuffPost) and Meg Carpentier (WashInde), here's the TOP 10 Ways The Paraasites Will Game The Law:

1. Raising premiums
There is absolutely, positively no prohibition on companies raising premiums at outrageous rates until 2014 — so they’re not going to stop....

2. Kicking people out for pre-existing conditions
The insurance industry may have relented about using pre-existing conditions to determine children’s eligibility, but ... the way they floated the idea that the law didn’t really totally require them to accept children with pre-existing conditions is a hint that they’re desperately looking for a similar loophole in 2014 and beyond.

3. Changing your insurance plan
...They’re busy shutting down and restricting access to managed care plans (HMOs) and pushing current customers into high-deductible plans, where customers have to pay all expenses out of pocket before the insurance company picks up a dime. ...[C]ustomers pay a (relatively) small premium each month and then the first $2,500 of their health care each year before the insurance company begins to cover a percentage of the costs of their medical care.

4. Making life more difficult for doctors
One great way to reduce insurance company payouts is to make it more difficult for doctors to file claims, which insurance companies are already planning on doing.

5. Tightening up internal practices
That’s a euphemism for giving patients and doctors enough of a run-around trying to get bills paid to convince them to give up asking for reimbursements.

6. Marketing only to healthy people
...[I]f they make certain drugs hard (or impossible) to find on pharmaceutical formularies, or put up physical barriers to obtaining the insurance, they can (and likely will) keep more elderly and sick people from even applying for their insurance.

7. Re-label current overhead expenses at health care
When the reform finally takes full effect in 2014, insurance companies will have to spend 80 percent of their premiums on care for their customers. Thus, in order to make more money, they’ll have to increase the money you spend on care, or figure out a way to classify expenses currently deemed “overhead” as “health care for you.”...

8. Taking full advantage of the unhealthy behavior premium
In the reform, insurers are allowed to makes premiums 50 percent more expensive for consumers who engage in “unhealthy” behaviors, which was intended to allow them to continue charging smokers higher premiums. But there are lots of behaviors deemed “unhealthy.”...

9. Charging old people as much as they can
The law allows insurers to charge people between 55 and 65 (the current age of Medicare eligibility) three times more than people 54 and under. So on their fifty-fifth birthdays, some customers could get new, higher insurance bills that put readjusted mortgage bills to shame — and there won’t be anything remotely illegal about it.

10. Lobbying to make the most of the loopholes that exist and create others
It likely goes without saying that all the money and lobbying time that went into watering down health care reform and trying to keep it from passing aren’t just going to stop flowing to Washington. Rather, as the Department of Health and Human Services spends its time promulgating rules to govern the various reforms in the bill, lobbyists will simply switch their focus from the Hill to HHS....
*CYCBI* = Change You Can Believe In

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