I am working my way through the 1,017 pages of this bill slowly but it is a great way to see what is actually in it apposed to what the media reports is in it. Today I found this starting on page 830:
SEC. 4376. SELF-INSURED HEALTH PLANS.
‘‘(a) IMPOSITION OF FEE.—In the case of any applicable self-insured health plan for each plan year, there is hereby imposed a fee equal to the fair share per capita amount determined under section 9511(c)(1) multiplied by the average number of lives covered under the plan.
IN GENERAL.—The fee imposed by subsection (a) shall be paid by the plan sponsor
So what is a self insured health plan: This is when a large employer operates it's own health care plan for it's employees. It usually hires a third party to manage it's plan. These can be very efficient health care plans.
PLAN SPONSOR.—For purposes of paragraph (1) the term ‘plan sponsor’ means—
A) the employer in the case of a plan established or maintained by a single employer,
What I am getting from this section of the bill is that these companies who are already providing health insurance for their employees will be imposed with a fee. So how does this reduce health care costs?
What is the major goal of this plan.
Check out this video: http://www.youtube.com/watch?v=VbXrSK_VfME
Thursday, August 20, 2009
Monday, August 17, 2009
America's Affordable Health Choices Act of 2009
I am a graduate of Health Care Administration from Idaho State University and currently work for a hospital that is part of a large health care system. The goal of this blog is to investigate the upcoming health care issues that affect us all. I invite all who read this to offer their opinions, any factual evidence that they find, or experiences that they have with health care. While reading through the America's Affordable Health Choices Act of 2009 today the SEC. 221. ESTABLISHMENT AND ADMINISTRATION OF A PUBLIC HEALTH INSURANCE OPTION AS AN EXCHANGE-QUALIFIED HEALTH BENEFITS PLAN caught my attention. I would like to share one particular thing that I found today.
What this refers to is the Health Insurance option that the government would set up to compete with current insurance companies in order to drive down costs. This is what part of the act says:
(A) IN GENERAL- Except as provided in subparagraph (B) and subsection (b)(1), during Y1, Y2, and Y3, the Secretary shall base the payment rates under this section for services and providers described in paragraph (1) on the payment rates for similar services and providers under parts A and B of Medicare.
As many people know rates from Medicare are significantly lower than rates of other insurance companies. Since the "payment rates" will be similar to that of Medicare some issues will arise.
I will be quoting from the following article In the New York Times:
Doctors Are Opting Out of Medicare
By JULIE CONNELLY
Published: April 1, 2009
"Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle."
Audrey Grayson From ABC News on July 8, 2008 Reported:
"Unfortunately, there are physicians that I know of in the Columbus, Ohio, area that are opting out [of Medicare]," said Dr. Mimi Ghosh, a family practice physician at the Ohio State University Medical Center. "Most physicians I know have taken a pay cut every year for years... Reimbursements are just getting worse, and more physicians are retiring early, or going to other careers [like] pharmaceuticals [or] real estate."
In one of my classes in Health care a biller from the local hospital shared some of the reimbursement that were offered. She showed us an example of a total knee replacement and the reimbursement of an insurance company was ten times what the reimbursement from Medicare was.
Many family physicians are struggling to keep practices afloat with the many different costs associated with their practices. I foresee an even bigger shortage of family physicians if this is passed. Please share your thoughts.
What this refers to is the Health Insurance option that the government would set up to compete with current insurance companies in order to drive down costs. This is what part of the act says:
(A) IN GENERAL- Except as provided in subparagraph (B) and subsection (b)(1), during Y1, Y2, and Y3, the Secretary shall base the payment rates under this section for services and providers described in paragraph (1) on the payment rates for similar services and providers under parts A and B of Medicare.
As many people know rates from Medicare are significantly lower than rates of other insurance companies. Since the "payment rates" will be similar to that of Medicare some issues will arise.
I will be quoting from the following article In the New York Times:
Doctors Are Opting Out of Medicare
By JULIE CONNELLY
Published: April 1, 2009
"Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle."
Audrey Grayson From ABC News on July 8, 2008 Reported:
"Unfortunately, there are physicians that I know of in the Columbus, Ohio, area that are opting out [of Medicare]," said Dr. Mimi Ghosh, a family practice physician at the Ohio State University Medical Center. "Most physicians I know have taken a pay cut every year for years... Reimbursements are just getting worse, and more physicians are retiring early, or going to other careers [like] pharmaceuticals [or] real estate."
In one of my classes in Health care a biller from the local hospital shared some of the reimbursement that were offered. She showed us an example of a total knee replacement and the reimbursement of an insurance company was ten times what the reimbursement from Medicare was.
Many family physicians are struggling to keep practices afloat with the many different costs associated with their practices. I foresee an even bigger shortage of family physicians if this is passed. Please share your thoughts.
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