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	<title>Comments on: Fines Are Not The Same Thing As Taxes</title>
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	<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/</link>
	<description>Research and discussion of the Colorado health insurance industry and the healthcare crisis in America.</description>
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		<title>By: Jay</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14121</link>
		<dc:creator>Jay</dc:creator>
		<pubDate>Wed, 14 Oct 2009 21:34:03 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14121</guid>
		<description>Good point Nate. I think the main point about employer sponsored insurance is that employers make different decisions about the type of policies getting purchased than an individual. Corporations will make buying decisions on anything (company cars, office furniture, vacation perks, health insurance, etc) with the extra decision making variables of:
&lt;i&gt;- attracting employees from competing employers
- the expense can be written off&lt;/i&gt;

Employers shouldn&#039;t have anything to do with the insurance at all.</description>
		<content:encoded><![CDATA[<p>Good point Nate. I think the main point about employer sponsored insurance is that employers make different decisions about the type of policies getting purchased than an individual. Corporations will make buying decisions on anything (company cars, office furniture, vacation perks, health insurance, etc) with the extra decision making variables of:<br />
<i>- attracting employees from competing employers<br />
- the expense can be written off</i></p>
<p>Employers shouldn&#8217;t have anything to do with the insurance at all.</p>
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		<title>By: Nate Ogden</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14120</link>
		<dc:creator>Nate Ogden</dc:creator>
		<pubDate>Wed, 14 Oct 2009 21:16:59 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14120</guid>
		<description>I don&#039;t think we have employer based insurance we have employer based financing. For many reasons we went from American&#039;s paying 50% of their health care out of pocket in 1965 to only 18% today. 

Employers shouldn&#039;t be able to deduct any expenses under a couple thousand deductible. If employers gave catostrophic insurance then a raise to make up the difference we would be better off. 

In any given year over 50% of Americans would have no dealings with an insurance company, that is the way it should be.</description>
		<content:encoded><![CDATA[<p>I don&#8217;t think we have employer based insurance we have employer based financing. For many reasons we went from American&#8217;s paying 50% of their health care out of pocket in 1965 to only 18% today. </p>
<p>Employers shouldn&#8217;t be able to deduct any expenses under a couple thousand deductible. If employers gave catostrophic insurance then a raise to make up the difference we would be better off. </p>
<p>In any given year over 50% of Americans would have no dealings with an insurance company, that is the way it should be.</p>
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		<title>By: Jay</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14118</link>
		<dc:creator>Jay</dc:creator>
		<pubDate>Wed, 14 Oct 2009 17:38:38 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14118</guid>
		<description>I like those a lot, thanks Nate. 
The massage therapy mandate was news to me. So out of curiosity, &lt;a href=&quot;http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2009.pdf&quot; rel=&quot;nofollow&quot;&gt;I looked it up&lt;/a&gt; and it turns out it is only a mandate in 4 states (Colorado is not one of them). And that would be just on group health insurance, not individual/family - for both the chiro and massage therapy mandates.
Also, the low deductibles are typically on group health insurance policies because the incentive for employers is attracting employees with a benefit more than getting a smart plan. Of all the individual plans our clients get, I would say that about 1 of every 25 even has a deductible below $1500.
So would you also be in favor of getting rid of employer sponsored health insurance?  That would fix those problems with the system, and a few more.</description>
		<content:encoded><![CDATA[<p>I like those a lot, thanks Nate.<br />
The massage therapy mandate was news to me. So out of curiosity, <a href="http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2009.pdf" rel="nofollow">I looked it up</a> and it turns out it is only a mandate in 4 states (Colorado is not one of them). And that would be just on group health insurance, not individual/family &#8211; for both the chiro and massage therapy mandates.<br />
Also, the low deductibles are typically on group health insurance policies because the incentive for employers is attracting employees with a benefit more than getting a smart plan. Of all the individual plans our clients get, I would say that about 1 of every 25 even has a deductible below $1500.<br />
So would you also be in favor of getting rid of employer sponsored health insurance?  That would fix those problems with the system, and a few more.</p>
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		<title>By: Nate Ogden</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14117</link>
		<dc:creator>Nate Ogden</dc:creator>
		<pubDate>Wed, 14 Oct 2009 12:15:18 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14117</guid>
		<description>Remove goverment mandates like massage therapy and chiro, these should not even be insured care let alone mandatory. 

