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Consumer Reports Article 04/06/2009
"7 Signs A Health Plan Might Be Junk"

Beware Of Discount  "Health Plans"

Tips for finding Health Insurance when you've lost your job.

Guaranteed Issue Defined Benefit Health Insurance: Lots of Limitations!

Fed Allows 65% Cobra Premium Reduction For 9 Months! What Do You Do After the "Cobra Stimulus" Ends?

New Illinois Dependant Eligibility Law Extends coverage to your dependant child up to age 26 (or 30). They no longer need to be attending college.

Ten Questions To Ask Your Agent BEFORE You Buy Health Insurance

What The Heck Is Consumer Driven Health Insurance? Can It Really Save You Money AND Lower Your Taxes?

If You Purchased Health Insurance From Mega Life & Health or Midwest National Life Through The National Association For The Self Employed (NASE) You Need To Know The Truth!
 

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The TRUTH about Obama Care

Here's how BAD the new "Patient Protection & Affordable Care Act" and subsequent "Health Care & Education Affordability Reconciliation Act" (a.k.a. "ObamaCare") is for our country:

1.) The law expands entitlement spending by over $1 TRILLION in order to "cover" 30 Million more people. What will that do to State Budgets? We only need to look at history to find out. Cases in point?
a.)
In 1965 the Fed projected that costs for Medicare Part A would be $9 Billion. It ended up costing $67 BILLION!
b.)
The Medicaid special hospital subsidy was supposed to cost $100 MILLION. The real cost was $11 BILLION!
c.)
The initial cost projections for Romneycare in Massachusetts were $880 MILLION. Cost today? FOUR BILLION!
Why? Forbes Magazine breaks down the 5 painful lessons we can LEARN from Massachusetts.
 

2.) It adds $500 Billion in new tax increases at a time in our nation's history when a RECORD number of American's pay NO INCOME TAXES! And if you believe the lie told by President Obama in the following video:



you NEED to know the TRUTH:

Not only will Obamacare create the BIGGEST tax increase in U.S history but it will also cost you your retirement. Sally Pipes, President of the Pacific Research Institute breaks down the risk to your retirement. Speaking of NEW taxes, if you are a Small Business owner. Here's what's coming for you thanks to Obamacare:

Click here for a complete break down of the MULTIPLE onerous tax increases coming for Small Businesses. For a complete breakdown of the DEVASTATING impact Obamacare has on the Uninsured, the States, our Doctors, our Seniors, our Businesses, our Tax Payers, Federalism, Future Generations & our Families CLICK HERE.

Obamacare isn't ALL bad though! Big Pharmaceutical companies will get EVEN BIGGER:

Chicago's Heartland Institute breaks down an excellent time line of what is coming under Obamacare and how this legislation will NOT help low income Americans:

Hat tip to Mr. Jay Heflin over at THE HILL who wrote: "Taxpayers earning less than $200,000 a year will pay roughly $3.9 billion more in taxes — in 2019 alone — due to healthcare reform, according to the Joint Committee on Taxation, Congress's official scorekeeper. The new law raises $15.2 billion over 10 years by limiting the medical expense deduction, a provision widely used by taxpayers who either have a serious illness or are older. Taxpayers can currently deduct medical expenses in excess of 7.5 percent of their adjusted gross income. Starting in 2013, most taxpayers will only be able to deduct expenses greater than 10 percent of AGI. Older taxpayers are hit by this threshold increase in 2017. Once the law is fully implemented in 2019, the JCT estimates the deduction limitation will affect 14.8 million taxpayers — 14.7 million of them will earn less than $200,000 a year. These taxpayers are single and joint filers, as well as heads of households."Loss of this deduction will mean higher taxes for 14.7 million individuals and families making under $200,000 a year in 2019," In addition, Richard Foster, the Obama Administration's Medicare Actuary predicts net national health spending will increase by about 1% annually above the status quo that is already estimated to be $4.7 trillion in 2019. It's also important to note that under this new legislation, the cost for health insurance will INCREASE for millions of Americans. It also means that the illusion that this legislation will "bend the cost curve" is just that, one BIG ILLUSION!

3.) The law ROBS Medicare and Social Security (AND THEY'RE BOTH ALREADY BROKE!) In fact, the Trustees of Medicare & Social Security state that the total unfunded liabilities between both programs are now more than $84 trillion! Worse yet, as of March 2010 Social Security is NOW OFFICIALLY BROKE! For an in depth discussion on just how bad Obamacare will be for our already BANKRUPT Social Security & Medicare systems PLEASE watch the Medicare & Social Security symposium updated September 8th, 2010 on CSPAN. How bad is the impact of Obamacare on Medicare? According to Richard Foster (Medicare's Chief Actuary) Obamacare quite literally GUTS MEDICARE! Unlike what you may have been told, the new law CREATES a $662 BILLION DEFICIT! How? According to the CBO report issued AFTER the "reform" bill was initially scored by them, the Democrats did NOT include the following expenses prior to the bills passage:

a.) 70 Billion for the "Class Act" (long term care coverage)

b.) $53 Billion that WILL BE ROBBED from the Social Security Trust fund

c.) $71 Billion in appropriations needed to enforce the purchase of Insurance and to administer Obamacare (including $10 Billion for thousands of new IRS agents to "enforce" the Health Insurance purchase mandate and 159 NEW Federal Agencies to administer this behemoth)

d.) $398 Billion that WILL BE ROBBED from the Medicare Trust Fund

e.) $208 Billion "doctor fix" that was passed AFTER the "reform" bill was passed on April 1st, 2010

How may you ask, will they be able to include these costs later? Simple! Just include them gradually in other bills. For example, here's part of Obamacare that was included in the new "Jobs Bill".

Representative Paul Ryan breaks it down with an easy to understand chart:



Representative Kevin Brady assembled a team to design a High Resolution Chart of what our health care system now looks like under Obamacare. To view and print this detailed chart please click here. Here are the written results of his due diligence published in the August 1st, 2010 issue of Bloomberg. His team's due diligence produced the same bleak outlook for our nation's health care system as I have described in exhaustive detail in this blog.

After the aforementioned appearance on Fox News Sunday. Mr. Ryan further testified to this "double counting" in a Congressional hearing on March 20, 2010:

Only NOW is the main stream media FINALLY waking up to the fact that Obamacare will NOT reduce the deficit:

4.) In order to keep the final CBO score under $1 Trillion they counted these TRANSFERS from Medicare & the Social Security Trust Fund as "A Savings". What will be the REAL result of this economic trickery? Charles Krauthammer discusses the INEVITABLE "Value Added Tax".

5.) $468 BILLION in additional spending on subsidies to purchase government approved health insurance.

6.) $48 BILLION in additional spending for Medicaid. Did I mention that Medicaid costs are growing by 23% this year? This MASSIVE expansion of Medicaid will lead to even LARGER budget deficits for States like California, Arizona, Illinois, Michigan and many others already facing crippling Medicaid burdens. In fact, nearly HALF of all the new insured after 2014 will be enrolled on to our already bankrupt Medicaid roles. The worst part about enrolling more than 16 million American's on to our already bankrupt Medicaid roles is that according to a large and comprehensive study completed by the University of Virginia, surgical patients on Medicaid are 97% MORE LIKELY TO DIE than those with private insurance. And they criticized Sarah Palin for using the term "Death Panels"? Worse yet, the law could shift billions of dollars from cash-strapped states to the federal government by changing the way Medicaid prescription drug rebates are treated. This is exactly why so many States have filed suit to protect themselves against the new health care "reform" law. In fact, the State of Georgia's Insurance Commissioner has stated that he's not waiting for the lawsuits, he's saying no to Obamacare NOW!

7.) A Huge new increase on Capital Gains tax of almost 4%. Who does that affect? Anyone with any SAVINGS, most especially those in the market. So not only do we have RECORD unemployment, we're now going to lose EVEN MORE of whatever savings we have LEFT!

8.) The law has a DECADE of Medicare Cuts a DECADE of Tax Increases, and only 6 yrs of supposed benefits! In fact, there will be over $500 Billion in Medicare cuts. What kind of cuts? Below are the Medicare cuts and when they begin:

Medicare cuts to hospitals begin: long‐term and inpatient and rehabilitation facilities (FY10)
Medicare cuts to inpatient psych hospitals (7/1/10)
$132 Billion in Medicare Advantage Cuts Begin (2011)
Medicare cuts to home health (2011)

“Wealthy Seniors” (making $85k to $170k) begin paying higher Part D premiums (not indexed for inflation in Parts B/D) (2011)
Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans & other Nuclear Medicine Scans. (2011)
Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment (2011)

Prohibition on Medicare payments to new physician‐owned hospitals (2011)

Seniors prohibited from purchasing power wheelchairs unless they first RENT for 13 Months (2011)

MORE Medicare cuts to long‐term care hospitals begin (7/1/11)

MORE Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (FY12)

Medicare cuts to dialysis treatment begins (2012)
Medicare to reduce spending by using an HMO‐like coordinated care model (Accountable Care Organizations) (2012)
We ALREADY know how WELL HMO’s work!
MORE Medicare cuts to inpatient psych hospitals (7/1/12)
Medicare cuts to hospitals with high readmission rates begin (FY13)

Medicare cuts to HOSPICE begin (FY13)

New Tax of 2.3% on Medical Devices (2013)

Medicare cuts to hospitals who treat low‐income seniors begin (2013)

MORE Medicare cuts to home health begin (2014)
MORE Medicare cuts to home health begin (2015)


Worse yet an Independent Payment Advisory Board (not doctors) has now been established to determine what medical services will and will not be covered. This panel has unprecedented powers. In fact, in order to override decisions made by this panel, a Super majority of 67 votes in the Senate is needed. The Office of Management and Budget Director Peter Orzag leaves no ambiguity as to the powers granted to this panel in this video. There are MANY more things Seniors AND THEIR DOCTORS need to know about Obamacare and NONE of it is good. Click here to learn about out all the negative ramifications for Seniors.

9.) Let's say we could afford to add another $682 BILLION (plus the aforementioned recently noticed $115 additional Billion) to our already MASSIVE $13 TRILLION debt. Does ANY ONE REALLY BELIEVE that's ALL this legislation is going to cost us? Let's look at some history:

a.) In 1965 the Fed projected that costs for Medicare Part A would be $9 Billion. They ended up being $67 BILLION.
b.) The Medicaid special hospital subsidy was supposed to cost $100 MILLION. Instead the real cost was $11 BILLION! That's ONE HUNDRED TIMES GREATER!

10.) The law includes $132 Billion in CUTS to the Medicare Advantage program

11.) One of the MANY costs associated with this law that were NOT included in the CBO score were the appropriations (money needed to fund the 159 new government agencies needed to implement "Obamacare"). $10 BILLION OF WHICH WILL BE SPENT HIRING ANOTHER THOUSANDS OF NEW IRS Agents! To whom you will report each month confirming purchase and maintenance of Government approved Health Insurance for each of your employees AND their families. How much will you pay?

12.) Depending on the size of your business, the law mandates that employers pay 72.5% of all of their employee's health insurance premiums and 65% of all of their employee's families premiums! Employers must also provide a health insurance "voucher" to all low wage workers to help them pay for health insurance. In addition, changes to the tax code’s section 6041 regarding 1099 reporting were slipped into the 2000-page health legislation. The changes will force millions of businesses to issue hundreds of millions, perhaps billions, of additional IRS Form 1099s every year. Click here for more about how the new 40% "Cadillac Tax" will also negatively impact the MAJORITY of businesses. What harm will this do to our American Businesses? Companies like John Deere, Boeing, Caterpillar, Prudential Life, 3M, Honeywell, AK Steel Holding Corp, ITW, Valero Energy, Allegheny Technologies and EIGHTY other companies have stated this new law will cost them MILLIONS. In fact, because the fines for not maintaining health insurance are so small compared to the cost to maintain health insurance. Many companies are considering canceling their employees coverage. The centers for Medicare & Medicaid services released a damning report on this legislation. More on this:

13.) Remember when the President said "You can keep your plan"?

Click here to see why the President apparently "mis-spoke".

14.) Remember when the President said "The penalty for NOT purchasing Health Insurance is NOT a Tax?

Click here to see why the President apparently "mis-spoke" AGAIN!

15.) Remember when the President said during the State of the Union speech that a man from Downers Grove Illinois "had his coverage canceled, his treatment denied and he died because of it"? The video below tells us how the President "mis-spoke" AGAIN. Remember the rule in baseball, three strikes you're out? Well, 3 "mis-speaks" and you are a LIAR!

We've discussed the outright LIES but what about ALL of these BROKEN Obamacare Promises? The new law requires insurers to charge enrollees of the same age the same premium, regardless of health status. That’s a price control, and it will cause premiums for healthy people to rise dramatically and thus lead to massive adverse selection. Healthy people will gravitate to High Deductible HSA qualified plans where they will also face much higher premiums than they would have before Obamacare.

16.) But wait a minute! Doesn't the AMA (American Medical Association) support Obamacare? Yes, but the AMA comprises only 17% of doctors in the U.S. This number is also comprised of medical students & medical professors but very few private practice physicians. The AMA also has a HUGE financial incentive for supporting Obamacare. The Wall Street Journal explains why the AMA has 100 MILLION REASONS to support Obamacare. More on this less than transparent allegiance from Dr. Arie Friedman, a well known PRACTICING Pediatrician from the State of Illinois:

Dr. Friedman is a member of www.docs4patientcare.org which is an organization of many concerned physicians committed to the establishment of a health care system that preserves the sanctity of the doctor-patient relationship, promotes quality of care, supports affordable access to all Americans, and protects patients' freedom of choice. Here's what a few of the other members of Docs For Patient Care.org think about the new Health Care "reform" law:

Another PRACTICING Physician, Dr. James P. Brown (a Urologist from Chicago) explains in GREAT detail what the implications of this Health Care "reform" legislation will be in the videos below:

Click the link below to download Dr. Brown's excellent Power Point presentation on the Implications of Health Care "Reform": The Implications of Health Care "Reform".

Forbes magazine explains why most PRIVATE PRACTICE physicians DO NOT support Obamacare. There is one doctor who supports Obamacare. His name is Dr. Donald Berwick and without ANY Congressional vetting process he was appointed as the new head of the Centers for Medicare & Medicaid Services over the Independence Day holiday. Why was there no Congressional vetting process? Click the link below to download Dr. Arie Friedman's Power Point Presentation that explains why: The TRUTH about Dr. Donald Berwick The health care rationing that Conservatives were concerned about may well have already begun. Speaking of doctors. The State of Massachusetts has MORE doctors than ANY other State due to their "Mass Care" (e.g. Romney Care) legislation. Yet the average waiting period to see a doctor in Massachusetts is 47 DAYS! We are also facing a doctor shortage nationwide. This will only INCREASE under "Obamacare". Click here to read how the Canadian Government took control of private medicine by price controls, rationing and mandates much to the detriment of Canadian citizens. This historical debacle is eerily familiar to what our current Administration is trying to accomplish right now. This is a MUST READ for all Americans.

17.) What about those Tax Credits that are supposed to be so "helpful" to Small Businesses? The Associated Press breaks down just how "elusive" those are. The National Center for Policy Analysis breaks down how these Tax Credits will actually IMPEDE the growth of business. Hat tip to NFIB for doing an even better job of breaking down these Small Business Tax Credits: The CBO cites that just 12 percent of the small business population would benefit in any way. The credit is very restrictive and puts small business owners through a series of complicated “tests” to determine the actual amount of the credit. Three conditions must be met for small businesses to qualify for any portion of the credit:

Business size – Very few small firms will receive the full credit (only firms with 10 employees or less). For firms with 11-25 employees, the credit is reduced per employee. Firms with more than 25 employees get NO credit.
Average employee wages – The credit is tied to the average wage of workers. Only firms who pay their workers $25,000 or less are eligible for the full credit. The credit is reduced as the average wage goes up, stopping at $50,000. (Note: Average wage for a firm with 10 or fewer employees is approximately $27,000.)
Employer contribution – Only firms covering 50 percent or more of insurance costs will be eligible. The credit is only available for a maximum of six years, but healthcare costs will continue to increase well after those six years.

