Has he bought the WSJ yet? Or did he just take Rupert Murdoch out for lunch a couple days ago while they agreed what headlines should go in the next paper?
I was already pissed about healthcare because last night I found out my insurance won't reimburse me AT ALL for therapy and won't even explain why, and now this.
@Lymed: How, exactly, do I go about appellation, asking for an explanation, etc.? All I got was this explanation of benefits form with numbers on it, pretty much saying "This cost this much. You will pay this much." and nothing else.
I'm only 25 so I usually ask my parents for guidance if it's my first time dealing with some great Adult Responsibility (TM), but they're not so therapy-positive.
@Ri_L: Do you have individual insurance or insurance through your employer? If it is through your employer, they are required to send you a summary plan description (SPD) that explains how to appeal. You should ask for that, but you can also call and ask for where to send appeals. When you appeal, give a reason, not just that you think they should pay. Why should they pay? Why do you think it is covered under the plan (read the SPD for answers). There should be something explaining why. Look for a little letter that goes to a footnote. They usually use letters to code the reasons for denials. You can also call and ask why it was denied. They should be able to give a more detailed explanation. You may have gone out of network or needed pre-authorization. If it was mental health therapy, unfortunately some plans dropped mental health coverage so they don't need to meet parity requirements.
If it is individual insurance, they should still have to provide you with the same basic information. You can call your state insurance commission for details.
If anyone trusts, believes, and supports Karl Rove and his comments is truly not an American that believes in a democratic law or respect.
While I will support his rights to say what he says, he in turn would never support mine. He is in this game for his own profit and perspectives and not the Ameican people.
I am a republican and I denounce Karl Rove as the crimminal he truly is.
Support true health care reform that lowers our costs and stops the imperial insurance companies from receiving and taking our money, homes, and lives.
We would never let a dictator do this, why are we allowing insurance companies to do this to us?
How did we get to a place where health care is a financial decision in this country? I really don't want some executive sitting in a conference room somewhere deciding whether my health is a good investment or not. And neither should any of these people who rally against reform. I boggles my mind that so many of them are just like me, we have what amounts to just barely adequate coverage that we're paying for through our company anyway. I mean, I pay $65 pre-tax every pay check for my health insurance. Would a tax for a public health plan really be so much more?
@lucyjae: "How did we get to a place where health care is a financial decision in this country?"
When we decided to make health care a for-profit industry. Because once we decide it's a good idea to let the free market dictate health care, that leads to the scenario you described: an executive in a boardroom deciding his first priority is to the shareholders, not the people who buy policies and trust that those policies are going to protect them when they get sick.
In reading comments here and other related posts expressing disappointment in the likely plan to pass, and feeling some disappointment of my own, I think about how quickly we (meaning Democrats - sorry for the generalization) eat our own. We want something big to happen, it doesn't turn out as great as it could be or we want it to be, so we get mad, we get sad, and we don't show up at the polls next time. Then the other team comes in and mucks and/or stalls it all up. Republicans are much better at sticking together through shit like this. Admittedly, they are in some disarray now, but they also seem poised to come out in big numbers to vote next time, because even if they don't agree with each other, they are energized about hating Democrats. When Obama signs that bill with his magic pen, we ought to get energized too. Getting any kind of health care reform passed - however imperfect - is a big fucking deal.
@dreamweave: no its not. its really really not. It's not a big fucking deal. It's paltry. I'm sick of these low expectations we have for the people we elect into Congress to represent us.
@bluebears: I get it that we disagree on this, but I don't understand how not allowing insurance companies to deny coverage b/c of pre-existing conditions is not a big fucking deal. I also don't understand how getting health insurance for 29 million Americans who didn't have it before is not a big fucking deal.
@dreamweave: why do you assume that they would even be able to afford it? do you honestly think that when this bill goes into effect 29 million americans will become magically insured? I think its not a big deal based on how horribly fucked up the system is top to bottom. If something is fucked up in 50 different ways and you correct 1 single thing, that is not a big deal. That is a very slow start.
@dreamweave: The Republicans are better at sticking together because they require sticking to the party line or they will back a primary opponent against whoever disagrees with the party platform. The Democrats do not do this, and so-called Dems go against the party platforms in favor of those who provide their campaign funds. I think that is more of a factor than that we don't support our party enough.
@dreamweave: There are some good things in the Senate bill. But I'm really pissed that the Senate bill doesn't have a public option and if I had the chance to vote out a Democrat who voted against the public option in favor for a more progressive Democrat, I would (alas I don't get to vote for a Senator at all though).
