It seems snippy threats can get you places. After McDonald’s threatened to drop health coverage for 30,000 workers unless the government granted it an exemption from a mandate to spend 80 to 85 percent of premiums on benefits, the Department of Health and Human Services granted a waiver to the company and 29 others.
A Bloomberg report quotes a health policy consultant who speculates that the waiver is political:
“The big political issue here is the president promised no one would lose the coverage they’ve got,” the consultant said. “Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they’ve got.”
So McDonald’s employees, if you were kicking around the idea of contracting ailments that would land you in the hospital, proceed as planned.
McDonald’s, 29 other firms get health care coverage waivers [Bloomberg via USA Today]
Previously: Will McDonald’s Drop Health Care?
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The loss of this coverage would have been a blesssing. It’s pretty atrocious coverage for the price. Unless you have a chronic medical condition, pocket you money and save it for your occasional medical needs.
You can argue one way or the other, but for $700 getting $2000 worth of coverage is a deal if you think you’ll have more than $700 of medical expenses in the year.
But the bigger picture is… we’re already getting exemptions. The law isn’t even a year old and already we’re finding things in it that aren’t working. Mostly because of the way they had to build it to get the thing passed… all the provisions should kick in at the same time. Ha…
$700 for $2000 worth of coverage may be a deal if you have more than $700 worth of bills for the year, but it hardly qualifies as insurance. It’s more like a medical discount program. To sell it as insurance is dishonest.
LOL that’s what my work offers….
My dental insurance is like this…It costs me more than two cleanings/year and wouldn’t even cover the cost of something like a root canal. It is much cheaper for me to pay out of pocket, assuming I have fewer than one filling/year.
Luckily you can get several extractions per year. Never could understand the phrase “its like pulling teeth”, to which I reply fantastic.
Until you get into a medically expensive car accident.
actually, many health insurance companies will deny all car accident claims until all other payment avenues have been used
Exactly. If you have a health insurance claim that fits the profile of an auto accident or worker’s comp claim, you’ll likely be contacted by their subrogation department.
The situation gets trickier if you’re hit by an uninsured driver or during a hit and run.
The problem with the two party system is that both parties are full of politicians.
How is this a two-party problem? I don’t see that…
Healthcare Reform passed with barely any Republican support. It was from the beginning the love-child of the Democratic Congress, signed by the Democratic president. Now, the Democratic-appointed Secretary of Health is granting exemptions from the new law.
Where were the Republicans involved in this? Did I miss something and cross into bizarro world/
The reform was watered down to the point of being a waste of time at best and a gift to the insurance industry at worst in order to appease Republicans, yet most of them still wouldn’t go for it. This is how the bill was a two-party problem. We need universal health care, but partisan nonsense has kept it from happening. The Democrats should have returned the bill to its original state and ignored the Republicans altogether.
You do realize that a lot of the changes were to get Democrats on board, right? Who was it at the very end that nearly doomed the whole thing (and sold out for a worthless piece of paper)? Of the things that the televised conference they said they could agree on, how many made it into the bill?
But go ahead and go back to bizarro world…
And it never occured to you that the few Democratic holdouts might have been doing so because they wanted to get re-elected and not because it was the right thing or even the Party thing to do?
Are you referring to the senator who has to qualify his own party affiliation because he doesn’t want to be identified as a regular Democrat? Also, your last sentence implies that none of the changes were made to appease Republican interests, which is utterly ridiculous. I’m going to assume that it wasn’t your intention to do so.
He makes a very good point, but so do you. Fact is, had all the Dems been on board, they could’ve passed whatever the hell they wanted. But the healthcare bill became big national news, and many Dems realized they could now play hardball with their own party for personal and political gain. There was that whole Blue Dogs thing for example. A bunch of conservative Dems decided that the only way they were signing this bill is if they were getting a piece of the cake. Then there was Bill Nelson, with his uber-conservative bullshit.
That’s the kind of shit that led to the ballooning cost and decreased usefulness of this bill. While I am pleased that the damn thing passed in the first place, and it really does do some good things, it doesn’t go nearly far enough.
FactCheck.org is a really good place to go and read up on this if you’re interested. Really sets the record straight on a lot of stuff. I hope you will check it out.