 
18.) The law imposes a tax on small business health insurance plans. Messaged as a “health insurance fee,” this tax is actually a tax on small business. The new tax is structured as an annual fee on insurers and it does not expire. The annual “fee” begins at $8 billion in 2014 and steadily increases to $14.3 billion in 2018. In subsequent years, this fee remains at $14.3 billion annually added to whatever the rate of premium increase is for that year. One thing health insurers (and the CBO) have made clear: new taxes on them mean new costs passed on to customers. Small businesses will be paying for this new tax.
· How it works: An insurer’s portion of the annual tax will be determined based on their market share. Insurers aren’t simply going to absorb this new, expensive tax.
· These new costs will be passed solely onto the fully-insured market (where nearly all small businesses buy their insurance) because Congress exempted self-insured plans (big business and labor unions are exempt).
· Early estimates from policy analysts show family premiums are expected to go up at least $500 per year.
· Simply put: This is not a tax insurers will be paying. This is a tax on small businesses’ health insurance plans.
· Small businesses already suffer from high and volatile costs increases; a new tax like this doesn’t help to reduce future costs. For a PDF of the onerous new requirements and multiple new taxes placed on employers click here.
 
19.) The law increases the tax paperwork costs on small businesses. The so-called “corporate reporting” requirement will place a new and enormous tax-filing burden on all small business owners. The cost of complying with the new filing requirements will increase the cost of doing business and falls disproportionately on small business owners.
· Businesses will have to send Form 1099s for every business-to-business transaction of $600 or more – a tremendous new paperwork burden.
· The costs associated with tax paperwork (on average, more than $74 per hour) is the most expensive paperwork burden that the federal government imposes on small business owners.
· The cost of tax compliance falls heavily on small business and is 66 percent higher for a small business compared to a large business.
· Complying with the tax code is especially burdensome to small business owners, because they lack in-house finance departments like most large businesses. This means the burden to comply with the paperwork is either handled by the owner or outsourced to an accounting firm.
This new law has also place significant additional Tax and accountanting fee burdens on those who purchase, sell or own Gold. Read more about these onerous additional Tax burdens from ABC News.
20.) The Bill imposes an unprecedented increase in Medicare payroll tax. Since its creation, payroll taxes that fund Medicare programs have been dedicated specifically to funding Medicare. Not only does H.R. 3590 increase the Medicare payroll tax to 2.35 percent but it uses the additional revenue to pay for non-Medicare programs, creating a dangerous precedent to use payroll taxes to pay for more non-Medicare programs in the future.
· The bill adds a new tax on income over $200,000 for individuals ($250,000 for joint filers). Adding to the problem, wages are not indexed for inflation, meaning that more small businesses will face this tax increase each year.
· Since 75 percent of small business owners pay their taxes at the individual level, this tax will hit the business income of many small business owners.
· The businesses most likely to see the tax increase are those that employee between 20 to 200 workers. These businesses account for more than one-quarter of the American workforce.
21.) The law imposes a new Medicare tax on non-payroll income. This new tax continues the unprecedented trend of dedicating Medicare tax revenue to non-Medicare programs and also expands the tax to additional sources of income.
· Medicare has traditionally been funded by taxes paid on a worker’s wages. The new 3.8 percent tax on those reporting $200,000 in income ($250,000 for joint filers) will, for the first time, apply to non-wage income such as capital gains, rents, interest, royalties and dividends. (75 percent of small business owners pay their taxes at the individual level).
· Ninety-five percent of small business owners own real estate. Whether the real estate is sold for a profit or rented to another business, this income will now be subjected to an additional 3.8 percent tax.
· This new tax will deter investment in businesses and other profit-earning ventures.
 
22.) The new law allows ANYONE to purchase Health Insurance at ANY TIME regardless of Pre-existing conditions. That sounds very "fair" doesn't it? There's only ONE problem with that? Since they can buy it at ANY time without regard to Pre-existing conditions, THEY HAVE NO REASON TO KEEP THE POLICY once they're treatment is over! What will that do? We don't have to wait to find out. We just need to look at Obamacare's evil twin "Romney Care" in the State of Massachusetts to find out. The initial cost projections for "Romneycare" were $88 Million. Today "Romneycare costs the American Tax Payers FOUR BILLION DOLLARS with a projected 2011 fiscal DEFICIT of $294 Million.

23.) The Law imposes an “individual mandate.” All Americans who earn more than the poverty line will be required to obtain some form of health insurance. If they do not, there will be a "penalty" (TAX) in 2014 of $95 a year or 1 percent of household income. In 2015 the fine will increase to $325 or 2 percent of income and in 2016 the fine will increase to $695 or 2.5 percent of income (with a maximum of $2,085 for a family) Congressman (and Doctor) Ron Paul explains why such an "individual mandate" is CLEARLY Unconstitutional: [youtube=http://www.youtube.com/watch?v=9Zrjz-3H6Jg&feature=player_embedded] John Cassidy of "New Yorker" Magazine states "Two issues immediately arise. Even if the fines are vigorously enforced, many people may choose to pay them and stay uninsured. Consider a healthy single man of thirty-five who earns $35,000 a year. Under the new system, he would have a choice of enrolling in a subsidized plan at an annual cost of $2,700 or paying a fine of $875. It may well make sense for him to pay the fine, take his chances, and report to the local emergency room if he gets really sick. (E.R.s will still be legally obliged to treat all comers.) If this sort of thing happens often, as well it could, the new insurance exchanges will be deprived of exactly the sort of healthy young people they need in order to bring down prices. (Healthy people improve the risk pool.) If the rules aren’t properly enforced, the problem will be even worse. And that is precisely what is likely to happen. The I.R.S. will have the administrative responsibility of imposing penalties on people who can’t demonstrate that they have coverage, but it won’t have the legal authority to force people to pay the fines". “What happens if you don’t buy insurance and you don’t pay the penalty?”

Ezra Klein, the Washington Posts industrious and well-informed blogger, asks. “Well, not much. The law specifically says that no criminal action or liens can be imposed on people who don’t pay the fine. Quick question, if criminal penalties are no longer in the legislation and the only way to collect the "Penalties" (a.ka. TAXES) is through the use of the Internal Revenue Service. How EXACTLY will these penalties be collected from the 51.6 Million tax filers who paid NO INCOME TAXES last year? (some of which earned $50,000/year) More importantly, since the criminal penalties were removed (for not buying health insurance) the WORST the IRS can NOW if you do not buy health insurance is send you a "STERN LETTER". So guess who will be picking up the tab to insure all those who refuse to purchase health insurance? You guessed it! You and I, the ALREADY overburdened U.S Tax payers. This legislation is NOT about cutting costs, it is instead, about SHIFTING costs from those who do NOT pay to those who are ALREADY paying. In short, by 2014, you the American Tax Payer (the few, the proud) will now be paying substantially more for your health insurance because YOU will now be BUYING 33 MILLION people a brand new Health Insurance policy. Not a policy that just covers catastrophic care (you know like the one you probably have now because you're trying to SAVE money). Oh NO, this is going to be a "gold plated" health care plan, without ANY out of pocket expense for a MASSIVE amount of new Preventative Care and other medical benefits. Just LOOK at all the new Preventative Care benefits that you can now get for "Free" from Obamacare. You see the problem is, NOTHING is free! It may be "free" for some, but the vast majority of tax payers and health insurance policy holders will pay MUCH more now for their health insurance coverage. In fact, premiums will begin increasing as early as September 23rd, 2010. Click here to find out why.

24.) Arguably the most troubling language in the law is the new 80%/20% and 85%/15% MLR's (Medical Loss Ratios) applied to all private Health Insurance companies. These new MLR's could very conceivably bring about the END of most smaller Health Insurance companies that offer Individual and Small Group coverage in a very short period of time. In fact, it could begin happening as soon as June 2010. Robert A. Book PHD & Senior Fellow of Health Economics at the Heritage Foundation explains why. Even the NY times now admits (2 months after Obamacare was passed) that these new onerous MLR's mean that MANY American's will NOT be able to "keep their plans". Five health insurance carriers have closed their doors since Obamacare was signed on March 23rd. I comment on why in the June issue of Health Plan Week from Washington D.C. (My comments begin on page 5 of the PDF)

25.) Besides the MASSIVE taxes that begin immediately, MANY CUTS begin as well and the bulk of them will hit Medicare recipients. Oh and remember when we were told by President Obama & Speaker Pelosi that children would be able to get coverage for pre-existing conditions 6 months after the new bill was signed? They FORGOT to include that in the bill! So now, NOT EVEN THAT “benefit” will begin until 2014! That was, until the Health Insurance companies agreed to honor this new law THIS YEAR, EVEN THOUGH the legislation stated they did not have to until 2014! Strangely enough, people have forgotten that THIS IS ALREADY THE LAW IN MOST STATES! Moreover, the dramatic expansion of SCHIP already ensures that most children have access to guaranteed issue health insurance already. Although States like Arizona have recently terminated their SCHIP program because it has rendered them BANKRUPT. So be sure to check with your State SCHIP administrator to make sure there's entitlement money left for you! In addition, many States like Illinois have already passed similar legislation that allows children with pre-existing conditions to be insured on a guaranteed issue basis and to stay on their parents policy until the age of 26. Side bar: Are they REALLY still children at age 26?

Did you know that SEVENTY FIVE PERCENT of the children insured on our Illinois Tax Funded "All Kids Covered" program are ILLEGAL ALIENS? LONG before Obamacare, adults could already get guaranteed issue health insurance coverage on an individual basis in 45 States in our union. The truth is we do not need Obamacare to solve pre-existing conditions. Most especially since Government is to BLAME for pre-existing conditions in the first place. Obamacare is not ALL bad though. In fact, if you are Uninsurable, live in one of the 5 States that does not already have a High Risk health insurance pool or a guaranteed issue individual mandate AND you have been uninsured for 6 months AND you can afford HIGH premiums. Then ObamaCare's severely underfunded Temporary High Risk Health Insurance Pools are the answer for you! Click here to sign up NOW!

26.) The democrats also left the 21% reduction in medicare payments to physicians out of the bill and state they will tackle that in another bill. BUT by NOT counting it in the final CBO score, they consider it "a savings". By the way, that passed on April 1st, 2010 and here's how that will not affect YOU. This 21% "doctor fix" passed AFTER the Mayo Clinic stated because of MASSIVE losses in 2008 they will NO LONGER BE ACCEPTING MEDICARE!

27.) You know the CBO (Congressional Budget Office) that the Democrats "TRUSTED" to give "accurate predictions" on what the cost of their health care reform legislation would be? Their Director stated on March 8th, 2010 that the current U.S. Fiscal Policy is UNSUSTAINABLE. Why would the CBO state that our Fiscal Policy is UNSUSTAINABLE? The following video makes it CRYSTAL clear:

28.) Speaking of the President, the law also EXEMPTS HIM & SENIOR CONGRESSIONAL STAFF MEMBERS FROM THIS LEGISLATION!

29.) Remember the other LIE promoted as a justification for this health care "reform" law. The one about "Uncompensated Care"? Here's the TRUTH about that!

30.) Remember the "law of unintended consequences". This ALWAYS applies to ANY Federal Legislation. Click here to see the MULTIPLE NEGATIVE "side effects" of Obamacare. Below is a four part round table discussion that Illinois 8th District Congressional Candidate Joe Walsh, Arie Friedman M.D (the pediatrician in the video above) Steve Stevlic (the Chicago Tea Party Coordinator) and myself taped for Chicago public T.V:

I spoke about just how BAD this new legislation is at a recent health care town hall for the Northern Illinois Patriots:

Remember when our President said that if you make less than 250,000 (as a couple) or $200,000 as an individual, your Taxes will NOT GO UP ONE SINGLE DIME? Paul Mitchell revealed the TRUTH about that statement at the Libertyville Tea Party on July 5th, 2010:

I went in to greater detail about Obamacare immediately after Paul's excellent break down of the new Obamacare taxes:

Even more details were discussed including a Q&A at the July 3rd, 2010 Tea Party in Palatine, Illinois

More TRUTH about Obamacare from the Chicago Tea Party Freedom Rally on 9/12/2010:

Click here to read Congresswoman Melissa Bean's letter to her constituents regarding why she voted yes on Obamacare

Click here to read my response to Congresswoman Melissa Bean's emotional (BUT FACTLESS) letter.

Click here to read my comments & Dr. Arie Friedman's comments in "Obamacare Hurts Small Business in Illinois"
by Keith Liscio in the December 2010 issue of the Conservative Magazine of Illinois.

Click here to read my response to Eric Holder & Kathleen Sebellius entitled "A Health Reform for Everyone?"

For more required reading on the Obamacare legislation visit: Champion News.net Champion News did a GREAT piece on the Health Care town halls being held around Illinois each month by our 8th District Congressman Elect Joe Walsh

Read Part 1) HERE
Read Part 2) HERE

Obamacare One Page Leave Behind

Now for three Hat Tips to other bloggers & news sources tackling the TRUTH about this new law:

1.) CNN (yes I said CNN): The TRUTH about Health Care Reform

2.) If you love Liberty, you will NOT like the ramifications this law has on families. Chuck Donovan at the Heritage Institute breaks down the Liberties families LOSE under this new health insurance "reform" law below:

More Families Covered but Less Family Choice
Millions of families gain an entitlement to health insurance under the mandates on individuals and employers in PPACA. The law’s creation of new affordability tax credits will ease the purchase of health insurance for middle-income Americans. But the new credits go hand in hand with increased regulation of private health plans. Moreover, families gained nothing from PPACA that will permit them to purchase better or cheaper plans across state lines.[2] The new law also does nothing to increase the variety of insurance available in the market, which could include family-friendly options like health plans managed by professional associations, unions, and faith-based groups. Nor will families be able to purchase health plans that exclude coverage for services to which they ethically object or which they do not need.

Undermining the Role of Parents
PPACA expands several funding streams that undermine parental responsibility and authority to direct the upbringing of their children. The law lavishes federal dollars on programs like school-based health centers and a new “Personal Responsibility Education” (PRE)[3] program that deny parents knowledge of sensitive services their children receive in federally funded projects. First, PPACA creates a new $50 million per year appropriation for school-based health centers, many of which either offer contraception on site or refer for contraception and even abortion. The law states that the recipient clinics must honor “parental consent and notification laws that are not inconsistent with Federal law.”[4] However, the federal Medicaid and Title X (Public Health Service Act) laws stipulate that the confidentiality of teens obtaining services must be respected, nullifying any state or local parental notice or consent policies.[5] Second, the new PRE program provides $75 million per year for grants to help states reduce pregnancies and births to teenagers. Unlike the 1996 welfare reform, however, the new program does not incentivize states to reach these goals without increasing their abortion rates.

Penalizing Marriage
Another disturbing feature of PPACA is the fact that it imposes—across a broad range of income and age—significant financial penalties on the decision to marry. The marriage penalty imposed by the law could exceed $10,000 per year for certain couples.[6] This is because the affordability tax credit phases out rapidly as income rises. Not only does this health insurance marriage penalty dissuade a younger, low-income couple from getting married—which is one of the most beneficial life decisions they can make for themselves and for their children—but it also provides older couples, some of the hardest hit by this law, with an incentive to obtain a “divorce of convenience.” For example, a 60-year-old couple, each with an income of $15,000 per year and purchasing insurance in the non-group market, would gain $4,212 in tax savings if they obtained a sham divorce and bought insurance separately. A similar couple, each making $30,000, per year would realize $10,425 in tax savings if they divorce and cohabit rather than remain married.

