The PPACA and Insurance Companies

March 1, 2012

Because of the incredible rhetoric against The Patient Protection and Affordable Care Act of 2010 (PPACA),  euphemistically called ObamaCare, I’m trying to summarize this legislation in bits and pieces to make it a little easier for us folks-on-the-street to absorb.  If you find this helpful, or if I get something wrong, just let me know in the comments below.

Here is some of what the PPACA requires of private health insurance companies:

1. They cannot exclude applicants because of pre-existing conditions.

2. Policies must be renewable.

3. Plans can no longer charge more because of the health status of a population, but they may vary ratings based on age, number of family members, tobacco use, and other non-health issues.

4. There will be no lifetime or annual limits.

5. Dependents up to age 26 are covered.

6. Companies with more than 50 employees must buy health insurance for their employees.

7. Qualified health plans must cover preventive services such as immunizations and other preventive care and screenings for women and children.

8. Health plans must report the proportion of premium dollars spent on cost of services, and if it goes above that prescribed by a pre-calculated Medical Loss Ratio, rebates must be given to policy holders.

9. Unreasonable premium increases must be vetted through the Secretary of Health and Human Services and state regulators.

These are just a few of the provisions of the PPACA.  You can find out much more at http://www.healthcare.gov/law/index.html

You can decide for yourselves whether or not you believe this plan is in the best interests of the people of our nation.  The plan sets in place regulations to govern health care.  Yes, it does.  If you are one of those that believes that all regulations are bad and lead to socialism, you might want to temper that view just a bit.  Right now, we have millions of fellow citizens who are shut out of adequate health care plans by circumstance or by choice.  When these people seek care through hospital emergency rooms because they have nowhere else to go, the rest of us are the ones who pay.  Personally, I would rather that people pay for their own health care through affordable premiums and stay out of my pocketbook.

More later. . . .

 

 

 


ObamaCare and Mental Health

February 27, 2012

One of the most important pieces of legislation to come along in decades is The Patient Protection and Affordable Care Act of 2010 (PPACA), often called ObamaCare.  Most Americans have not read this act, or even read unbiased accounts of what it addresses.  Instead people listen to all the wrong voices that rail against this legislation for their own political agendas that have nothing to do with the merits or shortcomings of the act itself.

Currently I am taking a graduate level course called U.S. Healthcare Management that examines the history of healthcare in the United States including this most recent legislation.  As the class moves along, I will share with you some of what I learn in a way that I hope is readable and understandable.

For openers, PPACA requires that Insurance plans offer coverage for mental health conditions which has been lacking.  Mental illness can be just as debilitating as physical illness, and appropriate treatment may help to lessen the stigma that is attached to these conditions.  With attention being paid to the treatment of mental illness, hopefully we will work harder toward finding the cause of these kinds of mental aberrations and may someday be able to prevent many of them from happening.

PPACA also requires insurance coverage assistance for addiction and substance abuse.  I am personally horrified at the foolishness of individuals who knowingly abuse their bodies in any way for whatever reasons whether it is “to drown their sorrows” or “to experience a high” or “to go along with the crowd” or “to defy authority just because they can.”  Should these people finally come to their senses, PPACA gives them a chance to regain their health.  That is a good thing for them and for us.  Productive members of society are certainly better than self-destructive ones.

As I learn the incredible and very interesting history of health care in the United States, I am amazed at how recent much of its development is.  Only fifty years ago it was barely beginning to come onto the national scene.  Prior to that it had been available in certain situations only.

What I’d like you, the reader, to do is to ignore all the rhetoric against the Patient Protection and Affordable Care Act. These politicians and Obama-haters (regardless of party) are using their platforms for their own selfish agendas, and they are quite aware of what they are doing and why.  Don’t fall for it.

I’ll try to bring you an unbiased summary of the history of health care in the United States and how this led to the PPACA of 2010.  Stay tuned.


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