High deductible, $250 deductible is not insurance it is financing. Paying a 20% surcharge is very inefficient. 

Break up Medicare and have payors compete for members, we can&#039;t continue to lose 10% of every dollar to fraud and waste

Stop the mergers and break up BUCA, no insurer should control more then 20-30% of a market, competition will bread innovation in delivery and cost containment.

Set up a federal clearing house like the banking fed to clear EDI transactions both claim and financial. This will allow government to collect data for public health and reduce cost. 

Providers must bill electronically by law, and no they aren&#039;t getting a handout to do it, the payors came up with the money to accept them the providers save money by doing it.

That is the first 10%</description>
		<content:encoded><![CDATA[<p>Remove goverment mandates like massage therapy and chiro, these should not even be insured care let alone mandatory. </p>
<p>High deductible, $250 deductible is not insurance it is financing. Paying a 20% surcharge is very inefficient. </p>
<p>Break up Medicare and have payors compete for members, we can&#8217;t continue to lose 10% of every dollar to fraud and waste</p>
<p>Stop the mergers and break up BUCA, no insurer should control more then 20-30% of a market, competition will bread innovation in delivery and cost containment.</p>
<p>Set up a federal clearing house like the banking fed to clear EDI transactions both claim and financial. This will allow government to collect data for public health and reduce cost. </p>
<p>Providers must bill electronically by law, and no they aren&#8217;t getting a handout to do it, the payors came up with the money to accept them the providers save money by doing it.</p>
<p>That is the first 10%</p>
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		<title>By: Jay</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14114</link>
		<dc:creator>Jay</dc:creator>
		<pubDate>Tue, 13 Oct 2009 15:43:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14114</guid>
		<description>Nate,
Thank you for the links. Both of those have a lot of really good data. I tried to put together where you came up with the 5-8 million number though, and I still only come up with over 25 million.  You still make very good points.  Would you mind sharing your opinion of what should be done?</description>
		<content:encoded><![CDATA[<p>Nate,<br />
Thank you for the links. Both of those have a lot of really good data. I tried to put together where you came up with the 5-8 million number though, and I still only come up with over 25 million.  You still make very good points.  Would you mind sharing your opinion of what should be done?</p>
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		<title>By: Nate Ogden</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14104</link>
		<dc:creator>Nate Ogden</dc:creator>
		<pubDate>Sat, 03 Oct 2009 23:44:53 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14104</guid>
		<description>forgot to answer the math and lost the full post, summary;

http://covertheuninsured.org/content/quick-facts-uninsured

20.2% make over 50K

http://www.kff.org/uninsured/7613.cfm

This brief analyzes health coverage data and determines that 25% of the nation&#039;s uninsured population is eligible for either Medicaid or SCHIP. 