Undercutting Freedom of Conscience
As health care reform proceeded, strong majorities of Americans supported protecting provider and insurer rights of conscience as well as limiting the use of tax funds for abortion. In March 2009, 87 percent of respondents to a national poll supported ensuring “that healthcare professionals in America are not forced to participate in procedures and practices to which they have moral objections.”[7] A January 2010 Quinnipiac Survey found that 67 percent of Americans oppose public funding of abortion.[8]

Conscience Protections.
PPACA does make clear that no qualified health care plan can be required to cover abortion as an “essential” benefit. It also ensures that no health care plan that participates in the state-based exchanges may discriminate against a health care facility or provider because of its unwillingness “to provide, pay for, provide coverage of, or refer for abortion.”[9] The law does not, however, prevent the federal and state governments from practicing this same discrimination. An effort to add such an amendment to the bill failed in a Senate committee in September 2009. While there is an annual appropriations rider to this effect on the bill funding the Department of Health and Human Services, it lacks permanent force, and regulations to implement it were suspended by President Obama in March 2009 as a step toward its likely rescission.

Abortion Funding.
Currently, every health care plan in the Federal Employees Health Benefits Program may not as a matter of law include coverage of elective abortion. Under PPACA, health care plans that cover elective abortion may participate in the state-based exchanges provided they require each enrollee to pay a separate premium of not less than $12 per year for elective abortion coverage.[10]

The Executive Order.
On March 24, President Obama signed an executive order that attempts to apply conscience protections and abortion funding limits to the full text of PPACA. Regardless of the order’s intent, judicial rulings for the past 35 years have made it clear that public funding of elective abortions in federal programs cannot be barred without the kind of direct ban that Congress failed to include in many parts of PPACA.[11]

Reason for Disappointment
Advocates of family values in health care reform have reason to be deeply disappointed with the overall impact of PPACA. The passage of legislation that increases parental control and choice regarding health care insurance, avoids marriage penalties, guarantees conscience protections, and limits taxpayer support for controversial practices like abortion must await a future Congress.

If you are walking your precincts and are in need of a 1 page leave behind on the TRUTH about Obamacare click here.

3.) The following EXCELLENT break down between Myths and Truth by the folks @ www.firedoglake.com

Myth

Truth

1. This is a universal health care bill. The bill is neither universal health care nor universal health insurance. Per the CBO:
  • Total uninsured in 2019 with no bill: 54 million
  • Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Insurance companies hate this bill This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.
3. The bill will significantly bring down insurance premiums for most Americans. The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.Annual premiums in 2016, status quo / with bill: Small group market, single: $7,800 / $7,800 Small group market, family: $19,300 / $19,200 Large Group market, single: $7,400 / $7,300 Large group market, family: $21,100 / $21,300 Individual market, single: $5,500 / $5,800* Individual market, family: $13,100 / $15,200*
4. The bill will make health care affordable for middle class Americans. The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.A family of four making $66,370 will be forced to pay $5,243 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.
5. This plan is similar to the Massachusetts plan, which makes health care affordable. Many Massachusetts residents forgo health care because they can’t afford it.A 2009 study by the state of Massachusetts found that:
  • 21% of residents forgo medical treatment because they can’t afford it, including 12% of children
  • 18% have health insurance but can’t afford to use it
6. This bill provide health care to 31 million people who are currently uninsured. This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.
7. You can keep the insurance you have if you like it.
The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.
Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.
8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages. There is insufficient evidence that employers pass savings from reduced benefits on to employees.
9. This bill employs nearly every cost control idea available to bring down costs. This bill does not bring down costs and leaves out nearly every key cost control measure, including:
  • Public Option ($25-$110 billion)
  • Medicare buy-in
  • Drug reimportation ($19 billion)
  • Medicare drug price negotiation ($300 billion)
  • Shorter pathway to generic biologics ($71 billion)
10. The bill will require big companies like WalMart to provide insurance for their employees The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.
11. The bill “bends the cost curve” on health care. The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019.“Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.In 2009, health care costs were 17.3% of GDP. Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP) Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)
12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition. Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.
13. The bill prohibits dropping people in individual plans from coverage when they get sick. The bill does not empower a regulatory body to keep people from being dropped when they’re sick.There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.
14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions. The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state. Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level.
15. This bill will stop insurance companies from hiking rates 30%-40% per year. This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.
16. When the bill passes, people will begin receiving benefits under this bill immediately Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014. Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.
17. The bill creates a pathway for single payer. Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer. Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.
18 The bill will end medical bankruptcy and provide all Americans with peace of mind. Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.
  • In 2009, 1.5 million Americans declared bankruptcy
  • Of those, 62% were medically related
  • Three-quarters of those had health insurance
  • The Obama bill leaves 24 million without insurance
  • The maximum yearly out-of-pocket limit for a family will be $11,900 (PDF) on top of premiums
  • A family with serious medical problems that last for a few years could easily be financially crushed by medical costs
Sources - A. Is America about to go broke? - MSN Money B. Paul Ryan vs. The President - Wall Street Journal
  1. March 11, Letter from Doug Elmendorf to Harry Reid (PDF)
  2. The AHIP Plan in Context, Igor Volsky; The Max Baucus WellPoint/Liz Fowler Plan, Marcy Wheeler
  3. CBO Score, 11-30-2009
  4. “Affordable” Health Care, Marcy Wheeler
  5. Gruber Doesn’t Reveal That 21% of Massachusetts Residents Can’t Afford Health Care, Marcy Wheeler; Massachusetts Survey (PDF)
  6. Health Care on the Road to Neo-Feudalism, Marcy Wheeler
  7. CMS: Excise Tax on Insurance Will Make Your Insurane Coverage Worse and Cause Almost No Reduction in NHE, Jon Walker
  8. Employer Health Costs Do Not Drive Wage Trends, Lawrence Mishel
  9. CBO Estimates Show Public Plan With Higher Savings Rate, Congress Daily; Drug Importation Amendment Likely This Week, Politico; Medicare Part D IAF; A Monopoloy on Biologics Will Drain Health Care Resources, Lancet Student
  10. MaxTax Is a Plan to Use Our Taxes to Reward Wal-Mart for Keeping Its Workers in Poverty, Marcy Wheeler
  11. Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS (PDF)
  12. Health insurance companies hang onto their antitrust exemption, Protect Consumer Justice.org
  13. What passage of health care reform would mean for the average American, DC Examiner
  14. How to get a State Single Payer Opt-Out as Part of Reconciliation, Jon Walker
  15. Medical bills prompt more than 60 percent of U.S. bankruptcies, CNN.com; The Patient Protection and Affordable Care Act Section‐by‐Section Analysis (PDF)
  16. The Worst Study Ever - Scott W. Atlas (PDF)
  17. The TRUTH about U.S. Infant Mortality Rates (PDF)
  18. Obamacare One Page Leave Behind (PDF)
  19. Blue Cross Blue Shield of Illinois record premium increases.
  20. Dubuque Tea Party Obamacare Forum Press Release
  21. Randy Hultgren - The UGLY Truth
  22. Tea Party Guest Blast Obamacare

Tyranny Disguised As Health Care Reform & How To Truly Reform Health Insurance

After more than a year of back room deals and bribery. The Democrats passed their health care “reform” bill on March 23rd 2010 against the will of the majority of We The People. Click here to view the new law. If you don’t have the time to read the entire bill (like most members of congress). You can click here for an excellent chart published in the Wall Street Journal on March 18th, 2010 that breaks down the differences between all of the bills proposed prior to the signing of the final bill. Oh and the cost? Well Representative Paul Ryan broke that down for all of us at the recent 7 hour long "Bi-Partisan Health Care Summit":

How did the Democrats pass a $2.4 Trillion bill that creates a new $1 TRILLION entitlement by robbing Social security and Medicare with absolutely no bipartisan support? I will now detail the Democrats ENTIRE nightmarish process of incompetency and blatant partisanship during their health care reform efforts. But before I do, let me first expose a little piece of information that the Democrats DO NOT want you to know.

If we were to simply cut the $760 BILLION in annual waste that exists in our current Health Care system, we could provide EVERY SINGLE ONE of the 46 Million Uninsured a Gold Plated Health Care plan that would make the CEO’s of Blue Cross Blue Shield GREEN with envy. Oh, and it would only cost us HALF of the aforementioned $760 BILLION. So WHY in GOD’s NAME do the Democrats want to spend $2.4 TRILLION over the next 10 years to cover the 46 Million Uninsured AND also MANDATE the purchase of GOVERNMENT APPROVED HEALTH INSURANCE? Because it’s not about health care, it’s about Tyranny.

The massive 2074 pg. Senate Health Care reform bill is called the Patient Protection Affordable Care Act and Harry Reid SWEARS it’s “deficit neutral” and that it “protects” Medicare. Even though he planned to expand Medicare to Americans as young as age 55. This was a “trade off” that took place when the Public Option was FINALLY killed on December 9, 2009 and replaced with the now equally dead Medicare “Buy In Option“. Did I mention that Medicare is already BANKRUPT with $43 Trillion dollars in unfunded liabilities? Maybe this is why Timothy Geithner, Kathleen Sebelius, Hilda  Solis and Michael Astrue were less than encouraging in their troubling 2009 annual report on Social Security & Medicare. Did I also mention that in order to GET Medicare at age 55 they were planning on charging $7,600 a year in premiums to each enrollee at a cost to Tax Payers of more than $1 TRILLION? I’m glad that’s Dead. But wait! The bill still cuts Medicare by $500 BILLION! Here’s the BEST PART of these bills! No health care “Hope” or “Change” begins until 2014!

In fact, the only thing that begins is HIGHER TAXES (for those of us who actually pay taxes and who most likely ALREADY HAVE OUR OWN HEALTH INSURANCE!) We were told by Obama & Pelosi that children would be able to get coverage on a guaranteed issue basis immediately after the new bill was signed! However, they FORGOT include that in the bill! So now, NOT EVEN THAT “benefit” will begin until 2014!

It’s a good thing that THAT IS ALREADY THE LAW IN MOST STATES! The dramatic expansion of SCHIP already ensures that most children have access to guaranteed issue health insurance already. In addition, many States like Illinois have already passed similar legislation that allows children with pre-existing conditions to be insured on a guaranteed issue basis and to stay on their parents policy until the age of 26. Side bar: Are they REALLY still children at age 26?

Speaking of TYRANNY, did I mention that the THE PRESIDENT AND SENIOR CONGRESSIONAL MEMBERS ARE EXEMPT FROM THIS BILL?

Even before the "Public Option" provision in the Senate bill was killed, there was a provision in the bill for States to "opt out" of the Government Health Insurance option. I wonder if this is because they actually READ the 3rd, 4th, 5th, 9th or 10th Amendment of our Constitution which clearly prove that these bills are UNCONSTITUTIONAL? Remember when Speaker Pelosi said that the bill will "not add ONE dime to the deficit"? I can only assume that she "mis-spoke" because these bills will add MILLIONS OF DIMES TO OUR DEFICIT. In fact, they are Ponzi schemes that would make Bernie Madoff look like a philanthropist!

These bills are economy KILLERS, Small Business KILLERS and Middle Class destroyers! Equally troubling is the fact that those who have been chosen to represent our best interests apparently have NO IDEA that we have NO MONEY to pay for this! We have now amassed a $12 TRILLION National Deficit. With this reckless spending comes consequences. The Inflation Institute outlines exactly what those consequences will be below in their short but powerful film:

By the way, if you think EITHER of these bills will cost less than $2.4 Trillion, you might want to do your own due diligence like the CATO Institute did. John Boehner tells us ALL ABOUT these bloated pieces of Govt. special interest payola on America's News Room:  

An even better assessment was made on 10/30/09 by Constitutional Attorney Mark Levin of the Landmark Legal Foundation. This could be the reason why the Wall Street Journal called the House bill "The Worst Bill EVER". Worse yet! These bills literally commit HARD TYRANNY on the American citizen BY IMPRISONING AMERICAN CITIZENS FOR UP TO 5 YEARS if they don't BUY HEALTH INSURANCE! Oh yeah it's in there! I have a natural aversion to fine print. So I've taken the Liberty of "blowing up the IRS code" (pun intended).

Want more proof? Here's some clarification on the fine and prison time clauses directly from Congress http://bit.ly/25P0Y0. If you have not read House Health Care "Reform" Bill HR3200 yet, below is a video that highlights some gems from this nightmarish bill:

One of the most enjoyable videos I have seen in a LONG time is the one where Speaker Pelosi was asked by an intrepid reporter if she felt it was "fair" to imprison people who do not buy Health Insurance. Always nice to see a politician squirm when questioned about their OWN LEGISLATION!



How are former Health Care reform activists responding to this? Watch
MSNBC's Dylan Ratigan Yell at Congresswoman Debbie Wasserman Schultz (D-FL) as she tries to "spin" the truth about the health care "reform" bills.

Even the Patron Saint of health care "reform" Dr. Howard Dean is now saying KILL THIS BILL!

Keith Olbermann goes a step further and states "I will got to jail before I buy Obamacare Insurance!" KILL THIS BILL!

Pelosi's Bill will also cut $500 BILLION in Medicare. What will that do? Listen to Senate Minority Leader Mitch McConnell on 11/17/09

Congressman Ed Whitfield (Kentucky) lists some other "ugly truths" about Pelosi's "health care reform" bill (also on 11/17/09):

Did I also mention that Senator Barbara Mikulski's (Maryland Democrat) bill that designates ABORTION AS PREVENTATIVE CARE just passed in the Senate as well?  This is MADNESS! According to CBS News, there are ONE MILLION VETERANS WAITING for their disability claims RIGHT NOW through the Veterans Administration & we want to expand this bloated bureaucracy nationwide? More MADNESS:

You may be asking yourself. HOW DID THIS BILL GET PASSED? Well at first it was hopeful that AT LEAST A FEW Democrats would have a 'crisis of conscience" and vote against the Senate bill. However, their guilty conscience was quickly appeased with MILLIONS & MILLIONS of YOUR TAX DOLLARS. First, there was the $300 MILLION bribe to Senator Mary Landreiu (which is now known as the new "Louisiana Purchase"). Senator Landreiu was very public about her lack of support for the health care bill. She even told the press that "I can not be bought" But after she received YOUR MILLIONS for her State, she quickly changed her vote to "YES".

Then there was the "Nebraska Purchase" to Senator Ben Nelson. He was the last "holdout" in the Senate. First, the Whitehouse threatened to close Offutt Air Force Base in Nelson's home state if he did not vote "Yes". Once this threat was exposed in the media, the Democrats chose to fall back on the tried and true negotiation tactic known as "PAYOLA". After Senator Nelson & Senator Reid spent 13 hours behind closed doors. Senator Nelson (a former staunch advocate against funding abortions with tax dollars) ALL OF A SUDDEN changed his vote to a "YES". Why? Because his State would now be EXEMPT FROM PAYING ANY ADDITIONAL MEDICAID COSTS ASSOCIATED WITH THE PASSAGE OF THIS BUREAUCRATIC MONSTROSITY! Funny how a MILLIONS OF YOUR TAX DOLLARS can "ease the conscience" of your elected officials!

Those are only 2 of the dirty back room deals cut by Harry Reid. For a complete list of every "dirty deed" see The Washington Post.

Here's how Harry Reid makes his back room deals:

How exactly can President Obama state that he "will not increase taxes on the middle class" if he allows these massive 1,990 & 2074 paged TRAIN WRECKS to pass? Does he not know what American's think about these bills? Did he not here us in Washington D.C on the steps of our nation's capitol at the "KILL THE BILL" rally on November 5, 2009?

OR at the Code Red Rally on December 15, 2009?

JUST LOOK at all the NEW TAXES nestled deep in side these massive bills! Not to mention the $6.7 BILLION in new Premium Taxes!

How will ALL of these new taxes affect us? Forbes Magazine does a GREAT job of breaking it all down.

Senator Jim DeMint (R-S.C.) pointed out some VERY DISTURBING language in the Senate health care bill during floor remarks on 12/21/09. First, he noted that there are a number of changes to Senate rules in the bill--and it's supposed to take a 2/3 vote to change the rules! And then he pointed out that the Reid bill declares on page 1020 that the Independent Medicare Advisory Board cannot be repealed by future Congresses! This is unprecedented legislation that is tantamount to TYRANNY!
 