Please, put blame where it belongs. There are two reasons you didn’t get the bill you wanted.
1) Democrats who said they wouldn’t support the bill without changes being made.
2) Democrats who didn’t want the bill to be a completely Democrat supported bill. They wanted Republican’s to sign on so that they could share the blame.
The Dems had a filibuster proof majority. If the only ones opposed to the bill were the Republican’s, the Dem’s could have forced through anything.
Share the blame? This wasn’t a bill to euthanize senior citizens, it was a dramatic reform of health care (or at least it was supposed to be). What kind of blame could have been earned by it? If they were worried about losing votes in the next election, then they didn’t understand that those votes likely would not have gone to them anyway. People who think that health care reform is socialism probably don’t vote Democrat in the first place. So on one hand we have adults acting like children, and on the other hand we have adults acting like… well, children (naïve ones, anyway). It’s like junior high all over again. (Yes, I know that this is a simplification of the issue, but it covers the majority of the problem.)
Dems simply don’t have the “party discipline” it takes to push through something as big as healthcare reform. There are too many people in the party that have their own ideas or are just willing to exploit the situation for their benefit.
If anything,that should have been a good sign to not bother or to just not eat the whole elephant at once.
We can pull out the history books and find all the boners Republicans and Democrats each pulled at the expense of the citizenry.
This November, remember that the only wasted vote is for the status quo: it’s only a two party system if everyone votes two party.
In a lot of areas, there aren’t any serious candidates running outside of those two parties.
That’s hardly a counter-argument. Candidates don’t run at independent because in the current system no one wins as an Independent. In only very few instances has this occured.
I wasn’t arguing against the statement, I was just pointing out how entrenched this mindset is. I would love to see some real differences in political candidates, but this battle is up a very steep hill.
The Republican involvement was a lack of involvement. They chose to be the upset school child because they didn’t get to play with their favorite toy.
They CHOSE to be ineffectual and push back at everything. They CHOSE not to participate. And the CHOSE to be a roadblock for the sake of being a roadblock.
That was their level of participation. Being the Obstacle.
But you do realize that they couldn’t be an obstacle. Democrats had 60 votes… that’s filibuster proof. They didn’t lose that until Scott Brown… when was that? Oh right, almost a year after they started on HCR.
Republicans didn’t play but they couldn’t be a problem. It was that the Democrats weren’t as unified as they had thought. You can’t blame Republicans for anything that comes out of HCR. Also can’t give them credit either.
That’s the bigger question… why did the Democrats even want Republican votes? They could pass it without even speaking to one, yet they kept trying to get them. Why? Wouldn’t the glory be shared at that point? Political calculations… many feared that things like this would have happened.
That was the result of bi-partisan bridge building (and other terms that are a waste of breath). Presumably, the Democrats wanted the Republicans on-board so that the reform wouldn’t be overwritten by later candidates or otherwise legislated into oblivion. Realistically, something this dramatic is still going to be challenged until government no longer exists, so you can see how useful this frame of mind was. This brings us back to dbeahn’s original statement, though: both parties are full of politicians, and that is their number one problem.
Hear, hear!
It’s filibuster proof until somebody like Joe Lieberman or Ben Nelson decide they want to play gatekeeper and fuck over their own party by withholding their cloture votes.
A two party system doesn’t mean you have to have two parties that work together. The fact that two parties routinely flip-flop who is in control makes it a two party system. A one party system is a system where at the very minimum, there is one party that always wins the election, possibly where only one party is allowed.
While I agree that the two party system has many flaws right now we are not even really seeing any of the benefits of a two party system because there is no compromise. Right now we just have the two sides fighting tooth and nail and either not passing anything or forcing crappy bills through while the other side tries to stall. This is in no way helped by false information passed out by some members of the media. For example, I bet we less time had been spent covering “death panels” and more time had been spent covering problems with the bill that actually existed we would have a bill that everyone liked better.
We don’t have a two party system in the US.
One party? Are you trying to claim there is a third or more party out there with even a slight shred of power?
First past the post elections pretty much guarantee it, actually.
Officially, we don’t. For all intents and purposes, we do.