I know signing up for any goverment program is hard but if my taxes are going to provide them free coverage I expect them to put in the effort to get it. I had to labor hard to earn the money to pay those taxes they can labor to benefit from them</description>
		<content:encoded><![CDATA[<p>forgot to answer the math and lost the full post, summary;</p>
<p><a href="http://covertheuninsured.org/content/quick-facts-uninsured" rel="nofollow">http://covertheuninsured.org/content/quick-facts-uninsured</a></p>
<p>20.2% make over 50K</p>
<p><a href="http://www.kff.org/uninsured/7613.cfm" rel="nofollow">http://www.kff.org/uninsured/7613.cfm</a></p>
<p>This brief analyzes health coverage data and determines that 25% of the nation&#8217;s uninsured population is eligible for either Medicaid or SCHIP. </p>
<p>I know signing up for any goverment program is hard but if my taxes are going to provide them free coverage I expect them to put in the effort to get it. I had to labor hard to earn the money to pay those taxes they can labor to benefit from them</p>
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		<title>By: Jay Norris</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14103</link>
		<dc:creator>Jay Norris</dc:creator>
		<pubDate>Sat, 03 Oct 2009 16:16:53 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14103</guid>
		<description>Nate,
Thanks for your comments.  I&#039;d be very interested to see links to some of the studies you referenced.  Qualifying for free insurance because of income is actually harder than it sounds.  Medicaid is available for people who are low income and also part of a specific population (children, pregnant women, some parents, the disabled, and elderly who need long term care and have no assets).  The guidelines vary from one state to another, so eligibility for Medicaid depends heavily on where people live.
More than half of the uninsured fall below 200% of the federal poverty level:
http://aspe.hhs.gov/health/Reports/05/uninsured-cps/index.htm#income
Poverty level is currently just over $22,000 for a family of four:
http://aspe.hhs.gov/poverty/09poverty.shtml
I agree that there are some people who can afford coverage and choose to go without, I talk to them every day. But I haven&#039;t seen any independent studies with data that indicates they are anywhere near the majority of the uninsured.</description>
		<content:encoded><![CDATA[<p>Nate,<br />
Thanks for your comments.  I&#8217;d be very interested to see links to some of the studies you referenced.  Qualifying for free insurance because of income is actually harder than it sounds.  Medicaid is available for people who are low income and also part of a specific population (children, pregnant women, some parents, the disabled, and elderly who need long term care and have no assets).  The guidelines vary from one state to another, so eligibility for Medicaid depends heavily on where people live.<br />
More than half of the uninsured fall below 200% of the federal poverty level:<br />
<a href="http://aspe.hhs.gov/health/Reports/05/uninsured-cps/index.htm#income" rel="nofollow">http://aspe.hhs.gov/health/Reports/05/uninsured-cps/index.htm#income</a><br />
Poverty level is currently just over $22,000 for a family of four:<br />
<a href="http://aspe.hhs.gov/poverty/09poverty.shtml" rel="nofollow">http://aspe.hhs.gov/poverty/09poverty.shtml</a><br />
I agree that there are some people who can afford coverage and choose to go without, I talk to them every day. But I haven&#8217;t seen any independent studies with data that indicates they are anywhere near the majority of the uninsured.</p>
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		<title>By: Nate Ogden</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14102</link>
		<dc:creator>Nate Ogden</dc:creator>
		<pubDate>Sat, 03 Oct 2009 13:35:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14102</guid>
		<description>&quot;Most people who don’t have health insurance aren’t uninsured by choice&quot;

Every study I have read says the exact opposite. Most of the poor already qualify for free insurance and choose not to sign up, and those making over 55K can afford insurance but choose not to buy it. Out of 47 million uninsured only 5-8 million are uninsured by something other then choice.

&quot;For the latter, the idea of doing away with medical underwriting on individual policies has widespread support among lawmakers.&quot;

Of course it doesn, most of them aren&#039;t smart enough to realize if you eliminate pre-ex and don&#039;t have a meaningful mandate with a tax equal to the cost of insurance people will pay the penalty until they need care, then buy a policy they can&#039;t be turned down for, then drop the policy once the bill is paid and go back to the penalty. This is already happening in MA, they have the data that shows people taking policies for 6 months then dropping them and those people have loss ratios considerably higher then the populaiton that stays insured. Individual private insurance will be forced out of business under the current law being proposed. Most politicians would be ok with that.</description>
		<content:encoded><![CDATA[<p>&#8220;Most people who don’t have health insurance aren’t uninsured by choice&#8221;</p>
<p>Every study I have read says the exact opposite. Most of the poor already qualify for free insurance and choose not to sign up, and those making over 55K can afford insurance but choose not to buy it. Out of 47 million uninsured only 5-8 million are uninsured by something other then choice.</p>
<p>&#8220;For the latter, the idea of doing away with medical underwriting on individual policies has widespread support among lawmakers.&#8221;</p>
<p>Of course it doesn, most of them aren&#8217;t smart enough to realize if you eliminate pre-ex and don&#8217;t have a meaningful mandate with a tax equal to the cost of insurance people will pay the penalty until they need care, then buy a policy they can&#8217;t be turned down for, then drop the policy once the bill is paid and go back to the penalty. This is already happening in MA, they have the data that shows people taking policies for 6 months then dropping them and those people have loss ratios considerably higher then the populaiton that stays insured. Individual private insurance will be forced out of business under the current law being proposed. Most politicians would be ok with that.</p>
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		<title>By: Steve Brown</title>
		<link>http://www.healthinsurancecolorado.net/blog1/2009/09/23/fines-are-not-the-same-thing-as-taxes/comment-page-1/#comment-14092</link>
		<dc:creator>Steve Brown</dc:creator>
		<pubDate>Thu, 24 Sep 2009 07:45:08 +0000</pubDate>
		<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1338#comment-14092</guid>
		<description>Agreed but I dont think this must be this way. Forcing people to go insured. There may be some better options.</description>
		<content:encoded><![CDATA[<p>Agreed but I dont think this must be this way. Forcing people to go insured. There may be some better options.</p>
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