With all of the aforementioned evidence stacked against the health care bills. Senate Democrats STILL say Republicans are "evil" for opposing it. My favorite video showing the Democrat's "righteous indignation" towards Republicans was the recent drunken tirade by Max Baucus from the floor of the U.S. Senate. That's right, I said DRUNKEN tirade from the floor of the US Senate:



All of this insanity began last July, when the Congressional Budget Office scored the Democrat's HR3200 Health Insurance reform bill
BEFORE Democrats  snuck 75 "phantom" amendments in to the bill (which were NOT scored by the CBO). On October 7th, 2009 the CBO was then commissioned to score the first 1502 paged Senate reform bill hilariously named America's Healthy Future Act of 2009. The assessment (at first) seemed to be more favorable than the earlier score given to HR3200 back in July. That is of course, until Price Waterhouse Cooper exposed the TRUE COST of the Democrat's Health Insurance reform bills. Let's just say the word ROB doesn't even begin to describe what an abject failure the Democrats "reform" bills would be. Moreover, not only will the bills NOT be deficit neutral, they will actually end up costing Tax Payers dramatically more for their health insurance For excellent in depth video commentary on Price Waterhouse Cooper's cost analysis please watch the informative video below:

Democrats have made it clear that they believe that health care is a "Fundamental Right". However, no one seems to be discussing the "fundamental rights" we LOSE under both of these bills. In fact, if it were not for Patriotic American Tax Paying Citizens voicing their INFORMED dissent at Town Hall Meetings across the country AND the ONE MILLION NINE HUNDRED EIGHTY SIX THOUSAND Patriots who showed up in Washington D.C. on 09/12/09. President Obama and a Democrat controlled House & Senate would have MOST DEFINITELY passed HR3200 in it's original UGLY form!

The sad truth is the vast majority of the population (and the majority of Senators) have not bothered to actually READ the 1,000 plus paged HR3200 bill or the 1,502 paged "America's Healthy Future Act of 2009. To save us time  the U.S. Chamber of Commerce outlined the fundamental rights we loose under the HR3200 bill Click here to read their analysis. An even better in depth analysis was recently completed by...wait for it....an ACTUAL Insurance Broker with 22 years of experience in.....wait for it.....The Health Insurance Industry! What a concept! Consult with those who actually know what they're talking about! His excellent in depth analysis of the House Health Care "Reform" Bill HR3200 can be found on his web site @ www.wrongreform.com

Regarding America's Healthy Choices Act. All you need to do is read
Section 2203 entitled "Guaranteed Issue and Renewal For Insurance Plans" (starting on Page 19). I
n this section we enter in to what I like to call "Lawmaker La La Land" where not only must an Insurance company COVER ALL APPLICANTS REGARDLESS OF PRE-EXISTING CONDITIONS, but they also are PROHIBITED from charging ANYTHING EXTRA because of pre-existing conditions. For those that have no idea how health insurance works (like those in the Senate who actually wrote this ridiculous legislation) I'll quote (in part) directly from the Wall Street Journal article of 8/12/09.

"If insurers are forced to sell coverage to everyone at any time, many people will buy insurance only when they need medical care. This raises the cost of insurance for everyone else, in particular those who are responsible enough to buy  insurance before they need it; they end up paying even higher premiums. And the more expensive the insurance, the less likely people will buy it before they need it.

That's one reason that only five states—Maine, Massachusetts, New Jersey, New York and Vermont—have Mr. Obama's proposal for "guaranteed issue" on the books today. New Hampshire and Kentucky repealed such laws after finding that they soon had an even smaller individual insurance market as companies fled the state.

Another proposed reform known as "community rating" imposes uniform premiums regardless of health condition. This also blows up the individual insurance market, by making it far more expensive for young, healthy or low-risk consumers to join pools—if they join at all. And if the healthy don't join risk pools, then premiums go up for everyone and insurers have little choice but to reduce their risk by refusing to cover those who have a high chance of getting sick, such as people with a history of cancer. This is why 35 states today impose no limits whatsoever on how much insurers can vary premiums and six states allow wide variation among consumers.

New York, New Jersey and Massachusetts have both community rating and guaranteed issue. And, no surprise, they have the three most expensive individual insurance markets among all 50 states, with premiums roughly two to three times higher than the rest of the country. In 2007, the average annual premium in New Jersey was $5,326 for singles and in New York $12,254 for a family, versus the national average of $2,613 and $5,799, respectively. Obama Care would impose New York-type rates nationwide."

So you see Health Insurance is about MANAGEMENT of RISK. Insuring everyone regardless of medical history and without charging anything extra is actuarially UNSOUND. Since Health Insurance companies have to be fiscally responsible, such practices lead to unmanageable risk and in turn unaffordable premiums. This is exactly why a Federal "Public Option" could NEVER POSSIBLY be considered "Healthy Competition". Why? Because insurance companies can not tap in to the Federal reserve when claims exceed revenue. A Federal "Public Option" would most certainly do so (as the Federal Government has been doing feverishly lately).

This is clearly NOT the way to "reform" our health care system and this is why we have seen predominantly Liberal news outlets like The New York Post, The Huffington Post, Salon.com and The Washington Post vehemently condemn President Obama's "Health Care"...er...."Health Insurance" reform plans. Whilst both parties (and most American's) feel that something has to be done. The question is, what is the best course  of action?  There are still those who actually believe that a "Single Payer" system would be the best option. The President does not  agree, although he clearly stated his support for such a system prior to his election.

One of the most passionate statements made by any Congressman thus far on the current health insurance reform debate was made by Michigan Congressman Mike Rogers. After actually READING the bills, he had some genuine concerns and he was not afraid to voice them and boy did he EVER voice his concerns!


For those of you old enough to remember Jack Webb, you will thoroughly enjoy his thoughts on President Obama's plans here:

Nevertheless, we still definitely need health care reform on many levels and if Government must play a part, there are intelligent things they can do. Here’s where they can actually help:

  •  Eliminate the ridiculous State imposed Mandates that PROHIBIT Health Insurers from offering coverage in EVERY SINGLE STATE! For example, Small Businesses in California have roughly 6 (yes that's six) options for Health Insurance. Yet there are 1,300 Health Insurance companies in America! States like Colorado FORCE carriers to cover "substance abuse" which DOUBLES the Health Insurance premiums in Colorado (you can now waive "substance abuse" coverage and your premium is subsequently reduced BY HALF!). This kind of State Mandate (and so many more) is what prevent the majority of Health Insurance carriers from offering their products in every State.

    Basic economics 101 teaches us that NOTHING increases quality and drives down prices LIKE COMPETITION! How can we increase quality and competition when we stifle it by imposing ridiculous mandates that inhibit competition from the get go? All 1,300 Health Insurance carriers should be able to offer ALL of their products in EVERY SINGLE STATE. This way if you do not like your current coverage you have 1, 299 OTHER OPTIONS. With that many options available, carriers are NATURALLY FORCED BY THE RULES OF COMPETITION AND FREE MARKET ENTERPRISE to IMPROVE not only the quality of their products but to also improve their customer service OR THE CONSUMER WILL PURCHASE their Health Insurance from 1,299 other carriers! It's as simple as that! Also, actuarial tables teach us that the more lives that are in the pool, the lower the premiums for all. How much lower could premiums be if everyone in EACH state had 1300 carriers to choose from? This is why I support the repeal of the outdated McCarran-Ferguson-Act of 1945
     

  •  Instead of bailing out GM with Billions of our blood sweat and tears and then letting them file bankruptcy 3 months later. Why not expand State Run High Risk Pools to ALL States for those who are rendered uninsurable? We already have such State Run High Risk Health Insurance pools in the majority of States. These Risk Pools will cover anyone regardless of their medical history. The problem is they are under funded so the premiums are extremely high. Instead of spending up to $2.6 TRILLION over the next decade to insure only 20 Million of the 45 Million uninsured. LEAVE the bulk of the nation's risk where the money is, namely with the insurance companies. Since the uninsured FAR outweigh the uninsurable, this would cost far less than the currently proposed $2.6 Trillion over the next 10 years.
     

  •  Update the outdated Health Insurance Portability laws (regarding credit for pre-existing conditions) to INCLUDE Individual Health Insurance Policies. As it stands now, HIPAA law allows an insured to move from one "Employer Sponsored Group Health Insurance Plan" to another "Employer Sponsored Group Health Insurance Plan" and receive FULL coverage for "pre-existing" conditions so long as they can prove to the new carrier that they have had 18 months of prior coverage with no lapse of more than 63 days. Millions of American Entrepreneurs have chosen to leave Corporate America and strike out on their own since these outdated laws were written in the 1990's. As the face of our work force changes so too should the laws that protect it. Most especially since these entrepreneurs shoulder the BULK of the nation's risk and PAY the bulk of the nation's tax load! Throw them a legal bone!
     

  •  Make ALL Health Insurance 100% TAX DEDUCTIBLE! I say ALL Health Insurance because employer sponsored health insurance IS 100% tax deductible BUT it's NOT tax deductible if you purchase your own Individual Health Insurance policy on the open market.
     

  •  Educate the American consumer about the primary reason for the high cost of health insurance! Namely, LOW DEDUCTIBLE, LOW CO PAY (a.k.a. Traditional) Health Insurance. NOTHING drives up the cost of Health Insurance like maintaining a low deductible, low co pay plan. Instead, offer new more intelligent option to the American Consumer like "Consumer Driven Tax Qualified Health Insurance". There simply is no more intelligent or cost effective way to insure anyone. The sad part is, these Consumer Driven Tax Qualified concepts have been around for more than a DECADE! Yet, only a small minority of the American population has even explored these intelligent (& much lower priced) Health Insurance alternatives. Those that have, are WAY AHEAD of the rest of population when it comes to managing medical risk.
     

  •  I would say weed out the 12 million Illegals (that we know about) who are sucking our Medicaid system dry...but as Congressman Joe Wilson so aptly stated, Obama CLEARLY wants to "provide a PATH TO CITIZENSHIP for the 10 to 12 million Illegals in our country". Once they're legal, he can then cover them ALL on our tax dollar! So YES his plan IS to cover Illegals, he'll just make em legal first! Think they're not sucking our Medicaid system dry? Just visit California or Illinois. Good old “Blago” enrolled thousands of Illegals in to our Medicaid system, thereby running the program in the ground & leaving our Illinois Medicaid system approx. $1.5 BILLION behind in payment of claims to physicians who have been providing “free” care to all illegals who were lucky enough to flock to the State of Illinois to insure themselves for “free”. In fact, according to the U.S. Census Bureau 10 to 12 Million of the Uninsured in America are illegal aliens. Who comprise the rest? Find out here.
     

  • TORT REFORM! This is one area of reform that is rarely spoken of by the Liberal left. Medical malpractice liability forces providers into practicing defensive medicine. In other words, it causes medical practitioners to order multiple expensive (and often times unnecessary) tests and procedures "in defense of" potential lawsuits, JUST IN CASE they miss something in a patient's case. All for fear of being sued for ridiculous amounts in a malpractice lawsuit. Limiting liability lawsuit awards to reasonable amounts will deter those who seek the "big pay day" by filing frivolous lawsuits against medical practitioner.
     

  •  Establish a Federal oversight committee to regulate and hold accountable physicians who make medical mistakes. What’s one of the biggest reasons why health care is so expensive? Hint: It’s not “rich CEO’s” and “outdated medical records transfer processes.” It’s Medical Mistakes! Here’s the real facts you won’t find in the media outlets:

1994: Five years after a groundbreaking Institute of Medicine report focused attention on medical errors in hospitals, Americans say that they do not believe that the nation’s quality of care has improved. In fact, 1 out of 3 patients states that they have experienced a serious medical error http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.534

1995: A Study published in the Journal of American Medical Association (JAMA) found that only two percent of medication errors that occurred during the medication administration process were intercepted.
a. More people die from medication errors than from work place injuries
b. Medication errors account for approximately one out of 131 outpatient deaths and one out of 854 inpatient deaths.

1999: Institute of Medicine (IOM) releases its first report on healthcare quality and medical errors. http://www.iom.edu/?id=12735 The Study finds in part that:

    a. Medical errors are responsible for injury in as many as 1 out of every 25 hospital patients.
    b. Between 44,000 and 98,000 Americans die each year from preventable medical errors in hospitals alone.
    c. The deaths from preventable medical mistakes are equivalent to the number of people who would die if a jumbo     jet crashed EACH AND EVERY DAY OF THE YEAR, and all its passengers died!
    d. Medical errors cause more deaths than motor vehicle accidents, breast cancer or AIDS…..and this study is TEN     YEARS OLD and STILL no Federal oversight committee! Oh wait! It gets worse!

2002: A Study issued by the United States Pharmacopeia (USP) concluded that more than 200,000 medication errors occurred during 2002

2004: CDC reports that 90,000 patient deaths occur each year due to patients contracting hospital acquired infections.  http://www.cdc.gov/ncidod/dhqp/pdf/nnis/2004NNISreport.pdf
    a. Many hospital acquired infections are caused by health care workers who fail to wash their hands in between patients.

2006: Studies assessing the state of hospital patient safety conclude that current progress is slow, results in general are at best modest, and the gap between the best possible care and actual care remains large.  http://www.healthgrades.com/media/dms/pdf/PatientSafetyInAmericanHospitalsStudy2006.pdf

More Facts:

Preventable medical errors result in extended hospital stays, expensive treatment for chronic medical conditions and astronomical medical costs that are associated with treating debilitating life-long illnesses. Some experts state that these costs may be in the range of $150-200 Billion dollars per year. Gee, where else could we spend that money??? Quick reminder:

ALL of the aforementioned happened under the nose of our Federal Government. And we want them to regulate Health Care?? Let’s not save ALL of our anger for the “greedy” insurance companies and “over paid” doctors and CEO’s. Let’s focus our Anger on our GOVERNMENT who has allowed this systemic problem to continue over three administrations!

Ask yourself, why does the health care industry basically regulate and report on itself? Why is certification and accreditation voluntary? Why don’t we have a Federal agency that acts like the FAA and investigate medical mistakes, just like airline accidents or near misses? Why do only some states have mandatory reporting requirements of medical errors? All Good Questions that need to be answered before we hand over our very health freedoms to the same Government to “regulate”.

In summary, REAL healthcare reform can be accomplished through consumer education, weeding out abuse of existing Federal entitlement programs (via a legitimate needs assessment) and increased funding and expansion of existing State sponsored Risk Pools so that people who are declined for insurance have an affordable option to continue coverage if declined on the individual major medical market. Following these few simple steps will go a long way towards not only maintaining our current health care system, but also towards keeping the bulk of our nations risk where it belongs, namely with the private health insurance industry. In light of the recent multi Trillion Dollar "Bail Outs" and many other failing corporations coming to the table with their hats in their hands (and their private jets on the tarmac) the last thing our government should do is start cutting more blind "bail out" checks in an effort to "reform" the U.S. health care system.

The big question is, why is Congress not listening to the cries of We The People? Listen to the frustration of this CA Small Biz Owner:

More importantly why are they not listening to the THOUSANDS of physicians who DO NOT support these "reform" bills?



But hey what do I know? The video below sure makes Government sound wonderful! I mean just look at their track record!

What this Administration (and others before it) do not seem to understand are the basic fundamental principles and guidelines our Founders knew long before our current fiscal insolvency. For a refresher course on the wisdom of our Founders watch this:

By the way, unlike the lies told by the Democrats. Conservative Republicans DO HAVE a plan to reform our nation's health insurance system. It is called the "Empowering Patient's First Act" or HR3400. If you ever wondered what the differences are between Conservatives and Liberals this Power Point Presentation sums it up quite nicely. Here's what's coming this year for Democrats:

Watch the brief Customer service videos below for a brief snapshot of what we have to look forward to under Obamacare:








Dick Morris breaks down what could really happen if Obamacare passes:

Now that you've read all this please take the "Red Pill" (in liquid form) to forget all about the nightmare described above:



The Obama Administration One Year Later:

Power Point Presentation: The TRUTH about Dr. Donald Berwick The new head of the Centers for Medicare & Medicaid Services.