I’m not sure if I should be outraged since I’m not surprised at all that this is happening.
So a mandate specifically included to increase health coverage and affordability for consumers could easily be avoided by dropping health coverage altogether? Companies get the choice of increasing their current costs, or paying nothing at all and receiving no penalty? Am I not understanding this correctly?
Well, technically the penalties start in 2014…
The problem is the ingrained belief that companies should provide healthcare for their employees. It was, once upon a time, offered as a BENEFIT, i.e. something that made one employer more attractive than another. Over time, it became standard, and at the same time, it became cost-prohibitive for the average person to get insurance on his/her own.
This mindset needs to be reversed, and people need to realize that the government is really the only entity capable of providing for the healthcare of its citizens.
“people need to realize that the government is really the only entity capable of providing for the healthcare of its citizens.”
Are you serious? You have that much Blind Trust to throw around? How reliable has our Government been in past years? You want to be subjected to science experiments like Guatamala, then apologized to decades later? That’s what happens when you mix health and government.
Testing. **cough, Gulf Of Mexico, cough**
“The government” and “our government” aren’t always the same thing. Do you have a better idea?
Gov’t doesn’t need to _provide_ the healthcare, necessarily (although it does so quite well in a number of countries), but it’s the only institution that can endure that health care is _funded_ for all citizens.
It’s not an easy transition, but there’s lots of evidence from countries comparable to ours (Canada, UK, Germany, really all of Western Europe), that gov’t funded (and sometimes provided) health care works very well, producing better outcomes for less money.
In the US, there’s very good evidence (i.e. the VA system) that the gov’t can _provide_ health care very effectively, and Medicare does a pretty respectable job of paying for it, so the idea that gov’t somehow _can’t_ do a good job on health care doesn’t really make sense.
All this being said, if you’re talking about something on the edge of medical science, _and_ you have the ability to pay for it, the US system works very well.
Well, when you have a political party whose goal is to make government small enough to drown in a bathtub, what did you expect? Why do you think we’ve had trouble with all these agencies, when the political party in power for the previous eight years hates even the concept of them? It will take a few years to dig out of that problem.
I think we should have UHC/Single Payer for all. If you think that will mean poor care, long wait lists, etc. and you’re wealthy enough then you’re free to obtain private insurance (either as a supplement or instead of Gov care). England and other countries have this model.
I agree with you and disagree with you. The bigger reason why employer-provided health insurance became the standard is that the government passed tax laws that allowed the company to deduct that expense from their income, but also not making it taxable income for the employee. That actually reduces the overall expense to the company because they don’t pay the employer share of payroll tax on that… plus it looks good to the employee at the time “We’ll give you $500 worth of salary tax-free by providing it in-kind…” Government policy created this mess by taking it out of the hands of the public.
But I think we could fix a lot of the health care mess if we put the policy back into the general public’s hands. If people knew how much a physical cost and went “I can get that for 25% less at Dr. Snow’s office!”, competition would bring down the costs of most of the regular, foreseeable expenses. Emergency Care would remain expensive because you can’t shop that around, but that’s a different problem. Right now very, very few people know how much something costs at the physician’s office – they know their co-pay, but they haven’t a clue how much things really cost (ie, what the insurance company’s portion is).
The best analogy I’ve heard is “grocery insurance”. You pay a premium every month that lets you get all the groceries you need. You also have a co-pay every time you buy something, but because you have that insurance, you can get as much as you want. Maybe you don’t need that extra can of beans… but its paid for, right? And why bother getting sirloin when you can get filet for the same price. Same goes with medical care. How many tests are run that really aren’t needed… most never ask if its really needed or not. Heck, insurance will cover it…
(I’m a CPA and for years have worked with doctors. I started off working with ER practices doing their books and taxes, so its been interesting watching the medical world change…)
“The best analogy I’ve heard is “grocery insurance”. You pay a premium every month that lets you get all the groceries you need. You also have a co-pay every time you buy something, but because you have that insurance, you can get as much as you want. “
For your analogy to work, you’re assuming that everyone has a PPO or an HMO.
