The first sections of the Obamacare bill make it crystal clear that the insurance companies will be all but taken over by the government. Bureaucrats will essentially make all business decisions for the companies, while the companies do little besides perform billing and reimbursement.

The government will dictate who can be covered, how much companies must charge, what benefits will be provided, what the medical loss ratio (how much companies actually spend on paying doctors) will be, eliminate pre-existing conditions, and make it impossible for providers to drop customers. An all-powerful Health Services Commissioner will have near-unilateral authority to make these regulations.

Private insurance will exist on paper, but it will exist solely at the pleasure of the government. There will be no competition or choice, and everything will be decided at the whim of another unelected, unconfirmed, and unaccountable Obama czar.

Vega, Vega, Vega – Medicare Advantage is only available to seniors through private insurers. Those insurers have added coverage and services to the basic Medicare plan to come up with what is known as Medicare Advantage. The insurers receive a capitated payment from Medicare each month for each enrollee along with a premium which they charge the enrollee. No one has Medicare Advantage unless it's through a private insurer, so if you're monitoring the Medicare Advantage programme, you're monitoring private insurers.

Whats_up – you're allegedly learned – you should damn well be able to realise from what I wrote that I was simply responding to Vega's questioning of the comment made by the OP. Now you come along and try to change what I said into a comment about something which I didn't address, had no intention of addressing and frankly wasn't part of what I said at all.

If you want to put words in my mouth, please, I beseech you, use words with more flair and pizazz.

Posted by martinhale

2009-10-06 12:25:33

Martin,

I was asking you a legitimate question. Should the govt follow the money that they dole out in Medicare or not?

Only if there is a suspicion of corruption or inefficiency. They cannot and should not have a say in what the company sends to it's policy holders.

Posted by bthewolf

2009-10-06 12:59:26

bthewolf,

I would agree with the majority of this answer. The question I believe is were they using a federal list of medicare recepients or not, that is illegal to do. However if they were not doing this, then they should be allowed to send what they want to the consumer.

Posted by whats_up

2009-10-06 13:22:43

They were using list of their own policy holders, People who have supplemental insurance sold by them! So the govt has no right to say what they can or cannot send out.

They were using list of their own policy holders, People who have supplemental insurance sold by them! So the govt has no right to say what they can or cannot send out.

Posted by bthewolf

2009-10-06 13:37:04

No they didnt, they used a mailing list of medicare advantage seniors provided to them by the government, a direct violation of their agreement. Had they done a mass mailing to everyone they would have been fine, but thats not what they did.

The agreement covered marketing materials, which this letter clearly wasn't.

Just admit it, you want the government jackboot to slam down on the face of anybody that disagrees with Obama. Once again, the wannabe fascists in the article cry "misinformation" and demand silence as soon as somebody tells the truth about their agenda.

Posted by Mike_M

2009-10-06 14:06:40

Sorry Mike the letter was clearly marketing materials, in clear violation of their agreement. I have no problem with Humana sending out mass mailings. The AARP has done this and not gotten in any trouble. Interesting that you dont think companies should have to abide by their agreements, why is that?

Unless it is specifically part of a contract…

Posted by Mike_M

2009-10-06 13:54:26

And in this case it was specifically part of a contract.

Posted by whats_up

2009-10-06 14:10:27

Yet when medical insurance companies go by their contracts with the polciy holders, they are called crook by the left.

Thanks for proving the hypocrisy of the left.

The AARP has done this and not gotten in any trouble.

Posted by whats_up

2009-10-06 14:09:07

And why do you think AARP hasn't gotten in trouble for doing the exact same thing? Could it possibly be that they support Obamacare? Could it be that AARP doesn't sell Medicare Advantage and want to see it eliminated so they can sell more of their plans? Could it be payback just like the pharmacudical companies got from Obama?

No they didnt, they used a mailing list of medicare advantage seniors provided to them by the government, a direct violation of their agreement. Had they done a mass mailing to everyone they would have been fine, but thats not what they did.

Posted by whats_up

2009-10-06 13:53:34

BULL it says quite plainly that Humana sent the letter to IT'S Madicare Advantage clients. That's people who buy MA plans through Humana. MA plans are PRIVATE INSURANCE.

Sorry Mike the letter was clearly marketing materials, in clear violation of their agreement.

Posted by whats_up

2009-10-06 14:09:07

What expertise do you have in marketing materials under the legal definitons as they pertain to health insurance? Because as someone LISCENCED in insurance I can tell you are WRONG!

Posted by Dick_Nixon

2009-10-06 15:50:51

He doesn't even qualify as nvoice in googlefu, he's more qualified in burger flipping and bathroom cleaning. I mean c'mon his efforts to show conservs calling libs traitors for not supporting Bush = EPIC FAIL.