The problem is that this is our moment, this is our time (as our President once said). I lived through health reform failing in the 90's and it took over 10 years to get another opportunity. This is our opportunity for a public plan. We won't have the opportunity next year. People will say health reform was done and when people are unhappy, they will say the Democrats screwed up. Then nobody will want to ever talk about a public option again just like nobody wants to talk about single payer after it failed in the 90's.
I work every day with people who are underinsured. People who have insurance but can't pay their hospital bills. People who have insurance but skip pills because they can't afford their medications. They are underinsured because their employers won't pay for good coverage. It sickens me every single day and I don't think the Senate Bill will do anything for them.
oh and? My friend told me yesterday she just got a letter in the mail from her provider informing her that her payment for her coverage would be increasing by 25% (!!) because of new government reforms that hurt the insurance companies. nice huh? yeah again, no public option = empire strikes back
@bluebears: I've heard this a lot and it infuriates me. Isn't this fraud? No bill has passed yet so that can't possibly know what will be in it and the eventual cost to them enough to come up with a specific number. This seems like a blatant political move to scare and rile up their customers to get them to oppose reform.
@greengrey: Well, the 29 million people who are currently uninsured and would be insured under reform might feel a win. (based on bill out of Senate Finance Committee)
@dreamweave: the only uninsured people who will see relief from this bill are people who have been denied due to pre-existing conditions. That is definitely an important step, but they'll still be paying out the ass for the coverage and insurance companies will just raise premiums on all of the rest of us who are insured (they're already doing it in some cases) using this as justification and we'll all have NO RECOURSE.
@bluebears: also getting some relief via increase subsidies will be some of the people who make too much for Medicaid, but not enough to afford insurance. That seems important to me. Look, I don't want to come off as some sort of cheerleader for this beautiful bill. It's not a beautiful bill. And I don't understand why Baucus and others wimped out so quickly on so many things. But it is a very important step towards making millions of lives better, something that can be improved on in the future.
@dreamweave: yeah and the people who make too much to get subsidies but not enough to afford an insurance policy will now get tax penalties. I'm not trying to fight but I think this bill is a pile of shit. I appreciate what you're saying but if not now when?
@bluebears: OH IT IS ON BLUEBEARS! I kid, I kid. it's a good conversation to have. I agree that many things in the Senate bill are pieces of shit - I'm just not yet convinced that the bad outweighs the good yet. I suppose we'll have this talk again after reconciliation and we see what the final beast looks like. Maybe I'm just worn out with being discouraged and I'm having a Pollyanna moment.
@bluebears: I agree that this bill has major problems. But it will get more people access to health care. The insurance exchange will make it easier and less expensive for small employers to provide coverage. There are a lot of employees of small businesses that will get coverage through this bill. I'm not sure how the penalty works, but in Massachusetts, there are people who earn too much to get the subsidy who are still exempted from the penalty because they earn too little to buy insurance. Now, I wrote over 20 pages once on problems with the Massachusetts reform, so it is not a perfect model. But I expect a similar exemption by the federal government.
@bluebears: And I'm still praying for a public option through reconciliation and I'm still furious that we lost reimbursement for end of life counseling.
I believe this will be the only time in my life when I will agree with Karl Rove.
The GOP is winning the debate right now because they are so much better at scaring the American people than the Dems are. From a purely political perspective, the opposition to health care was brillant. Death panels? Amazing what they can come up with.
Maybe the Democrats will pull it together and surprise the hell out of us, but I'm not holding my breath.
@7states: Ditto, the opposition's propaganda tactics will be studied for years to come. I doubt that the Dems will effectively counterpunch, given their history of easily feeing discouraged.
Two things
1. Publicly traded companies are not going to raise salaries to make up for the fact that they're using less expensive employee health plans. They're in the business of making profits to please shareholders. Despite what Ben Bernanke says, this recession is not over in the sense that businesses and individuals will be feeling the effects of it for awhile before things on a micro level get better. Companies have trimmed themselves to bare bones staff and aren't rehiring in order to preserve the illusion that they're profitable. They're certainly not going to scare already skittery investors further by cutting away at a potential source of future profit on paper (cost cutting via going skimpy on the health care plan).
2. Just as everyone feared when Murdoch bought the WSJ, his crazypantsness is creeping from the conservative editorial page into the main pages of his paper. I trust the WSJ for basic information, but I no longer look to it for a nuanced and balanced approach to business goings on. It's heading in the direction of becoming Fox: The Newspaper. Srsly.