There are a lot of us who have HSA/HDHP plans or just major medical. We pay 100% of all of our medical expenses until we hit our very high deductibles — no copays, co insurance, etc. My deductible is so high ($5,000), that we’d never hit it unless we had a hospitalization. The insurance protects us from financial catastrophe and gives us discounted care for routine visits.
But it is difficult to “shop around” for health care. I don’t have dental coverage, so I called about a dozen dentists to get prices for services. While most would tell me the price for a cleaning, only about half could give me an estimate or range for a root canal or a crown. The rest refused, saying they had to see me first to see exactly what had to be done. Well, I don’t have time to spend an hour each at six different dentists to price compare a root canal (plus they’d still make me pay for that time).
How can people “price shop” for medical services when they don’t even know what to ask for? And who has time to visit multiple doctors? Its not like a car that you can drop off at the shop while you go to work. Taking off a couple of hours from work to see the doctor is one thing, taking off several days while I visit doctors to price shop for services is something else entirely.
I agree wholeheartedly. I have dental insurance, but an annual cap at around $2.5k. I had a lot of major work done this year after a bicycling accident and quickly reached that limit so the $3k plus I’ve paid since then has all been out of pocket. Not only is this type of price shopping prohibitive for the reasons you mentioned, but you’re not comparing apples to apples. Not every dentist is created equal. I would personally pay slightly more upfront to know that I am in the hands of a skilled dentist than one that is going to go in, f things up and cost me double to try to go back and fix it. A good dentist can also make the difference regarding early detection of cavities or other more routine problems before they become more serious, much more expensive problems.
I had a fractured root that I got four different opinions on. Two of the endodontists freaked at the sight of my x-rays showing me the humongous infection that was growing at the site. They even let me feel the bump where the bacteria sat and let me compare it to how smooth it should be. The third endo thought it was a toss up to proceed, and never mentioned any bacterial growth while the fourth didn’t even notice the fracture! An uncorrected bacteria festival draining into your bloodstream will likely lead to death. Period.
It’s just silly that as a society we spend so much money on frivolous things, but when it comes to our HEALTH, that is where we are asked to compromise. What on earth is more important than your health?
Agree on the middleman problem. Interestingly, the whole employer-provided health insurance thing came about as a way for employers who wanted to hire to get around wage controls during WW2. Employers couldn’t raise wages to attract workers, but they were allowed to offer free health insurance, so they did so, as kind of a backdoor wage increase.
Even the idea of “shopping around” shows a huge change in the culture of medicine. It used to be that a person saw the same doctor for potentially his/her’s own life. Now we shop around, we move frequently, or we just decide to change doctors for one reason or another.
This change also increases the chance that redundant care and things like tests will happen. The problem is compounded by the fact that we don’t have a universal health record where our information stays in one central place.
Ok, but why are companies being given tax breaks?
Obama wants to drive the insurance companies out of the health market and drive everyone to a single payer, public option.
I would have preferred he just gone out and done that. This is going to create a real mess in the mean time. And it won’t be budget neutral or positive as they’ve said…
If only that were the case.
I’d be interesting in how you think that’s going to happen, now that he’s giving out favors to big business.
However, there were a number of businesses that did push for UHC/Single payer at the beginning. Why? because if health care is no longer tied to employment, that can save them a lot of money (more than offsetting any potential tax incrase). But when it got dropped, they shifted to oppose HCR
Really? W00t!
That would be great!
You like waiting lists?
The crass for-profit insurance companies should be all lynched anyways.
They should go back to being mutuals or something that might actually pay claims and manage risk as opposed to playing the stock market. If the insurance industry ends up on a tight leash, they will have no one to blame but themselves for being such crass jerks.
Yes, that’s pretty much what’s going on.
But in all reality, for a company like McDonalds, it wont make any difference come 2014 when the mandate kicks in. The vast majority of their employees make so little that they would be eligible for very subsidized insurance via the exchange and not subject to no coverage penalties due to their income levels.
As it is, I’d be surprised if the majority of their current workforce wasn’t eligible for Medicaid already.
Maybe we should ask the opinion of people who know what they’re talking about.
I didn’t study this in depth, but it’s something like that because of the way the health care bill is phased in over the next six years, McDonald’s could drop the coverage now. But by 2014 they’d have to offer coverage.