Power Point Presentation: The Implications of Health Care "Reform"

Representative Melissa Bean's letter to her constituents sent April 20, 2010

My Response to Representative Melissa Bean

Melissa Bean response in July issue Conservative Magazine of Illinois

Real World Ramifications of Obamacare

False Promises of Obamacare

Obamacare Medical Loss Ratios

PPACA Mandated Rate Increases

Somos TeaConos: The Growth Of Hispanics Within The Tea Party Movement" ENGLISH

Somos TeaConos: The Growth Of Hispanics Within The Tea Party Movement SPANISH

Universal Health Care. What Are The Facts? Would It Work For The United States?

Since there are so many ideas on the table, it is difficult to know what the right course of action is. Most especially when you are on the outside looking in. One thing we know for sure is an NHS system or a "Single Payer" system has NEVER worked in other countries. All one needs to do is open any newspaper and read the thousands of medical horror stories experienced by those who are victims of such systems. Recently ABC's 20/20 program did an in depth study of this issue. The result of which clearly outlined the problems with the U.S. Health Care System, and outlined a clear & concise path regarding what needs to be done on a National scale to truly reform our Health Care System. If you have not seen the 20/20 episode entitled "Sick in America" with John Stossel. Please take the time to watch all 6 videos. It will take about 45 min of your time but it is well worth it to know what's really going on and what can be done right now to accomplish REAL reform without spending Trillions of U.S. Tax Payer Dollars. In fact, it will SAVE us money!

Sick in America" (Part 1 of 6)

"Sick in America" (Part 2 of 6)

"Sick in America" (Part 3 of 6)

"Sick in America" (Part 4 of 6)

"Sick in America" (Part 5 of 6)

"Sick in America" (Part 6 of 6)



A common example used to further the cause of adopting a Single Payer system in the United States is to point out how well it is working in countries such as France and Canada. 20/20 touches on this in the above episode. However, very few have done a more in depth study of Canada's Single Payer system than documentary film maker Stuart Browning. For even more about what is really going on with the Canadian health care system please watch his short but very informative documentary videos below. Again, well worth your time.
 



What's it like JUST TO SEE A DOCTOR with Canada's Single Payer System? Watch Steven Crowder's hidden camera video:

Health Broker - Rick Baker (featured in the above film) asks you to help stop Congress from adopting Canada's system by signing the petition at www.freeourhealthcarenow.com Please help secure your rights to your own health care choices.

Why is Rick so passionate about his plea for your help in stopping the adoption of a Government Run Health Care System for all Americans? Because certain "progressive" states have already adopted such State Run Health Care Systems. Take a look at what happened to Barbara Wagner who was a victim of the "Oregon Public Health Insurance Plan". When Government runs ANYTHING it's all about price containment and not the Health & Welfare of the Patient.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world.  Economists, government officials, insurers and academics alike are beating the drum for a far larger government role in health care.  Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex.  However, before turning to government as the solution, some unheralded facts about America's health care system should be considered, says Scott W. Atlas, a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center. 

Americans have better survival rates than Europeans for common cancers:

  • Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom.
  • Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway.
  • The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Americans have better access to treatment for chronic diseases than patients in other developed countries:

  • Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease.
  • By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Lower income Americans are in better health than comparable Canadians:

  • Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent).
  • Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."

Americans spend less time waiting for care than patients in Canada and the United Kingdom:

  • Canadian and British patients wait about twice as long -- sometimes more than a year -- to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.
  • All told, 827,429 people are waiting for some type of procedure in Canada.
  • In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

Source: Scott W. Atlas, "10 Surprising Facts About American Health Care," National Center for Policy Analysis, Brief Analysis No. 649, 3/24/09 http://www.ncpa.org/sub/dpd/index.php?Article_ID=17770


 
Because of how the Single Payer System is designed, citizens of England & Canada have NO WHERE NEAR the choices that we as American citizens do. As a matter of fact, until very recently (2005) it was simply not possible for a Canadian citizen to pay for their own health care or to purchase private medical insurance that would "bump them up the long waiting list" for medical treatments. The reason Canadian citizens now have the right to do so (and it is still limited) is a direct result of long hard battles (many that are still being fought) that have been waged by brave Canadian citizens like Dr. Jacques Chaoulli who took his clients case all the way to the Canadian supreme court and won! Dr. Chaoulli (http://www.healthcoalition.ca/chaoulli.html) and his patient, George Zeliotis, launched their legal challenge to the Canadian government's monopolized healthcare system after waiting more than a year for hip-replacement surgery.
 
Canada's high court found for the plaintiffs and in doing so issued the following statement: "The evidence in this case shows that delays in the public healthcare system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public healthcare. The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital healthcare result in physical and psychological suffering that meets a threshold test of seriousness." Furthermore, Justice Marie Deschamps said, "Many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life. The right to life and to personal inviolability is therefore affected by the waiting times."

Furthermore, the Vancouver, British Columbia-based Fraser Institute which keeps track of Canadian waiting times for various medical procedures. According to the Fraser Institute's 14th annual edition of "Waiting Your Turn: Hospital Waiting Lists in Canada (2006)," total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, rose from 17.7 weeks in 2003 to 17.9 weeks in 2006. Depending on which Canadian province you live in, a simple MRI requires a wait between 7 and 33 weeks! Orthopedic surgery could require a wait of 14 weeks for a referral from a general practitioner to the specialist and then another 24 weeks from the specialist to treatment! For even more real life horror stories about Canadian citizens left in the lurch by the Canadian healthcare system read the well researched and fact based Wall Street Journal article entitled "Too Old For Hip Surgery" here: http://online.wsj.com/article/SB123413701032661445.html?mod=article-outset-box This is what happens when you put government in control of your health care decisions. Doing so in this country, would be nothing short of a train wreck. Anyone who thinks otherwise is simply uninformed or "willfully ignorant".

What has our government done, to convince people to hand over our very health freedoms for it to govern over?
Katrina……..?
Fannie Mae – bailout? (this is a government entity who's employee's receive bonuses!) What other government employee receives bonuses for doing their jobs?
Social security – bankrupt ? (robbed for other expenditures)
Medicaid – ? (robbed for other expenditures)
$2 trillion Porkulus bill - ? (and growing)
AIG – bail out, yet nobody knows where's the money gone? No committee of oversight in place (was promised by our representatives to be in place immediately)
Gas prices - ? (50% of every dollar at the pump goes to Washington) But who did you point your finger at as the problem?

Since our government "cannot" be sued, how will one be able to be recompensed for its malfeasance or neglect? How will the government, once it tells 300 million people "go see the doctor we will pay all the bills", be able to control the consequences? By overwhelming our medical profession or breaking it, will come another "grand government solution," we need more money to fix it"! You are already familiar and have accepted this excuse for too long, and know this to be their power solution. Our government has impoverished our families' financial freedom to pay our own way, by immoral taxation. Want to know what such a government endeavor will cost the U.S. Tax Payer? Read the April 12, 2009 Wall Street Journal article entitled "The End of Private Health Insurance" http://online.wsj.com/article/SB123958544583612437.html?mod=googlenews_wsj

Even more suggestions towards reforming the US Healthcare system were made by United Healthcare CEO, Stephen J. Hemsley. Read his suggestions made on 4/9/09
 http://www.insurancebroadcasting.com/insurance-news-042009-3.htm

Find out what's really driving the increase in Health Insurance premiums. Read the in depth study by the Institute of Health Care Knowledge published May 2009:  http://www.wellpoint.com/pdf/Premium%20Cost%20Drivers.pdf

Is Health Care A Fundamental Right? If So What Should Governments Role Be?

As a multi-state Licensed Broker/Agent, I have been providing quality Health Insurance services for hundreds of families  and Small Businesses around the country for the last 15 years and I have seen first hand how WELL our health care system  works and how well our Health Insurance system works. I have seen first hand (over and over again) what happens when  a Health Insurance company pays claims (by the hundreds of thousands) thereby protecting the financial future of their  insured and ensuring that they receive the very best medical treatment. Specifically by allowing them access to  expensive  medical  procedures that they could never afford on their own. I have also helped many consumers obtain  access to legitimate major medical Health Insurance even if they were labeled as "uninsurable" on the open market.

Yet time and time again, I read how "evil" insurance companies are and how greedy their CEOs are and how they  routinely deny medical procedures and refuse coverage to those who are "deserving" of such coverage. I have also heard  many times how health care should be a "basic fundamental right" of all Americans. Even though, none of our  founding  fathers had any such "fundamental rights" in mind when crafting our Bill of Rights or our Constitution. Yet nearly  half of  the U.S. population thinks that we should turn entirely to the U.S. Government for the answer to health care  reform.  They feel as though a "Public Option" that would "compete" with private industry would solve the problem. Or worse yet they want a "Single Payer" system much like Canada has now.

You may be wondering yourself, is Government the solution? The late President Ronald Reagan summed it up best when he said: “Government is not the solution, it is the problem”. But way before him, our forefathers warned of INSIDIOUS government involvement in our daily lives. Look at their wisdom hundreds of years before our present situation:

Regarding adopting failed Single Payer health care options like other foreign governments have. What did Washington say? “Against the insidious wiles of foreign influence, (I conjure you to believe me fellow citizens) the jealousy of a free people ought to be constantly awake; since HISTORY AND EXPERIENCE prove that foreign influence is one of the most baneful foes of Republican Government".

Washington again at his Farewell Address, September 19, 1796. Regarding using others blood sweat and tears to pay for those who have not earned: What did Jefferson say? “ To take from one, because it is thought that his own industry and that of his fathers has acquired too much in order to spare to others, who, or whose fathers have NOT exercised equal industry and skill, is to violate arbitrarily the first principle of association, the guarantee to every one of a free exercise of his industry, and the fruits acquired by it.”

How does this apply today?

46% of American’s pay absolutely no INCOME taxes! That means the rest of us have the privilege of paying for all entitlements (which are ever expanding). Most recent case in point:

Last year, SCHIP covered about 7 million low-income children and Medicaid covered an additional 23 million. This year, 2009, the U.S House of Representatives passed the H.R.2 SCHIP Expansion Bill which adds another 6.5 million children to Medicaid. In fact, according to U.S. Census Bureau data, 42 million children will now be eligible. The bill also allows States to receive federal reimbursement for adding more immigrant children and pregnant immigrant mothers, and removes the 5 year waiting period now required for legal immigrants to be eligible. This would enable immigrants to become eligible for health benefits the moment they get here!

Currently, the present income eligibility cap is $44,000 for a family of 4. The new bill raised the Medicaid limit to $66,000. New York will even include families who earn $88,000 and other states allow families to subtract from their income calculation what they spend on rent or mortgage or heating or food or transportation. This means that children in some families who have incomes well over $100,000 will now be eligible. With the median U.S. household income around $50,000, 60% of U.S. households still earning less than $62,000. This means that 3 out of 5 American households will now qualify for free health care for their children. It also means that the other 2 out of 5 households will have the burden of paying for all of this!

Back to our forefathers: Jefferson’s Letter to Joseph Milligan, April 6, 1816: ” There lies the distinction of “charity” or coercion. Here stands Jefferson who feared that if citizens became lazy, apathetic, and IRRESPONSIBLE, government would gain ground and become tyrannical and corrupt, plundering taxpayers for special interests and violating even property rights and other freedoms.”

How does this apply today?

With the help of the U.S. Census Bureau, let’s break down the real empirical data behind the “50 million uninsured” in America. Who exactly are they? FACTS:

  •  17 Million live in households earning more than $50,000 (38% of American uninsured)

  •  9 Million live in households earning more than $75,000 (20% of American uninsured)

  •  18 Million of the “young invincibles” (ages 18-34) who spend more money on “cigarettes, entertainment & cell  phone bills. (40% of uninsured)

  •  14 Million are eligible for Medicaid and SCHIP due to low income and do not enroll. (31% of uninsured)
        Watch “Uninsured in America”: http://www.youtube.com/watch?v=uKCWbq18bNk&feature=channel_page

  •  There are also 12 Million illegal aliens (and growing) who don't buy Health Insurance but still get "free" health care.

    So how many are legitimately uninsured? About 8 Million. That's just 18% of the 45 Million we constantly here about.

Back to our Forefathers: Jefferson again: “We must not let our rulers load us with perpetual debt ($3 Trillion Dollar “Porkulus Maximus” Bill) We must make our election between economy and liberty, or Profusion and servitude. If we run into such debts, as that we must be taxed in our meat and in our drink, in our necessaries and our comforts, in our labors and our amusements, for our callings and our creeds, as the people of England are, our people, like them, must come to labor sixteen hours in the twenty-four, give the earnings of fifteen of these to the government for their debts and daily expenses; and the sixteenth being insufficient to afford us bread, we must live, as they now do, on OATMEAL and potatoes; have no time to think, no means of calling the mismanagers to account; (government) but be glad to obtain subsistence by hiring ourselves to rivet their CHAINS on the necks of our fellow-sufferers…private fortunes are destroyed by public (government) as well private extravagance. Till the bulk of the society is reduced to be mere automations of misery……than begins, indeed, the bellum omnium in omnia (War of all against all) …..and the fore horse of this frightful team is public debt. Taxation follows that, and in its train wretchedness and oppression.” (Letter to Samuel Kerchival, July 12, 1816)

How does this apply today?

Where is the outrage that our children already, BEFORE BEING BORN are now in debt to the government by $35,000 ! Nice immoral profit I say by our government and we haven’t even begun down the slippery slope to “Universal Health Care.” Even before we begin, the $3 Trillion “Porkulus Maximus” Bail Out continues to grow as more and more corporations come to the capital with their hat in their hands and their private jets on the tarmac.

Back to our Forefathers: Jefferson again: “To compel a man to subsidize with his taxes the propagation of ideas which he DISBELIEVES and abhors is sinful and tyrannical.” – Thomas Jefferson

John Adams (Vice President US for 2 terms 1788-1796, and in 1796 became our Second President) On taxation : “Property is surely a right of mankind as real as liberty. Perhaps, at first, prejudice, habit, shame or fear, principle or religion would restrain the poor from attacking the rich, and the idle from usurping on the industrious; but the time would not be long before courage and enterprise (political opportunists) would come and pretexts be invented (socialist agenda) by degrees to countenance the majority in dividing all the property among them, or at least in sharing it equally with its present possessors. Debts would be abolished first; taxes laid HEAVY on the rich, and not at all on the others; (46% of American’s pay NO income tax) and at last a downright equal division of everything be demanded, and voted. What would be the consequence of this? The idle, the vicious, the intemperate would rush into the utmost extravagance of debauchery, sell and spend all their share, and than demand a NEW division of those who PURCHASED from them.’

Thomas Pain (1737–1809) “If, from the more wretched parts of the old world, we look at those which are in an advanced stage of improvement, we still find the greedy hand of government thrusting itself into every corner and crevice of industry, and grasping the spoil of the multitude. Invention is continually exercised, to furnish new pretenses for revenues and taxation. It watches prosperity as its prey and permits none to escape without tribute.”

Daniel Webster (1782-1852) “An unlimited power to tax involves, necessarily, the power to DESTROY.”

How do these comments apply today?

If taxation strengthens a government, while relieving it’s citizens of the freedoms above forewarned from our Forefathers, how can anyone believe taxing Americans at 60% or more (to fund a "public option") is the solution? What else could stifle personal drive and achievement more than even more taxation?

Regarding a “Public Option.” There are several reasons why a Public Option will not work. Firstly, the private sector can not compete with a Public Option. So the lie that it will just create “healthy competition” is just that. An INSIDIOUS Lie perpetrated by a Government with an unholy lust for even more power. Why is it a lie?

Because unlike the Federal Government who can tap in to the U.S. Treasury (as they have been doing feverishly lately) when claims surpass revenue. The private sector is held to a higher standard. Namely, fiscal responsibility. If claims supercede revenue, an insurance company must be held to the ramifications that happen to any company that does not balance it’s portfolio correctly. Namely, FAILURE (except, of course if that company is AIG who gets bailed out over AND OVER again by our precious BLOOD SWEAT and TEARS)!