The tax on "Cadillac plans" is one of the stupidest policy proposals I have ever seen. You can't determine a benefit level by the price. Plans that cost the amount that are being taxed could be plans with an older employee base, they could be plans by employers who employee people with HIV/AIDS, they could be plans in places like McAllen, TX or the entire state of Maine where health care, and therefore health premiums, costs more.
Including a FoxNews poll in your argument automatically weakens it. It's like using a HuffPo poll to say that Health Care reform was winning. Both have strong political bases on either side of the spectrum. The polling pool is always going to be overwhelmingly on one side.
Once again I'd like FoxNews to just call a spade a spade: they are a conservative channel/site. "Fair and Balanced" my ass. If they were so 'Fair and Balanced" they'd be covering presidential speeches like everyone else. But no, regular programming takes precedent. Unlike during the Bush years...
The poll I saw on Andrew Sullivan the other day had support for health care reform on the up and up. [andrewsullivan.theatlantic.com]
God. The healthcare system is so broken. Something needs to change and I am so sick of this bickering and political pissing contest. Kieth Olbermann's comment is right the eff on.
10/08/09
Has he bought the WSJ yet? Or did he just take Rupert Murdoch out for lunch a couple days ago while they agreed what headlines should go in the next paper?
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I'm only 25 so I usually ask my parents for guidance if it's my first time dealing with some great Adult Responsibility (TM), but they're not so therapy-positive.
10/08/09
If it is individual insurance, they should still have to provide you with the same basic information. You can call your state insurance commission for details.
10/08/09
10/08/09
While I will support his rights to say what he says, he in turn would never support mine. He is in this game for his own profit and perspectives and not the Ameican people.
I am a republican and I denounce Karl Rove as the crimminal he truly is.
Support true health care reform that lowers our costs and stops the imperial insurance companies from receiving and taking our money, homes, and lives.
We would never let a dictator do this, why are we allowing insurance companies to do this to us?
10/08/09
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When we decided to make health care a for-profit industry. Because once we decide it's a good idea to let the free market dictate health care, that leads to the scenario you described: an executive in a boardroom deciding his first priority is to the shareholders, not the people who buy policies and trust that those policies are going to protect them when they get sick.
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The problem is that this is our moment, this is our time (as our President once said). I lived through health reform failing in the 90's and it took over 10 years to get another opportunity. This is our opportunity for a public plan. We won't have the opportunity next year. People will say health reform was done and when people are unhappy, they will say the Democrats screwed up. Then nobody will want to ever talk about a public option again just like nobody wants to talk about single payer after it failed in the 90's.
I work every day with people who are underinsured. People who have insurance but can't pay their hospital bills. People who have insurance but skip pills because they can't afford their medications. They are underinsured because their employers won't pay for good coverage. It sickens me every single day and I don't think the Senate Bill will do anything for them.
10/08/09
At least it puts the thing up to a referendum. Dunno, I'm undecided about this, but my guess is it's better than nothing.
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The GOP is winning the debate right now because they are so much better at scaring the American people than the Dems are. From a purely political perspective, the opposition to health care was brillant. Death panels? Amazing what they can come up with.
Maybe the Democrats will pull it together and surprise the hell out of us, but I'm not holding my breath.
10/08/09
10/08/09
1. Publicly traded companies are not going to raise salaries to make up for the fact that they're using less expensive employee health plans. They're in the business of making profits to please shareholders. Despite what Ben Bernanke says, this recession is not over in the sense that businesses and individuals will be feeling the effects of it for awhile before things on a micro level get better. Companies have trimmed themselves to bare bones staff and aren't rehiring in order to preserve the illusion that they're profitable. They're certainly not going to scare already skittery investors further by cutting away at a potential source of future profit on paper (cost cutting via going skimpy on the health care plan).
2. Just as everyone feared when Murdoch bought the WSJ, his crazypantsness is creeping from the conservative editorial page into the main pages of his paper. I trust the WSJ for basic information, but I no longer look to it for a nuanced and balanced approach to business goings on. It's heading in the direction of becoming Fox: The Newspaper. Srsly.
10/08/09
10/08/09
10/08/09
Once again I'd like FoxNews to just call a spade a spade: they are a conservative channel/site. "Fair and Balanced" my ass. If they were so 'Fair and Balanced" they'd be covering presidential speeches like everyone else. But no, regular programming takes precedent. Unlike during the Bush years...
The poll I saw on Andrew Sullivan the other day had support for health care reform on the up and up. [andrewsullivan.theatlantic.com]
10/08/09