You’re going to trust the news report of a health care provider? No, I guess it would be unbiased….
The quotes in that article are hardly full of effusive praise for these health care plans: e.g. “Nobody is going to pretend that this is the best coverage around, but having that coverage beats not having any coverage,” and “The concern is that these plans are faux insurance, and my organization looks forward to the day when they are no longer available.”
Actually, Kaiser Health News is pretty legit. It’s run by the Kaiser Family Foundation, and it has had no connection to Kaiser Permanente or Kaiser Industries since 1985.
I thought there was supposed to be an employer fine if companies didn’t offer coverage.
Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker qualifies for federal subsidies to purchase health insurance. Which most-if-not-all minimum wage employees do.
The problem is that the fine is much less than the cost of an insurance policy. Particularly in states that already have most of the regulations that the Federal system is about to impose, such as New York. You can’t buy a health insurance policy in NY for less than about $4500-5000/yr (before subsidies). So if it’s a $2000 fine, or a $5000 policy, they’ll take the fine.
So McD’s and others get to continue to screw their employees by threatening to screw them more.
One reason why McDonalds offers these mini-med plans may be to prevent people from working there just to get health insurance coverage. With how much turnover there is in the fast food industry and the relatively low requirements to work there, it would be very easy for someone to work there, get their medical care taken care of, and then quit. This would only make McDonald’s rates go even higher.
I’ve heard this before, and it’s bunk. Like saying don’t let gays marry because then men will marry other men for their insurance coverage. There is a waiting period for insurance coverage, and this can happen at any job, not just McDs.
So how can a company who is world-famous for their streamlined supply chain management not push around some paperwork for less than 20% overhead?
The reason given is due to the type of medical plan offered and very high turnover rate of employees.
I’m not going to say this is a valid excuse or not, but it does answer your question.
I actually think in McDonald’s case they have a point – you cannot hire a $7 an hour worker, and have to guarantee coverage with no limit, for a low enough premium that he can afford…..it just isnt an easy thing to do. I am not saying it isnt POSSIBLE if medical costs are lowered, but think about this – the biggest argument was against denying those for pre-existing conditions – basically this is the same thing – now McDonalds hires a worker, and it could cost them millions in health costs, if that member has a pre-existing condition. Previously, they could limit you to a cap of $100,000 in benefits, or whatever they wanted – now it says there can be no cap. So, if i have a crappy health plan at work, or no job, get hired by McDonalds, and let them foot the bill.
Business wise, i see why this could be a problem. Not saying it is RIGHT, but it is a problem. The opther biggest problem is for seasonal workers – stores that hire for christmas will not be able to offer benefits – that seasonal worker could cost millions of dollars.
Great example for some form of universal health care.
So I get to pay for the McDonald’s guy’s healthcare then?
You already do. Right now that guy waits until his easily treatable injury gets infected, then goes to the emergency room, and can’t pay the bill. The hospital writes off his debt, and instead charges it to the rest of us who do pay our bills.
Go eat at McD’s in some other part of the industrialized world and you won’t have to.
While that may be true, it’s also completely beside the point that is at issue here. The question isn’t one of total cost or adequate coverage. The waver they got was the “You must spend ~85% of the insurance cost on actual health care, rather than administration”. This means that McDonald’s wants to pocket more for itself and pay less to doctors and hospitals.
I guess you don’t understand all company has to do is pay 75% to 80% of the premium under the plan.
Premiums will have limits. So even if they hire the sickest person, instead of paying $7 an hour they pay $10 an hour and the employee gets healthcare. Someone not sick might only be $8 an hour.
These companies do not have to pay the costs, just the insurance premium that the bill limits tax premium within 3-1 of the lowest premium.
The funniest thing is that unions were a huge supporter for the President and the health care reform bill. Donating hundreds of thousands of dollars to “Healthcare for America Now” USA Today had an article about unions asking for and receiving waivers. Why would they want a waiver for something they so strongly supported?
Yea, cause 1 union = ALL unions.
Dumbass
The Union’s strongly supported getting their health plans, which would have fallen into the “cadillac” category – and thereby taxed accordingly… exempted.