SIDE BAR: Quick Translation of the term “Blood Sweat & Tears” for the aforementioned 46%. “Blood Sweat & Tears” means income taxes.

SIDE BAR: Further clarification of the term “income tax”. This is a percentage of income that is forcibly taken from roughly half of the American population when they produce an income.

Once the insurance companies fail (shortly after the “Public Option” starts promoting “Healthy Competition”) we will be left with “Medicare” for all! But wait! How’s Medicaid & Medicare working now? Let’s see. At the current rate of Medicare expenditures, by the time I am 65 there will be no Medicare for me according to ALL economist (on both sides of the isle). Why? Because they have been robbed for other expenditures by a fiscally irresponsible, over burdensome Federal Government. Who’s answer to EVERYTHING is to throw money at it! Easy to throw when it’s not yours.

The private sector does not have the luxury to play with America’s BLOOD SWEAT & TEARS. We must balance our portfolios responsibly and consistently or we will not have the the funds to pay the big claims when they arise (and they do arise, and they do so often). This being the case, it comes down to who the American Tax Payers (again, I stress the 50% that actually pay income taxes) want to handle their medical care. And overwhelming, those tax payers want choice and fiscal responsibility. They will receive neither through a government run “Public Option.”

Ok, well then we’ll just lean on Medicaid. Really? Will that be before or after the recent Medicaid Expansion of $87 Billion is used up or after the 78.2 MILLION Baby Boomers suck it dry to care for their long term care expenses? Gimme a break!

By the way, ever wonder why 35 Million American's don’t purchase Health Insurance? Because it’s FREE!!! There are hundreds of Free Hospitals & Clinics around the country: http://www.healthcentral.com/diabetes/c/17/66884/affordable-medical
Add to that the “compassionate care” that any one can get at every Emergency Room in the U.S. and is there any wonder why so many choose not to insure themselves? But that’s the point here. NOTHING is “free”! It’s all on the backs of the 54% of American’s who actually pay income taxes and this already MASSIVE burden will increase exponentially once Health Care is “FREE” for everyone!

Does this mean then that we should stop providing for those who are truly in need? Of course not. In fact, providing for those who are truly in need is one of the things that makes America great. We not only provide for those in our own country but we spill our precious blood on foreign soil around the globe defending the rights of our allies and protecting Liberty. We will continue to do so. My point is that what used to be entitlements for those who legitimately need them has now become entitlements for those who can MOST CERTAINLY provide for themselves.

What our forefathers envisioned was a “Just Society”. A Society that grows great upon the efforts of each citizens efforts and yet remembers that there are those amongst us WHO CAN NOT (due to infirmity, age, mental disability, disenfranchisement etc.) And we have always provided for those who are truly in need. And we will continue to do so.

Fiscal Conservatives believe wholeheartedly in helping those that are truly in need. But those that are not truly in need should PROVIDE FOR THEMSELVES! The decision to help those truly in need should be made by the hearts and minds of the individual citizen, not funded through increased tax dollars by an ever encroaching government.

Bill & Melinda Gates have contributed Billions of dollars to humanitarian efforts inside and out of this country. Oprah Winfrey has done the same, to name just a few. But no one told them they HAD to. No one forcibly took that money (other than the Millions in taxes they already forfeit to the government). Instead, their hearts were motivated to do so and this is the crux of the matter. Free citizens do not need their Government to tell them how to spend their money. Free citizens do not need their Government encroaching on their very lively hoods. And MOST IMPORTANTLY Free Citizens can certainly spend their money better than the Federal Government. Why? Because they have a vested interest in where that money goes due to the fact that they have EARNED it!

By the way, those that believe that we have a moral obligation to provide everyone with "free" health care, and feel compelled to do make sure that happens, should VOLUNTARILY pay more taxes for such programs. Those that do not, should not be forced to do so. This is the definition of a free society.

Medicaid Expansion Buckles Under The Stress of "Open Enrollment"

I have been an insurance broker in the state of Illinois for the past 15 years and I have seen first hand what happens when an over burdened, tax funded, Government controlled, entitlement program like Medicaid is offered to those with incomes well into the middle class.

Last year, SCHIP covered about 7 million low-income children and Medicaid covered an additional 23 million. This year, 2009, the U.S House of Representatives passed the H.R.2 SCHIP Expansion Bill which adds another 6.5 million children to Medicaid.

In fact, according to U.S. Census Bureau data, 42 million children will now be eligible. The bill also allows States to receive federal reimbursement for adding more immigrant children and pregnant immigrant mothers, and removes the 5 year waiting period now required for legal immigrants to be eligible. This would enable immigrants to become eligible for health benefits the moment they get here.

Currently, the present income eligibility cap is $44,000 for a family of 4. The new bill raised the Medicaid limit to $66,000. New York will even include families who earn $88,000 and other states allow families to subtract from their income calculation what they spend on rent or mortgage or heating or food or transportation. This means that  children in some families who have incomes well over $100,000 will now be eligible.

With the median U.S. household income around $50,000, 60% of U.S. households still earning less than $62,000.  This means that 3 out of 5 American households will now qualify for free health care for their children. It also means that the other 2 out of 5 household will have the burden of paying for all of this!

Let's take a look to see how some of these programs are doing. Click here to read about the Medicaid "expansion" program enacted in my home State, Illinois, by our recently impeached and now infamous Democratic Governor Rod Blagojevich.

In fact, Blago was so "generous" that he expanded these Medicaid entitlement programs to include a defunct
"All Kids Covered" plan, a defunct "Mom's & Babies" plan and an equally defunct "Family Care" plan.

These entitlement programs were designed to provide FREE health insurance coverage to all low income women who are currently pregnant (Mom's & Babies) and all children - here legally or ILLEGALLY (All Kids Covered) but they were also to provide FREE health insurance to all low income mothers of children who are insured under the "All Kids Covered" program (Family Care).

Now, one does not need to study actuarial science to quickly conclude that these types of entitlement expansion programs simply can not continue to work without massive and endless influxes of tax payer dollars. In fact, the State of Illinois is currently $1.5 Billion (yes, that's BILLION) behind in payment of claims to medical practitioners who have already provided treatment to program recipients. Furthermore, submitted claims by unpaid practitioners have accrued a potential liability of $81 million in interest due to payment delays over the past 8 years. Read more about the problems with claims payments
here

Update: As of January 2009 a moratorium has been placed on the sliding scale portion of the Illinois Family Care and the Mom's & Babies program. One can only wonder why. Could it be due to lack of funding?

Illinois had been lauded as the "Flagship" state for all others to follow regarding the expansion of the Medicaid entitlement programs. If this is the template for all others to follow, then god help us all, or at least those of us that actually fund the Medicaid system through our hard earned tax dollars.

Weighty decisions such as expanding the Medicaid system to virtually "All Kids" regardless of their actual need, simply can not be made based entirely on emotion! Prudent decision makers must weigh the desire to help all mankind against fiscal REALITY. There simply is not enough money to provide such irresponsible expansions of the Medicaid program.

This is the real reason why President Bush
vetoed the SCHIP program after the $780,000,000,000 (BILLION) "Porkulus Maximus" Bailout Bill passed in the Senate which was pushed hard by the Democratic Party. Of course, despite the caution of conservatives in the Republican party, the SCHIP bill did pass both the House and
Senate in 2009.

But how can we afford to pay for such entitlement programs? Should we limit these programs to those that truly cannot afford to purchase individual health insurance on the open market? How will we determine who is deserving of such entitlements (e.g. legal residents of this country who actually qualify during a legitimate needs assessment.)

What about personal responsibility? Should we also pay for the middle class if they can afford to purchase health insurance on their own?

Expansion of these entitlement programs to the middle class may be well meaning, but it is undoubtedly a fiscally irresponsible act that will end up crippling the already over burdened system.

We might not feel the direct impact of this now, but we most certainly will when all of the "Baby Boomers" start entering the Assisted Living and Long Term Care arena. Should we just let Boomers who don't have the forethought to purchase Long Term Care insurance off of the financial hook while taxpayers shoulder the burden?  

Today, those of us who are in need of health insurance have many options to choose from and, contrary to popular belief many of these options are priced very affordably.

An integral part of being personally responsible is that you take the time to explore ALL of your options so you can fiscally sound decisions BEFORE leaning on a an already over burdened Medicaid system.

If you have other options, you should never leave any decisions up government bureaucrats, especially your healthcare.

Health Insurance Tips & Advice For The Self Employed & Small Business Owner

I have been a health insurance broker for 15 years now and every day I read more and more "horror" stories that are posted on the Internet regarding health insurance companies not paying claims, refusing to cover specific illnesses and physicians not getting reimbursed for medical services. Unfortunately, insurance companies are driven by profits, not people (albeit they need people to make profits). If the insurance company can find a legal reason not to pay a claim, chances are they will find it, and you the consumer will suffer.

However, what most people fail to realize is that there are very few "loopholes" in an insurance policy that give the insurance company an unfair advantage over the consumer. In fact, insurance companies go to great lengths to detail the limitations of their coverage by giving the policy holders 10-days (a 10-day free look period) to review their policy. Unfortunately, most people put their insurance cards in their wallet and place their policy in a drawer or filing cabinet during their 10-day free look and it usually isn't until they receive a "denial" letter from the insurance company that they take their policy out to really read through it. The majority of people, who buy their own health insurance, rely heavily on the insurance agent selling the policy to explain the plan's coverage and benefits. This being the case, many individuals who purchase their own health insurance plan can tell you very little about their plan, other than, what they pay in premiums and how much they have to pay to satisfy their deductible. 


Excellent Health Insurance Advice from Dateline NBC

Excellent Health Insurance Advice from Doctor Jennifer Ashton on the CBS Morning Show 4/9/09

For many consumers, purchasing a health insurance policy on their own can be an enormous undertaking. Purchasing a health insurance policy is not like buying a car, in that, the buyer knows that the engine and transmission are standard, and that power windows are optional. A health insurance plan is much more ambiguous, and it is often very difficult for the consumer to determine what type of coverage is standard and what other benefits are optional. In my opinion, this is the primary reason that most policy holders don't realize that they do not have coverage for a specific medical treatment until they receive a large bill from the hospital stating that "benefits were denied." Sure, we all complain about insurance companies, but we do know that they serve a "necessary evil."

There are so many variables that consumers have to be aware of when it comes to buying health insurance. These variables, and confusing insurance terminology, are often difficult for the average consumer to understand which is why many small business owners actually put off looking for a new health plan until their rates have skyrocketed to the point that they can no longer afford the monthly premiums. Business owners, who find themselves in this position, often place a greater emphasis on how much the new plan will cost, rather than placing an emphasis on what benefits the new plan will actually offer. 

Quite often, consumers that base their purchasing decision entirely on price, don't even realize that their new plan may not provide coverage for specific medical conditions or that the amount allotted for certain treatments may be extremely limited. And, it usually isn't until they receive a large bill from a medical provider which states that "claims were denied" that they realize that they made a critical mistake in plan selection.

As a small business owner, myself, who primarily deals with other small business owners, I have come to the realization that part of the problem is that it is extremely difficult for individuals purchasing their health plan on the open market to distinguish the difference among health plans. It is also equally difficult for consumers to determine what type of health insurance coverage they actually need for their particular situation. 

Remember, there is a big difference between the type of health plan consumers actually "need" and the type of health plan consumers actually "want." Let me explain. 

Recently, I have read many blog articles that seem to stress that consumers should purchase health plans that offer 100% coverage with a very low deductible. 100% coverage means that after the deductible is met, usually $250, the plan will pay 100% of all covered medical expenses. 

Although I agree that these types of health plans have a great "curb appeal." I can tell you from personal experience that these plans are not for everyone, nor are they affordable. 

Will a low deductible plan that offers 100% coverage offer the policy holder greater peace of mind? Probably. But is a low deductible health plan that offers 100% health insurance coverage something that most consumers really need? Probably not. 

In my professional opinion, consumers must achieve a balance between four important variables; wants, needs, risk and cost when they purchase a health plan. Just like the car analogy, it is important for healthcare consumers to understand what type of health insurance benefits are automatically included or standard and which health insurance benefits are optional. For example, on most health plans, maternity and prescription drug coverage is optional. 

With this in mind, if one is healthy, takes no medications and rarely goes to the doctor, do they really need a 100% plan with a $5 co-payment for prescription drugs if it costs them $300 dollars more a month?  

Would it benefit a person to pay $200 more a month to have a 90/10 plan with a $250 deductible, or should they purchase an 80/20 plan with a $2,500 deductible which allows them to save $200 a month? Wouldn't the 80/20 plan still offer you adequate coverage? Isn't it more cost effective to put that extra $200 that would be spent on insurance premiums, totaling $2,400 per year in their bank account, "just in case" they may get sick or injured and might need to pay their $2,000 deductible?

Isn't it smarter to keep your hard-earned money yourself, rather than pay higher monthly premiums to an insurance company for an illness or injury that may never happen?

This is just one example of consumer-driven health care. Another example is an HSA qualified HPHP. A HSA qualified HDHP (Health Savings Account qualified High Deductible Health Plan) may offer a more affordable healthcare option to individuals that are searching for a health plan with very low monthly premiums. Typically, these plans offer policyholders greater flexibility and control in where their health care dollars are spent. Plans often come with a fixed aggregate family deductible, which mean that a separate deductible does not have to be met for each family member on the plan.

In addition to the significant cost savings, policyholders can fund their Health Savings Account (HSA) to pay for routine medical expenses or alternative medical therapies, like acupuncture.  Any money in the HSA that is not used for medical expenses can be rolled over to the next year and excess funds can be transferred to a tax deductible, tax deferred, interest bearing account, commonly referred to as a "Medical IRA." These types of health plans can offer tremendous tax advantages to policyholders. Not only can policyholders save money on their health insurance premiums, but they also can use this savings to build a nest egg for retirement. Many HSA administrators now offer thousands of no load mutual funds to transfer your HSA funds into so you can potentially earn an even higher rate of interest.

For more information on HSA qualified HDHPs, click here.

In my experience, I believe that individuals who purchase their health plan based on "wants" rather than "needs" feel the most defrauded or "ripped-off" by their insurance company and/or insurance agent. 

In fact, I hear almost identical comments from almost every business owner that I speak to about health insurance. 

Comments, such as:

  • "I have to run my business; I don't have time to be sick!"

  • "I think I have gone to the doctor 2 times in the last 5 years" .......and

  • "My insurance company keeps raising my rates and I don't even use my insurance!"

Again, as a small business owner myself, I can understand the frustration that many small business owners express. So, here is the $64,000 question: 

Q. Is there a simple formula that everyone can follow to make health insurance buying easier?

A. YES. Become an INFORMED insurance consumer!

If you are wondering what I mean by this, let me explain: 

Every time I contact a prospective client or call one of my client referrals, I ask that person a list of questions about their current health insurance policy. You know, that policy that is in their dresser drawer or filing cabinet. 

That same policy that they bought to protect themselves and their family from that "worse case scenario" so they wouldn't have to file bankruptcy or lose their home due to unpaid medical debt. 

That policy that they thought promised coverage for that $500,000 life-saving organ transplant, for the 40 chemotherapy treatments that they may have to undergo if they were diagnosed with cancer or the many months of physical and/or speech therapy that they might need to fully recover from a stroke. 

Q. So, what do you think happens almost 100% of the time when I ask these individuals "BASIC" questions about their health insurance policy?

A. They almost always do not know the answers!   

The following is a list of 10 Questions that I routinely ask a prospective health insurance client.

  •  1.  What Insurance Company are you insured with and what is the name of your health insurance plan? For example, Blue Cross Blue Shield-"Basic Blue." 

  •  2.  What is your Calendar Year Deductible and would you have to pay a separate deductible for each family member if everyone in your family became ill at the same time? For example, the majority of health plans have a per person yearly deductible, for example, $250, $500, $1,000, or $2,500. However, some plans will only require you to pay a 2 person maximum deductible each year, even if everyone in your family needs extensive medical care.  

