Obama outlines health care plan for all - Page 5 - Big Big Forums

speedygirl · 06-11-2009, 03:48 AM

Quote:

Originally Posted by anothersta

I wasn't suggesting you weren't telling the truth. I'm questioning the MSM and BHO who keep harping on all of the waste in the healthcare field. Yet, you are saying it would be very difficult to have the waste as private insurance companies are micromanaging everything.

What I am suggesting is that maybe the US citizens are getting fed another made up story by this admin, when the situation may not be as bad as they are making out.

Because what I'm getting from you, with you being in the field, is that there are already checks and balances put into the system via the insurance companies to try to keep it minimal.

and that was the reference to my question.

Thanks for clarifying that. Yes there are most definitely checks and balances put into the system. I understand the need on one hand, but on the other hand it frustrates the hell out of me to see them have so much say into a patients course of treatment.
To give you a personal example of why I get so pissed after what happened to me...
I'm the patient. My insurance company's fomulary dictated specific medications for my Crohn's disease. I took several on their fomulary and none of them succesfully put me into remission. In the meantime I get diverticulitis in the inflamed/damaged area. My doc fought with them over and over until they finally agreed.The one I did need is extremely expensive...in the thousands per infusion. Long story short. So much of my large intestine was destroyed in the process of waiting for their approval, I had to have half of it removed. In the long run it cost them a hell of a lot more money for the 5 times I was in the hospital in 8 months, each for a week at a time then the subsequent surgeries, post op care, etc...The cost for all of the surgeries, procedures, tests, etc... came out to close to half a million dollars. They could have saved hundreds of thousands if they weren't trying to micromanage and allow my physician to practice medicine and allow me the treatment I needed. This is from our private insurance.
Insurance companies need to police waste but many times they get it wrong and put the patient in a precarious position. I guess I see too much of this and get frustrated.
I wish I could go back 25 years when nursing was simple...we took care of patients, felt a sense of pride in doing patient care and were able to give our patients the time that they deserved.

Bahet · 06-11-2009, 12:42 PM

Quote:

Originally Posted by anothersta

s chip, covers children who's parents make up to 100K per year.

Where in the world did you come up with that number???

Most states will cover children whose family income is at or below 200% of the Federal Poverty Level (FPL). Five states (Idaho, Nebraska, Oklahoma, Oregon, and Wisconsin) cover children whose family income is at or below 175% of the FPL, while four other states have lower thresholds. On the other hand, some states are more generous - for example, New Jersey covers children whose families have incomes at or below 350% of the FPL.
http://healthinsurance.about.com/od/...id/a/SCHIP.htm

The FPL for a family of 4 in the 48 contiguous states is $20,600. So in most states that means that kids in a family of 4 with an income of less than $41,190 are eligible. Even NJ, with by far the highest threshhold is still $8000 shy of that $100,000 mark. Oh wait, you heard it on Rush or someone like that didn't you? Some ultra rightie mouthpiece who spewed a statistic that would cover a fmily of 6 in NJ and didn't bother to give the rest of the information that that is only in NJ and instead made it sound like an only child in Idaho would be covered if they made $99,999/yr.

anothersta · 06-11-2009, 03:24 PM

Quote:

Originally Posted by Bahet

Where in the world did you come up with that number???

Most states will cover children whose family income is at or below 200% of the Federal Poverty Level (FPL). Five states (Idaho, Nebraska, Oklahoma, Oregon, and Wisconsin) cover children whose family income is at or below 175% of the FPL, while four other states have lower thresholds. On the other hand, some states are more generous - for example, New Jersey covers children whose families have incomes at or below 350% of the FPL.
http://healthinsurance.about.com/od/...id/a/SCHIP.htm

The FPL for a family of 4 in the 48 contiguous states is $20,600. So in most states that means that kids in a family of 4 with an income of less than $41,190 are eligible. Even NJ, with by far the highest threshhold is still $8000 shy of that $100,000 mark. Oh wait, you heard it on Rush or someone like that didn't you? Some ultra rightie mouthpiece who spewed a statistic that would cover a fmily of 6 in NJ and didn't bother to give the rest of the information that that is only in NJ and instead made it sound like an only child in Idaho would be covered if they made $99,999/yr.

I read it in the bill which I'm searching for now. I don't accept my facts from talk shows. It was a family of four who could qualify making 100K per year.

And that bolded statement is really hateful. Geez, can anyone have a discussion or disagreement without hateful digs.

It makes you look crazy.