It’s the rest of us that get screwed.
am i missing something? i read this yesterday on CNN – this article points to the lifetime max plans offer, not that 80-85% of premiums need to be spent on benefits
I think this might be Consumerist’s editorial opinion, because there is no source for that.
Is there any way to Opt-out of this new Healthcare thing? I just got word from my employer that since my yearly household income is $88,000 – 98,999.99 that National Healthcare will cost me $1,980/month. I worked my butt off to earn that much per year and now I have to pay that much for something I don’t want from a president that I didn’t vote for. How is this fair?
The only way to opt out is to leave the country.
Potentially if republicans can defund it, you will get out of it.
beyond that revolution?
I think you are confused about which country we are talking about. There is no national healthcare plan in the US for someone in your income bracket.
It sounds like he’s just got garden variety health insurance in California. Despite of all of the overregulation that’s supposed to prevent that sort of thing, Californians get reamed on health insurance.
Unfortunately, insuring everyone does nothing for cost containment.
Easiest way to opt out is buy a shotgun, and have an employer willing to not deduct any fees personally, and then tell the IRS when they show up how you feel about it. I’m not saying that it will go well, but if enough people do it, that works.
Where you clearly got it wrong was the working your butt off part – your greedy capitalist tendencies that have allowed you to help produce better move valuable goods through your labor are cannot be assented by a progressive liberal administration.
This is a tax. It is nothing more than that. Any health care is a side effect of the tax. This is how it works: Government tells carriers, “we will force the whole population to buy your insurance, in exchange, you pay us a regulatory fee.”
Yes, it is as simple as that. Any company not having to “offer” health insurance is a gift from the politicians and McDonalds workers are going to get free care anyway, due to the pay scale. So it’s probably a wash from a tax standpoint.
You know, I never looked at it exactly that way before, and I think I agree with you.
I’m going to do some math for the media. There are one million people affected by the approved waivers.
McDonalds has 400,000 employees, and the plans covered by this waiver are used by 30,000 of them.
Jack in the Box has 42,500 employes, and the waivers affect 1,120 workers.
United Federation of Teachers has “200,000+” members, and the plans apparently affect 351,000 of them.
Why are McDonalds and Jack in the Box in the lede, while United Federation of Teachers is buried at the end?
Because McDonalds and Jack in the boss are big bad eveil corporations, while the teacher’s union is a heavenly organization that can do no wrong.
I know I implied that, but it’s not an argument I would make. An equally plausible explanation is they’re the most recognizable names on the list. I think I’m more likely to read an article headlined with “McDonalds” than “United Federation of Teachers”. This leads to the argument I most sympathize with:
Good observation.
Most of the “news” is about the latest conservative or liberal threat to our freedoms and way of life. Be scared, concerned, and outraged!
*ahem* http://neshaminyinfo.blogspot.com/
I ask this question, but I also note that the ostensibly opposite bias isn’t any better.
Really, NY Post, it’s a “sweetheart” deal? It’s hard for the reader to evaluate that opinion without understanding exactly what coverage UFT provides now or what sort of financial ramifications adjusting the limits immediately would have had.
Why are the other 27 missing from the article?
McDonalds is NOT complaining about the cost or their ability to provide mini health coverage. They’re complaining about rules about to go into effect that would prohibit them from diverting excess money in their health plan to ordinary everyday business expenses. Basically, their employees overpay for this health plan and McDonalds uses the excess money for things like marketing or advertising. They can’t do that now.
They are playing by the rules. They got an exemption, as provided for by law. Why the troll headline?
Why doesn’t McDonalds want to spend 80% of premiums on benefits?
Is their coverage process so ridiculously inefficient they have to spend more than 1/5 of premiums on management/overhead?
Because they don’t spend 80% on benefits – they spend LESS. They want to use the excess money for everyday business expenses. The new law won’t let them so they’re asking for a waiver.
Offtopic, but I need to rant about the whole healthcare system.
I got something in the mail today from the insurance provider from my last job, where I haven’t worked since January. It was for an emergency room visit that turned into an inpatient stay for my wife in January. It was a claim made by some company I’ve never heard of in PA (we live in MA) for “Medical Care” (only item listed on the form) for $633. My (now former) insurance provider rejected it with the succinct reason “Preauthorization Required”. I called them up, they had no information about the company making the claim, the specifics of the claim, or the reason for the rejection and gave me some other number to call. Which was closed for the day.