  •  3.  What is your Coinsurance percentage and what dollar amount (stop loss number) is it based on? For example, a good plan design works this way. After you have satisfied your calendar year deductible, the insurance company will pay 80% ($8,000) and you will pay 20% ($2,000) of the first $10,000 in medical bills that you incur each year. This first $10,000 is termed the "stop loss number." After this brief sharing arrangement is over, the insurance company pays 100% up to the Maximum Lifetime Benefit, which is typically, $2-5 Million per insured for the rest of that calendar year. Then, everything starts over again on the first day of each subsequent calendar year. Stop loss numbers can be as little as $5,000 or $10,000 or as much as $20,000. However, be aware that there are some policies on the market that have NO stop loss number at all! Therefore, it is critical that you ask what your stop loss number is before you purchase a plan. 

  •  4.  What is your Maximum Out of Pocket Expense per year? Keep in mind that the Maximum Out of Pocket Expenses per year includes all deductibles plus all coinsurance percentages plus all applicable access fees, service deductibles or other fees.

  •  5.  What is the Lifetime Maximum Benefit the insurance company will pay if you or someone in your family becomes seriously ill and does your health plan have any "per illness" maximums or caps? For example, some plans may have a $5 Million Lifetime Maximum, but there might be a benefit cap of $100,000 per illness. This means that you would have to develop many separate and unrelated life-threatening illnesses costing $100,000 or less to qualify for the $5 Million of Lifetime Coverage. 

  •  6.  Is your plan a Schedule Plan, in that it only pays a certain amount for a specific list of procedures? For example, Mega Life & Health & Midwest National Life, endorsed by the National Association of the Self-Employed, (N.A.S.E.) endorses schedule plans under the name "Health Markets."

  •  7.  Does your plan have Doctor Copays and are you limited to a certain number of doctor co-pay visits per year? For example, many plans have a limit of how many times you go to the doctor per year for a copay and, quite often the limit is 2-4 visits.  

  •  8.  Does your plan offer Prescription Drug Coverage and if it does, do you pay a co-pay for your prescriptions or do you have to meet a separate drug deductible before you receive any benefits and/or do you just have a discount prescription card only? For example, some plans offer you prescription drug benefits right away, while other plans require that you pay a separate drug deductible before you can receive prescription medication for a copay. Today, many plans offer no copay options and only provide you with a discount prescription card that only gives you a 10-20% discount on all prescription medications. This is a dangerous policy design that can lead to catastrophic out of pocket expenses if you were to contract any one of a host of major medical conditions such as, Multiple Sclerosis or Rheumatoid Arthritis that require expensive outpatient maintenance medications which are usually not available in Generic form. 

  •  9.  Does your plan have any reduction in benefits for Organ Transplants and if so, what is the maximum your plan will pay if you need an organ transplant? For example, some plans only pay a $100,000 maximum benefit for organ transplants for a procedure that actually costs as much as $500K or more. In addition, this $100,000 maximum may also include the cost of expensive anti-rejection medications that have to be taken after a transplant. If this is the case, the insured will often have to pay for all anti-rejection medications (a.k.a. Immunosuppressants) out of pocket. Keep in mind that these medications are among the most expensive medications which individuals requiring an organ transplant will have to take for the rest of their life.

  •  10.  Do you have to pay a Separate Deductible or Access Fee for each hospital admission or for each emergency room visit? For example, some plans, like the Assurant Health's "CoreMed" plan have a separate $750 hospital admission fee that you pay for the first 3 days you are in the hospital. This fee is in addition to your plan deductible. Keep in mind that many plans have benefit "caps" or "access fees" for out-patient services, such as, physical therapy, speech therapy, chemotherapy, radiation therapy, etc. Benefit "caps" could be as little as $500 for each out-patient treatment, leaving you a bill for the remaining balance if the fee for that particular service exceeds $500. "Access fees" are also additional fees that you are required to pay per treatment. For example, for each outpatient chemotherapy treatment, you may be required to pay a $250 "access fee" per treatment. So for 40 chemotherapy treatments, you would have to pay 40 x $250 = $10,000. Again, these fees would be charged in addition to your plan deductible

Now that you have read the list of questions that I ask a prospective health insurance client, ask yourself. How many questions you were able to answer? 

If you were not able to answer all ten, don't be discouraged. That does not necessarily mean that you are not a smart consumer. I am sure you comparison shop for everything else. Maybe you were just extremely confused by all of the insurance terminology or you had a "bad" insurance agent who did not take the time to really explain the type of coverage you were purchasing.  

So how would you know if you dealt with a "bad" insurance agent? Because a "great" insurance agent would have taken the time to help you really understand your insurance benefits and s/he would have answered all of your questions about your health plan purchase BEFORE you signed on the dotted line. 

Remember, insurance agents are not different from any other professional. There are "great" insurance agents and brokers that care about clients and offer exceptional customer service, and then there are "bad" agents that avoid answering questions and typically don't return phone calls when clients leave messages about unpaid claims or skyrocketing health insurance premiums.

Q. How do you know if you have a "great" agent?   

A. A "great" agent will recommend a health insurance plan based on all four variables; wants, needs, risk and cost. A "great" agent gives you enough information to weigh all of your options so you can make an informed purchasing decision. And, lastly, a "great" agent looks out for YOUR best interest and NOT the best interest of the insurance company.

Another way to tell whether or not you have a "great" or a "bad" insurance agent is to determine how many of the ten questions you were actually able to answer without looking at your health insurance policy.

If you were able to answer all ten questions, you have a "great" insurance agent. 

If you were able to answer at least seven out of ten questions, you probably have a "good" insurance agent. But, if you were only able to answer a few questions or less than seven out of the ten, you most likely have a "bad" insurance agent. 

Always keep in mind that your health insurance purchase is just as important as purchasing a house or a car, if not more important. So don't be afraid to ask your insurance agent a lot of questions to make sure that you understand what your health plan does and, more importantly, does not cover.

If you don't feel comfortable with the type of coverage that your insurance agent suggests or if you think the price for the plan is too high, ask your agent if s/he can select a comparable plan so you can make a side by side comparison before you make a purchase. 

And, always make sure that you read all of the "fine print" in your health plan brochure and please remember to take the time to read through your policy during your "10-day free look period." 

Remember, if you don't understand something, or aren't quite sure what the asterisk (*) next to the benefit description really means in terms of coverage, call your insurance agent or contact the insurance company directly to ask for further clarification. Furthermore, make sure you take the time to perform your own research on the Internet. 

For example, if you research Mega Life and Health and Midwest National Life Insurance Company, endorsed by the National Association for the Self Employed (NASE), you will find out that there have been multiple class action lawsuits brought against these companies since 1995. Many health insurance companies, especially the ones that have to pay huge insurance fines often change their name and target more unsuspecting consumers. In fact, today these companies are selling health insurance under the name "Health Markets." 

So please perform your own due diligence and ask yourself, "Is this a company that I can trust to pay my health insurance claims?"

Additionally, find out if your agent is a "captive" insurance agent or an insurance "broker." 

Why?  

"Captive" insurance agents can only offer ONE insurance company's products. In contrast, an "Independent" agent or insurance "Broker" can offer you a variety of different insurance plans from many different quality carriers.  

Over the years, I have developed strong and trusting relationships with my clients and I am constantly developing new clients through existing client referrals. This is partly because of my level of insurance expertise and primarily due to the level of personal service that I provide.

Because personal service is extremely critical to building long-term client relationships, this is the main reason that I caution people to be very careful when using online quoting engines and online applications to buy health insurance on the Internet. 

Again, in my professional opinion, there are too many variables to consider when shopping for health insurance. Therefore, I am a firm believer that a health insurance purchase requires the level of expertise and personal attention that only an insurance professional can provide. And, since it does not cost a penny more to purchase your health insurance through an independent agent or broker, my advice to you would be to use Ebay and Amazon for your less important purchases and to use a knowledgeable, ethical and reputable independent agent or broker for one of the most important purchases you will ever make....your health insurance policy.

Lastly, if you have any concerns about an insurance company, contact your state's Department of Insurance BEFORE you buy your policy. Your state's Department of Insurance can tell you if the insurance company is registered in your state and can also tell you if there have been any complaints against that company that have been filed by policyholders.

Also, if you suspect that your agent is trying to sell you a fraudulent insurance policy, for example, you have to become a member of a union to qualify for coverage, or s/he isn't being honest with you, your state's Department of Insurance can also check to see if your agent is licensed and whether or not there has ever been any disciplinary action previously taken against that agent.

In closing, I hope I have given you enough information so you can become an INFORMED insurance consumer and you can understand why "The Best Policy Is A Great Agent." Whatever decision you make in regards to your health insurance, please always remember to heed the following words of wisdom.  

  • "If it sounds too good to be true, it probably is!" ..........and

  • "If you only buy on price, you get what you pay for!"

What Do Women Really Want? Watch The Video Below To Find Out.

Ten Questions You Should Ask Your Agent Before You Buy A Policy

If you are a business owner, self-employed or an employee of a company that is not offered medical coverage through your employer, you may have to undertake the frustrating, daunting and time consuming task of purchasing health insurance on your own. If this is the case, there are certain things that you can do become an informed consumer so you can ensure that you are purchasing the type of health insurance coverage you really need at a price you can afford.

When you purchase a health insurance plan, it is important that you balance four important variables:
wants, needs, risk and cost, before you spend your money.

Although you may "want" a health plan that offers you 100% coverage and a $5 Copay for prescription medications, you may not "need" this type of health plan if you are healthy, take no medications and do not have any significant health related "risk" factors.

Since a 100% health plan will "cost" significantly more than an 80/20 Plan, it may not be in your best interest to pay higher monthly premiums for 100% coverage if you are currently healthy.

Although no one knows exactly when they will actually use their insurance coverage, considering these four key variables prior to purchasing a health plan is a good rule of thumb.

It is also critical for health insurance consumers to understand that all plans, even 100% Plans, have some form of coverage limitations. Knowing what your policy DOES NOT cover, is more important than knowing what it DOES cover.

Many plans also have a separate deductible for emergency room visits. These deductibles are in place to discourage policyholders from using the emergency room as a doctor's office. Typically, these ER deductibles are waived if the patient is admitted to the hospital. 

The following is a list of 10 key questions that should help health insurance consumers to better understand the coverage limitations of the plans they are considering purchasing. Make sure you ask your insurance agent these questions BEFORE purchasing a health insurance policy. 

  •   1. What insurance company do you represent and are you a "captive" agent, "independent" agent or an insurance "broker?" "Captive" agents represent ONE insurance company's products only.

An "independent" agent or insurance "broker," on the other hand, typically represent many quality insurance carriers and can sell a variety of different insurance products without any contractual restrictions.

BEWARE!  Dealing with a "captive" agent may limit your choices, since these agents can only sell that particular insurance company's health plans.

  •   2. What is the plan's calendar year Deductible and would I have to pay a separate deductible for each family member if everyone in my family became ill at the same time? The majority of health plans have a per person calendar year deductible, for example, $250, $500, $1,000, or $2,500. Some plans are designed so in a "worse case scenario" only two family members will have to pay their deductible in any given calendar year.

BEWARE! Some plans will require each person in the family to pay their calendar year deductible. This can be a huge financial burden if everyone in the family was involved in an accident or if members of the family became ill at the same time.  Many plans have a separate drug deductible before the plan will pay for any medications. Make sure you know what deductibles you will be responsible for before you buy a health plan.

  •   3. What is the plan's Coinsurance percentage and what Stop Loss Number is this percentage based on?  

    These percentages are typically based on a specific dollar amount, known as the "stop loss number." Here's where it get's tricky. Quite often, health insurance plans have different "stop loss numbers".
    I have seen some plans that have a "stop loss number" as low as $2,000 and as high as $25,000 or some with none at all. 

Let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $1,000 deductible and an 80/20 split of the first $5,000 ("stop loss number.")

$1,000 + 20% of $5,000 ($1,000) = A Maximum Out of Pocket of $2,000. 

Now, let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $250 deductible and a $10,000 "stop loss number."

$250 + 20% of $10,000  ($2000) = A Maximum Out of Pocket of $2,250. (Note: Total does not include any separate "service deductibles" or access fees. Many low quality plans also have these.) 

Again, after this brief 80/20 cost sharing with the insurance company, also know as a the coinsurance percentage split, most major medical plans will pay 100% of in-network covered charges up to the Lifetime Maximum amount that is specified in the policy.

BEWARE! Some policies on the market are sold with NO stop loss, but still list a coinsurance percentage. Therefore if you purchase an 80/20 with no stop loss, you will actually be paying 20% of all of your medical bills each calendar year. So unless you want to be responsible for 20% of all of your bills, make sure you find out what the "stop loss number" is BEFORE you purchase a health plan!

  •   4. What is the plan's Maximum Out Of Pocket Expenses per year? This expense is a total of all deductibles, plus all coinsurance percentages, plus all applicable "access fees", "service deductibles" or other "fees" outlined in your policy.

BEWARE! Quite often agents neglect to tell prospects about hidden fees, so make sure you have a good grasp on the basics, like deductibles, coinsurance & stop loss numbers. Always ask about additional "fees" BEFORE you purchase the plan!

  •   5. What is the plan's Lifetime Maximum Benefit if I become seriously ill and does the plan have any "per illness" maximums or caps? The majority of health insurance plans have a two million or five million dollar Lifetime Maximum Benefit. The Lifetime Maximum Benefit is the maximum amount the insurance company will pay if you or someone in your family becomes seriously ill.

BEWARE! Some policies will stipulate that there is a maximum benefit cap of $100,000 per illness. This means that you would have to develop many separate and unrelated life-threatening illnesses costing $100,000 or less to qualify for the five million dollar Lifetime Maximum Benefit. Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I., endorsed and promoted by the National Association for the Self Employed (N.A.S.E) and the Alliance for Affordable Services are known for selling "schedule" plans with "per illness caps."

  •   6. Is the plan a Schedule Plan, in that it only pays a certain amount for a specific list of procedures? Some health plans only pay a specific dollar amount for certain procedures, despite the fact that the procedure often cost more than the plan stimulates.

BEWARE! Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I., endorsed and promoted by the National Association for the Self Employed (NASE) and the Alliance for Affordable Services are known for selling "schedule" plans.

  •  7. Does the plan have unlimited doctor copays or is there a limited number of doctor copay visits allowed each year? Many quality plans have no limit on the number of times you can use your doctor copay.

BEWARE! Several plans have a limit of how many times you can go to the doctor each year for a Copay. Quite often, the limit is 2-4 visits per year.

  •  8. Does the plan offer Prescription Drug Coverage and if it does, what type of coverage? Some plans offer prescription drug benefits on both generic and brand name medications right away. Other plans will require you to pay a separate outpatient prescription drug deductible before you can obtain your prescription medication for a Copay.

BEWARE! Today, many plans offer NO outpatient prescription drug Copay options. Typically, these plans only provide the insured with a discount prescription card which only offers the insured a 10-20% discount on prescription medications. This can lead to catastrophic out of pocket expenses to the insured.

  •  9. Does the plan have any reduction in benefits for Organ Transplants and if so, what is the maximum the plan will pay out for an organ transplant? The majority of quality major medical plans treat organ transplants as any other illness. This means that the insurance company will cover the insured until the Lifetime Maximum Benefit of the plan is reached. Again, in most cases, this Lifetime Maximum is five million dollars. You should accept no less than one million dollars of coverage for Organ Transplants.

BEWARE! Today, some plans only pay a $100,000 maximum benefit for organ transplants. Plans that offer limited organ transplant coverage are extremely risky, since organ transplant procedures often range in the neighborhood of $350-$500K. In addition, it is not uncommon for a transplant patient to need a second organ transplant. Keep in mind, that the $100,000 maximum payment for organ transplants on many plans also includes the cost of expensive anti-rejection medications. If you have an organ transplant, you will quickly reach the $100,000 maximum benefit, which means that you will be required to pay for costly anti-rejection medication out of pocket. This can lead to catastrophic out of pocket costs to the insured.