Bahet · 06-11-2009, 04:04 PM

I've heard such half facts on Rush and Hannity more times than I can count. I've seen people repeat them as fact when in reality they might apply to some portion of the population but hardly the whole that they allude to. I wasn't calling you an ultra rightie mouthpiece. I was referring to Rush, Hannity, etc

anothersta · 06-11-2009, 04:18 PM

Quote:

Originally Posted by speedygirl

Thanks for clarifying that. Yes there are most definitely checks and balances put into the system. I understand the need on one hand, but on the other hand it frustrates the hell out of me to see them have so much say into a patients course of treatment.

I'm glad you asked about it so I could. It really surprised me when you thought I was saying you were lying. You and I have had several heated debates where we never took to 'personal attacks'. They were just debates.

But, in rereading my message, I didn't clarify that and see where it could've been misread. I'm glad you pointed that out.

With all of the scrutiny you're saying you see on the ground, I"m wondering how testing, etc could be cut back more. And I'm sure that you know, being in the field, that one test isn't neccessarily absolute. So many factors, so many variables, sometimes a good idea to retest before treating a disease. or, retest because it may not have been caught on the first test.

anothersta · 06-11-2009, 04:21 PM

Quote:

Originally Posted by Bahet

I've heard such half facts on Rush and Hannity more times than I can count. I've seen people repeat them as fact when in reality they might apply to some portion of the population but hardly the whole that they allude to. I wasn't calling you an ultra rightie mouthpiece. I was referring to Rush, Hannity, etc

That's why I never take my facts from 'talk shows' without doing my reading to verify. I've found tons of half truths from both sides.

The bill was passed 5 months ago, so I've got alot of digging to do, but I'll find it 'cause I know I read it. I actually made it through about 100 pages of the stimulus bill, but then gave up 'cause it would've taken forever to cross reference the stuff in there (that refers to other bills) and it was passed anyway. Seemed futile.

I wish they'd have given me a few weeks to dig into that thing before voting on it. I don't have 30 assistance to dig for me, I do the digging myself.

anothersta · 06-11-2009, 10:44 PM

Ammendment 67, proposed by Senator Cornyn January 28, 2009

Quote:

Madam President, I call up Amendment 67 and ask for its immediate consideration. I'm here today to lend my full support to the reauthorization of the State Children's Health Insurance Program. SCHIP was created with the noblest of intentions, to cover low-income children whose families did not qualify for Medicaid but who could not afford private health insurance.

Unfortunately, there are too many children today who are eligible for CHIP that are not enrolled. I strongly believe that before we consider expanding the scope of this program, as the present bill does, we need to focus on the currently eligible population of low-income children.

That's why I joined with a number of my colleagues in supporting an alternative known as Kids First. It focuses on the original intent of SCHIP, and that is to cover low-income children. Kids First provides funding to Texas over the next five years at levels beyond projected spending by the Texas Health and Human Services Commission. Across the country thousands of children are eligible but not enrolled in health insurance programs like Medicaid or SCHIP, and I believe we need to focus on those children first.

Tragically, in my state -- not something I'm proud of -- 850,000 children are eligible for Medicaid and SCHIP, but they're not enrolled. I think it's important we focus our efforts on getting these children covered. And that's why Kids First provides $400 million for five years for outreach and enrollment.

We can all agree that during these tough times, it's important that we assist as many low-income children as we possibly can. But it's also necessary that we accomplish this goal without placing excessive burdens on taxpayers. Kids First protects taxpayer dollars and pays for the funding by reducing administrative costs, duplicative spending and eliminating earmarks. Unfortunately, the bill that's now on the floor is structured in such a way that it provides billions of taxpayer dollars to cover children whose parents earn up to $100,000 and more, and eliminates the requirement that states first cover low-income children before expanding their programs.

You might ask how that could possibly be so. Well, through a mysterious thing known as income disregard, that would under this bill allow coverage at 350 percent or higher of poverty, but then allow the states to disregard certain income which, if fully employed, would mean that a family earning about $120,000 -- a family of four -- would be eligible for CHIP coverage even though children in my state whose families of four who make only $42,000 a year would not be covered. It's important we take care of the low-income children who are the original focus of the SCHIP program before we see that money being drained off, using it in other states to cover adults or to cover families making as much as 400 percent of poverty and more.
I think the bill on the floor takes an unfortunate step backward in terms of fiscal responsibility as well. The bill imposes regressive tax on middle- and low-income families and relies on the creation of 22 million new smokers to avoid the future imposition of an additional tax - a staggering, staggering fact.

To improve the bill and to focus on low-income children, I've offered this amendment that prohibits redistributing funds to states that have expanded their SCHIP program to higher income families or adults, at least until we take care of the low-income kids first. The current bill rewards states for exceeding their budget, even if they spent outside of the original intent of the program. In fiscal year 2007, for example, 14 shortfall states that received redistributed funds, out of those 14, seven of them had expanded the SCHIP program for children beyond the 200 percent of poverty level. Of those seven, four had expanded their programs above 300 percent. Redistributed funds should be reserved for covering low-income children, to assist states with specific outreach and enrollment activities that will help enroll large numbers of low-income children who are eligible but not enrolled.