My problems with all this:
- What required preauthorization? The emergency room visit? The inpatient stay? And if it was any of these things, wouldn’t the hospital, who has all this information and knows WHY the visit and/or inpatient stay is required, get in touch with the insurance instead of me, who was (quite frankly) in the middle of freaking out about my wife’s condition?
- How am I supposed to know what “Medical Care” means and if it’s actually something we really got? How am I supposed to know what the hell this company in Pennsylvania is that’s working at my Massachusetts hospital and submitting vague claims that keep getting rejected?
- Why doesn’t the insurance company have any of this info? They have enough info to reject the claim but not to tell me anything about it. The claiming company in Pennsylvania has no phone number on the form, just a PO Box. Google searches are turning up no useful contact info. They haven’t billed ME yet, just the insurance company, but I’d like to nip this in the bud before it gets to me, because I’ve heard the stories about people getting sent straight to collections over crap like this and I’d rather not become part of that story.
- Why are they putting in a claim NOW for something that happened 9 months ago? I shredded my old work insurance card months ago – now I really wish I had that number handy because everyone I call seems to want it.
Alright, sorry for the rant everyone. Felt good to vent though.
Sounds like someone is trying to scam your former health insurance carrier. The HIC probably denied the claim for lack of information. Also, just an FYI, unless specified differently in a preferred provider agreement, providers have 365 days to submit medical claims to HICs, double that for most government-funded plans.
“the government granted it an exemption from a mandate to spend 80 to 85 percent of premiums on benefits”
Not in the linked story!!!
I have read many iterations of this story, and they were all about the COST to increase the coverage caps, not about spending 80-85% on premiums.
Respond, please. This is politically charged enough. If you are adding your own editorial opinion and passing it as fact, you need to disclose that, or disclose your source for this statement.
This waiver isn’t permanent, it’s an exception until 2014 when the government starts up the marketplaces. Which I think is fair since one of the promises was to let Americans keep the coverage they have with no major changes.
Is it really a valid threat? If too small a percentage of premiums go to benefits, the coverage can be so limited as to be useless. What good is coverage with a co-pay so high that a McDonald’s employee can’t afford it?
The president wil not make anyone lose the coverage they have.
If company chooses to drop coverage that has nothing to do with the president or healthcare bill.
All this comes as no surprise to me. I think everything that was promised was outright lies, and they knew it. No one, especially Nancy “Pass First, Find Out Later” Pelosi knew that. The problem is that no one in Congress ever even seemed to think about all the unintended consequences of all this mess.
If they want to kill the health insurance industry (and throw all the sick people in turmoil in the process), they are doing a good job. The problem is that they are attacking it all wrong. Insurance isn’t the problem. We are actually over-insured, and simply do not have to run every health care dollar through a insurance scheme that does little besides siphon off 15-20% of every dollar in order to pay the doctor that you are already paying co-pay/etc at time of service. Major medical with reasonable deductibles are much less costly, and provide you with similar benefits. The big difference is that when you went to the doctor, you would part with your dollars then and only then and can see much more what you are getting. Rather than paying a large sum every month that you really have no idea what’s going on with it.
This is the second time that a marginal healthcare situation got resolved in favor of “money for the insurance companies”.
The first one is the PCIP (preexisting condition insurance program) that rejects you if you are already desperate enough to pay for partial private insurance, but will accept you if you’ve applied for and then rejected private insurance because of the exclusions.
Now you’ve got a waiver for excessive health insurance overhead.
I see a trend. When a decision doesn’t make sense, just consider if it would lower insurance company revenue.
Why would these companies object to a cap on administrative costs?
Are there kickbacks involved here?
wait a second…you mean to tell me that corporations can get politicians to carve out special financial benefits for them in laws?
do we live in the US or in a Oligarchical, Corporatecratic, Business Owns Politicians gover—-nevermind
If I were the government, I would have called McDonald’s out on their bluff.
How many of those employees do you think would stick around if they suddenly lost their medical coverage? McDonald’s would go from 30,000 to 10,000 or less employees overnight…