  •  10. Does the plan have any separate "services deductibles" or "access fee" for each hospital admission or for each outpatient test? Some plans, like Assurant Health's "CoreMed" plan have a separate $750 hospital admission fee for the first three days of each hospital stay. These hospital admission fees may also be called "Access Fees" on other policies. Typically the insured is responsible for paying these access fees for each hospital admission in addition to their calendar year health plan deductible.

BEWARE! "Access fees" and "service deductibles" are separate from your plan's calendar year health plan deductible. Be aware that many plans now have benefit "caps" or "access fees" for out-patient services, such as, physical therapy, speech therapy, chemotherapy, radiation therapy, etc. These "benefit caps" could be as little as $500 for each out-patient treatment, which will leave the insured responsible for the remaining balance that is over $500.

Again, "access fees" are additional fees that you may have to pay per treatment before the insurance company will pay the provider.  These fees can quickly add up. For example, if you need to have 40 outpatient chemotherapy treatments, and you must pay a $250 "access fee" per treatment, you would have to pay an additional 40 x $250 = $10,000.

Remember, purchasing a health plan is the most important purchase you will ever make. Insist that your insurance agent explain to you exactly what your health plan does and does not cover and take the time to read the "fine print" in the plan brochure and ask questions about terminology you don't completely understand.

In addition, when you receive your health insurance policy in the mail, don't just detach your insurance cards and place them in your wallet or purse and then throw your insurance policy in your desk drawer or filing cabinet. Take the time to sit down and read your policy page by page.

Once you receive your policy, you have a 10-day free look period, so if your coverage is not what you thought you purchased, you have time to call the insurance company and cancel the policy without incurring any fees.

Finally, if your being pitched a health plan that seems to good to be true (e.g. all pre existing conditions are covered, the plan is significantly cheaper than all other plans) contact your state's Department of Insurance BEFORE you buy the policy. Your state's Department of Insurance can tell you if the insurance company is registered in your state and can also tell you if there have been any complaints against that company that have been filed by policyholders.

Remember, if you suspect that your being scammed or you think the agent is trying to sell you a fraudulent insurance policy, (e.g. you have to become a member of a union to qualify for coverage) your state's Department of Insurance can also check to see if any prior disciplinary action has been previously taken against that agent.

Don’t Fall Victim To Health Insurance Scams: 10 “Red Flags” You Should Watch Out For

In today's fast paced world, business owners don't often have the time to thoroughly check out the companies they rely on to provide goods and services. In many cases, a determination of product/service quality can be made at the time goods are delivered or services are rendered. If goods or services do not meet expectations, there is often an immediate remedy available.  For example, poor quality goods can be shipped back to the supplier and/or payment for services can be withheld until services are satisfactorily rendered.

Unfortunately, business owners do not always purchase items that are tangible items, in the sense that they can immediately determine the quality of the goods and/or services at the time of purchase. One example of such a purchase is health insurance.  Since health insurance is not usually used immediately after purchase, the quality of care or the legitimacy of the policy may not even come into play until the business owner, or a family member, actually needs to have medical treatment. This is one of the primary reasons that many companies, often appearing legitimate, can get away with selling bogus health insurance coverage to unsuspecting business owners.

In most cases, fraudulent health insurance policies are sold to business owners by telemarketers or "agents" through bogus Associations and Unions. In that, the buyer must join a professional and/or trade association or become a union member to qualify for health insurance. In fact, in a study published by the U.S. General Accountability Office (GAO) in 2004, the GAO found that association schemes ranked at the top of the marketing methods followed by bogus health insurers.  According to the report, "Employers and Individuals Are Vulnerable to Unauthorized or Bogus Entities Selling Coverage, between 2000 and 2002, the U.S. Department of Labor and state insurance regulators identified 144 unauthorized entities selling health insurance unlawfully. These entities defrauded 15,000 employers and more than 200,000 policyholders out of $252 million."

However, it is important to mention that many individual and group health insurance products are endorsed by reputable Associations, such as the AARP and the American Bar Association and, many reputable Unions, such as the AFL-CIO and the Teamsters.  These organizations have long been recognized for bringing a common class of professionals or citizens together for other purposes that have very little to do with health insurance. Membership commonly includes a wide range of other benefits in addition to discounted health insurance. Typically, the organizations have a governing organization, a constitution and bylaws, a set of officers, voting rights, regular membership meetings and a professional code of conduct. 

Unfortunately, most individuals do not find out that they were making hefty monthly payments or premiums to fraudulent Associations or Unions until they have a severe condition that requires medical treatment. Usually, it isn't until after they receive treatment that they receive notice from their medical provider that the claim that was submitted to the insurance company was denied and that all the medical charges that were incurred are now their responsibility.

Often, the scheme starts when business owners are contacted by telephone or approached by someone who claims to represent a certain, official sounding, Association or Union. The business owner is then informed that if s/he becomes a member of the Association or joins the Union, s/he could qualify for a low cost group or individual health insurance plan. Typically the Association or Union is promoted to represent self-employed individuals and small business owners. The low cost health insurance is usually presented as one of the many "perks" that the business owner can qualify for, in addition to many other "member" benefits, like discounts on other services, such as dental, eyeglasses, office supplies, hotels, rental cars, etc. 

In many instances, these bogus companies involve licensed health insurance agents to sell their fraudulent health insurance products. Sometimes the "agents" know the products are fraudulent, other times, the "agent" also falls prey to the scheme.  Often, the schemes prey upon consumers who have been previously declined insurance coverage or suffer from a pre-existing condition. Since these consumers have very limited options to purchase private health insurance coverage, the benefits of an Association or Union membership that offers health insurance coverage for a "membership fee" or "union due" is enticing. To the unsuspecting consumer that has a pre-existing medical condition or is paying high premiums for coverage, the "membership fee" or "union due" is a small price to pay for what they believe will be a quality health plan that provides "guaranteed" coverage with no "pre-existing condition exclusions" and  no "waiting periods."

In many circumstances, the print materials that are left with the consumer are very well designed, however, the majority of the time, the language in the "health plan brochure," if there is one, is very unclear. The literature may name the entity that is authorized to act as the health plan administrator of the plan, but neglect to name the actual insurance company that is providing the health insurance coverage. Unfortunately, it is often difficult for the consumer to separate the illegitimate companies selling official sounding health plans from the legitimate ones. Typically fraudulent health plans have many commonalities. 

Here are 10 "Red Flags" that may indicate health insurance fraud:

  •  1.) The "agent" is not a licensed insurance agent but an "enrollment" or "membership" coordinator.

  •  2.) The term "discount plan" is written in the product literature, but the term health plan, health insurance or policy is frequently used by the plan promoter. Discount plans often provide nothing more than a discount for medical services, such as prescription medications, eyeglasses, dental, etc.  These plans are not designed to offer major medical health insurance coverage.

  •  3.) The official sounding "Association or Union" is one that you have never heard of before.

  •  4.) The plan is referred to as an ERISA plan. The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that allows employers to set up employee benefit plans for employees and their dependents. ERISA plans are not subject to state regulation and are not regulated by the state insurance commissioner.  ERISA plans are normally not sold as health insurance, but are instead, established by employers, unions or groups acting on behalf of employers.  Therefore, unsuspecting buyers believe these plans actually offer health insurance coverage, when if fact, they do not.

  •  5.) The buyer is told that the "membership fee or union dues" includes the health insurance premium, but there is no mention of the word "premium" in any of the plan literature.

  •  6.) The plan offers "guaranteed" insurance coverage with no exclusions for "pre-existing conditions" and no "waiting periods."

  •  7.) The plan is significantly cheaper in price than other health insurance plans.

  •  8.) The term "reinsured" is used in regards to the plan. Reinsurance is something insurance companies buy to protect themselves against their own risks. It is insurance for insurance companies. Licensed insurers rarely have their agents mention any of their reinsurance arrangements during a sales presentation.

  •  9.) The Association or Union is comprised of members from all walks of life and/or requires its members to state that they belong to a certain trade, class or group of professionals that they have no affiliation with, for example, the Association or Union is said to be comprised of "Food and Beverage" workers, but "Florists" and "Machinists" are allowed to enroll as members.

  •  10.) If the Association or Union is said to have a special arrangement with a health insurance company, a plan administrator or another third party that has designed the plan using a legal "loophole" that allows members to purchase health insurance at a discounted rate or to purchase a individual or group health insurance policy.

So how can you protect yourself from falling victim to a fraudulent insurance scam?  Make sure you contact your state's department of Insurance to determine if the health insurance company and the third-party administrator are licensed to do business in your state and make sure that the "agent" selling the plan is a "licensed health insurance agent."  Additionally, make sure that health insurance company has been approved to sell the particular policy that is being offered.  Since it may be difficult to tell if fraud is involved, always put off buying your health insurance policy until you have had the opportunity to perform your own due diligence.

Cobra continuation: Are there more affordable options?

If you are not familiar with the new "American Recovery and Reinvestment Act Of 2009" then you need to learn more at the U.S. Department of Labor  web site. In a nutshell, this new Federal Act entitles you to a 65% reduction in your monthly COBRA continuation premium if you lost your job after September 1st, 2008. Granted it only lasts for 9 months, but it is most certainly going to help millions of American's who have lost their employer sponsored group health insurance coverage.

However, there are "strings attached," for those who earn more than $125,000 or $250,000 for married couples filing a joint federal income tax return, in that, if your income meets or exceeds these amounts, you may have to repay all or part of the premium reduction.  Therefore, if you are in a higher income bracket, you may wish to consider waiving your right to the premium reduction as it may increase your income tax liability for the year. For more information on how higher income earners are affected by this Act, please refer to the March 25, 2009 Issue of Forbes Magazine

But, what if you decide to elect COBRA? The question then becomes, "What do you do after the nine month COBRA subsidy expires or when your COBRA runs out altogether?" Kimberly Langford at Kiplinger's Personal Finance discusses:

Excellent Advice on what to do after your Cobra subsidy ends from Kimberly Lankford at Kiplinger's Personal Finance on CNBC May 16th, 2009

As Kimberly mentions, there are several lower cost alternatives to paying high priced COBRA continuation premiums.  Depending on what state you live in, there may be other health insurance options that you can select when your 9 month subsidy expires or when COBRA finally runs out at the end of 18 months. They are as follows:

Let's take a look at these alternative plans:

  •  1.  The first option is "State Continuation of Coverage." Many States offer State Continuation of Coverage. While State Continuation of Coverage does not follow Cobra continuation laws, it does allow you to continue your employer sponsored group coverage for up to 9 months even if your former employer employed less than 20 employees. This law does not apply to self-funded plans, so make sure to check with your State's Department of Insurance to see if your State mandates State Continuation of Coverage.

  •  2.  The second option, an "Individual Health Insurance Policy" is typically the best and most affordable alternative for relatively healthy individuals. An individual health plan can be purchased at any time and is a great way to maintain many of the same kinds of benefits that you had through your former employer's sponsored group health plan.

However, an Individual Health Insurance policy has to be "underwritten" before it is issued. During the "underwriting" process, the insurance company scrutinizes the applicant's health history to determine if it will extend an offer for insurance coverage. This process allows the insurance company to "decline" coverage to applicants with serious pre-existing or chronic medical conditions or to modify the coverage it extends to the applicant.

Today, the "Individual" health insurance market has become quite competitive; therefore, many insurance carriers are willing to offer health insurance coverage to individuals with certain controlled pre-existing medical conditions, like high blood pressure or high cholesterol. 

Other times, the insurance company will offer the applicant coverage, but will refuse to cover a specific body part or pre-existing condition. In these cases, the insurance company issues what is known as an "exclusion rider." An exclusion rider is a way for the insurance company to exclude coverage for a specific body part or a specific medical condition (e.g. right knee, uterine fibroids). Exclusion riders can be permanent (body part or condition excluded coverage for the life of policy) or temporary, (body part or condition excluded coverage for a specific period of time.)

Often, if an exclusion rider is placed on a body part and the insured receives no further treatment on that body part or if the rider is in place to exclude a pre-existing medical condition and the insured's condition completely resolves, the policyholder can request that the insurance company remove the exclusion rider from the policy. Typically, requests to remove a rider can be made after one or two years. Ultimately, the insurance company will makes the final decision on whether the exclusion rider will be removed.

An HSA qualified HDHP (Health Savings Account qualified High Deductible Health Plan) may offer a more affordable consumer-driven healthcare option to individuals that are searching for a health plan with very low monthly premiums. Typically, these plans offer policyholders greater flexibility and control in where their health care dollars are spent. Plans often come with a fixed aggregate family deductible, which mean that a separate deductible does not have to be met for each family member on the plan.

In addition to the significant cost savings, policyholders can fund their Health Savings Account (HSA) to pay for routine medical expenses or alternative medical therapies, like acupuncture.  Any money in the HSA that is not used for medical expenses can be rolled over to the next year and excess funds can be transferred to a tax deductible, tax deferred, interest bearing account, commonly referred to as a "Medical IRA." These types of health plans can offer tremendous tax advantages to policyholders. Not only can policyholders save money on their health insurance premiums, but they also can use this savings to build a nest egg for retirement. Many HSA administrators now offer thousands of no load mutual funds to transfer your HSA funds into so you can potentially earn an even higher rate of interest.

For more information on HSA qualified HDHPs, click here.

  •  3.  The third option is a "Small Group Health Insurance Plan." This type of plan can be purchased immediately and might just be what the doctor ordered for those individuals that that have been "declined" coverage for an "Individual" health plan. It might also be another option for individuals who are looking for coverage without an "exclusion rider" on a pre-existing medical condition because group health insurance provides "guaranteed insurability," which means that all applicants and their families will receive health insurance coverage for all pre-existing medical conditions.

Because recent layoffs and a tough job market have created opportunities for many professionals thinking about starting their own business, here are a few things to keep in mind when considering group health insurance coverage. Typically, a company must have a minimum of two employees. Insurance companies typically allow husband and wife to enroll separately so the two-employee minimum can be met. The company must have a Federal Tax ID number, which means that sole proprietors, will have to incorporate, unless they have an existing business with a Federal Tax ID. To qualify for a small group plan, at least two of the employees on the plan must work a minimum of 30 hours per week and must receive a wage for the 30 hours worked.

On a Small Group Health Insurance plan, a large portion of the monthly premiums are determined by the health status of those individuals participating in the plan. Even if only one individual has a serious medical condition, that individual's condition is likely to adversely affect everyone's health insurance premiums. This means that even healthy group participants will pay a higher monthly premium. It may also mean that premiums can increase dramatically (up to 300% higher or more depending on your State) if someone covered on the group plan develops a serious condition or if an individual with a serious medical condition is hired at a later date.  

This is important to keep in mind if your business is likely to grow, as your insurance contract may require you to offer new employees health insurance benefits and also require the corporation to pay a portion of your employees health insurance premiums.

The main advantage of a Small Group Health Insurance Plan is that it provides seamless continuation of coverage for those individuals who have pre-existing conditions such as Diabetes or Cancer providing that they have a minimum of 18 months of prior continuous health insurance coverage with no lapse in coverage of more than 63 days.

  •  4.  The forth option is a "State Insurance Risk Pool." This option is primarily for individuals who have serious medical conditions and who have been "declined" individual health insurance coverage. Many states, but not all, provide individuals with pre-existing conditions the opportunity to obtain seamless continuation of health insurance coverage after their COBRA continuation expires, or if they lost their employer sponsored group coverage due to a policy cancellation and they were unable to obtain an individual health insurance policy on the open market because of their pre-existing conditions.

State Insurance Risk Pools often offer immediate coverage to individuals that would normally render someone "uninsurable" on the individual health insurance market. To qualify for a State Insurance Risk Pool, applicants have to show "proof of credible coverage" for a minimum of 18 months prior to application, with no lapse in coverage of more than 63 days. Although Risk Pool coverage is also available to those who have been "declined" coverage on an Individual Health Insurance policy, there is usually a 6 or 12 months waiting period before preexisting conditions will be covered if the applicant fails to show "proof of credible coverage." To find if your state has a State High Risk Insurance Pool, click here.


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