We have a choice. We can either focus on low-income children or we can choose to expand the program and leave many low-income children behind. I hope my colleagues will join me in refocusing our efforts to cover low-income children first, which is what my amendment will do.

http://cornyn.senate.gov/public/inde..._id=&Issue_id=

Motion tabled by Congress same day

Quote:

S.AMDT.67
Amends: H.R.2
Sponsor: Sen Cornyn, John [TX] (submitted 1/27/2009) (proposed 1/28/2009)
AMENDMENT PURPOSE:
To ensure redistributed funds go towards coverage of low-income children or outreach and enrollment of low-income children, rather than to States that will use the funds to cover children from higher income families.

TEXT OF AMENDMENT AS SUBMITTED: CR S943-944

STATUS:

1/28/2009:
Amendment SA 67 proposed by Senator Cornyn. (consideration: CR S961-962, S967, S968-969; text: CR S961)
1/28/2009:
Motion to table amendment SA 67 agreed to in Senate by Yea-Nay. 64 - 33. Record Vote Number: 20.

http://thomas.loc.gov/cgi-bin/thomas

In Congress, 'tabled' means killed.

Bahet · 06-11-2009, 11:44 PM

Ok, so it was proposed but didn't pass so it didn't happen. Sort of like additional benefits for our military members. (Now that ticks me off!)

anothersta · 06-12-2009, 07:29 PM

Quote:

Originally Posted by Bahet

Ok, so it was proposed but didn't pass so it didn't happen. Sort of like additional benefits for our military members. (Now that ticks me off!)

Blocking funds to families earning more than 100K wasn't passed. HR2 was passed.

anothersta · 06-12-2009, 07:51 PM

Quote:

Subtitle B: Focus on Low-Income Children and Pregnant Women - (Sec. 111) Gives states the option to cover targeted low-income pregnant women under CHIP through a state plan amendment if certain conditions are met, including that the state has established an income eligibility level of at least 185% of the federal poverty line for pregnant women under Medicaid. Sets the minimum income eligibility level for children under age 19 at 200% of the poverty line applicable to a family of the size involved. Provides for automatic enrollment for children born to women receiving pregnancy-related assistance.

MINIMUM eligibility at 200% above poverty line. NOT maximum, if certain conditions are met.

Quote:

(Sec. 112) Provides for phase-out of CHIP coverage for nonpregnant childless adults, leaving states an option to apply for a Medicaid waiver to continue coverage for such adults. Requires extension of an expiring waiver at state request, but only through calendar 2009 and only for childless adults who were covered through that year. Prescribes terms and conditions for coverage of parents of targeted low-income children.

Directs the Comptroller General to study and report to Congress on whether: (1) the coverage of a parent, a caretaker relative, or a legal guardian of a targeted low-income child under a state CHIP health plan increases the enrollment of, or the quality of care for, children; and (2) such parents, relatives, and legal guardians who enroll in such a plan are more likely to enroll their children in such a plan or in a state Medicaid plan.

(Sec. 113) Eliminates counting Medicaid child presumptive eligibility costs against CHIP allotment.

(Sec. 114) Limits the matching rate for states that propose to cover children with effective family income that exceeds 300% of the poverty line. Exempts from this denial (grandfathers) any state that already has an approved state plan amendment or waiver to provide such expenditures.

Limits, but does NOT remove federal matching funds.

Quote:

(Sec. 115) Allows the Secretary, at state option, to provide the state with the federal medical assistance percentage determined for the state for Medicaid with respect to certain expenditures or otherwise made to provide medical assistance under Medicaid to a child who could be covered by the state under CHIP.

Allows a state to cover: (1) certain individuals and thereby receive federal financial participation for medical assistance for them under Medicaid; or (2) receive such federal financial participation for children made eligible as a result of an income or resource eligibility level expansion.

From the families income (pre 200-300% above poverty level) they can deduct mortgage and other living expenses. So, just because it says 200% above poverty level, it could be much more depending on how expensive their house is.

There is more, but it's a big bill to read through. Going to take me some time to fish through it.

Here it is if you wanta read through it yourself. Don't go by blogs or commentaries. Go read for yourself.

http://thomas.loc.gov/cgi-bin/bdquer...11search.html|

Bahet · 06-12-2009, 08:20 PM

That makes no sense at all. Are you saying the bill says that someone making $80,000 in a family of 4 qualifies but someone making 30,000 doesn't?