Gimme a break, wolf. Conservatives calling liberals traitors is so common and long-standing, its become a cliche'.

Posted by D-Vega 2009-10-06 16:17:22

The thing that is boring is this continued LIE by idiots like you.

Get off it D-Vega. You haven't a leg to stand on!

The left are huge hypocrtics when it comes to their fake demonization of private insurance. In fact, they want to give them millions of new customers thru their Individual Mandate and a national Monoploy markert thru theres so-called "exchange" – only the largest private insurance firms will survive this regulation and any real choice and competition will be ruined.

In exchange for this corrupt bargin with big insurance firms, the left gets to take over Health Care since they will be seting the rules, forcing you into the government dominated system, and handing out billions in subsides to their political favored groups and their big/rich health insurance industry buddies.

This is simply Chicago thug "pay to play" politics at the national level!

They are trying to paint this heavy-handed government action to force people to buy a private product as a “practical” choice. This leftist counteroffensive to ROB us of our rights as a free born citizen to make our own choices!

These people are being rational with their money and the left wants to FORCE THEIR OPINION ON THEM! They are going to tell us to buy their government Health Insurance or go to jail!

Here are the real facts about the so-called “Free rider” talking point!

(1) Uncompensated care you cite is 1% of total annual HC costs! This problem is SOOO SMALL in the trillions being spent its laughable! So you want to turn our HC system over to the FED GOVT for 1% of the cost and less then 3% of the population who doesn’t choose to buy HC insurance!

Look at your Health Insurance Bill, figure out what 1% is – not much! And far, far, far less then how much the FED GOVT will drive up premium costs with bs regulation, fees and taxes!

The 1% is a small cost to pay to keep my liberty, right to choose to purchase health insurance, and to KEEP THE FEDS out!

(2) You presuppose ALL uninsured people don’t PAY the BILL for their medical care! Again, FALSE! Most people do try to pay, up to 75%. Some people actually save and pay out of their saving or pocket. You fall for the typical arrogant thinking – that your neighbor IS not doing the right thing when in fact most are. You would pay for your HC. Again, we want to take away rights based on false information and a small percentage of the population.

Here is how Health Policy expert Michael Cannon at the CATO Institute puts it:

“The left’s most powerful argument in favor of an Individual Mandate – that the Uninsured sometimes end up in the ER, and unable to pay their bills – isn’t powerful enough. The appropriate response to this problem is not to take away the freedom of the non-free riders. The appropriate response is to leave the non-free riders alone, to place the cost of the “uncompensated” care on the would-be free riders, and to write off any remaining uncompensated care as the price of living in a free and decent society.”

Here is an article that debunks these leftist lies about the Uninsured!

http://townhall.com/columnists/JacobSullum/2009/0…

Contrary to popular opinion in the media, the Individual Mandate, not the so-called public option is the key to stopping Obamcare in its tracks. Stop the Individual Mandate and the whole bill will unravel for lack of funding and mandatory participation in the scheme!

This is a very dangerous period because Nationalization will still occur even without an overt government run insurance plan like this "public option" provision everyone keeps fixating on – Wyden/Bennett and the Bacus bill are prime examples of this.

Individual Mandates to buy private insurance sound like a “free market” solution and “individual responsibility” but in this context they are not – they are simply a front for a government run system. Many conservatives can be easily fooled by this faux “private” front (Mitt Romney was) .

Here are the core elements what will be contained in the “health care reform compromise” after the so-called “public option” is in all likelihood dropped:

(a) Federal Regulation aka HEALTH CZAR/DEATH PANELS

(b) Employer/Individual Mandates aka NATIONAL HEALTH INSURANCE

(c) Government Subsidies aka MIDDLE CLASS MEDICAL WELFARE

With the Federal Government setting the rules, forcing everyone to participate, and is paying the bills for most of the middle class through subsidies how is this anything other than Nationalization?

Obamacare or any other plan that constains Individual Mandates is a corrupt bargain that benefits DC Politicians, Big Union, Big Industry, and Big/Nanny Government. The losers that get stuck with the bill and socialist medicine are the young, the elderly, the taxpayer and small business.

Its amazaing how stupid the left really is – they dont even know when they are being scammed lol!

Seems to be a contradiction there, wolf.

They can't have it both ways. If they want to take Advantage of the fact that these people are getting Medicare, and accept gov't money, they can't cry foul when the gov't asks them what was sent to the Medicare holders, regarding changes to Medicare. Especially when those changes haven't even been finalized.

You say they are given subsidies to stay in business, but then use the "PRIVATE" excuse to say they shouldn't have to provide squat.

That's nonsense. If they don't want gov't oversight, then get off of the gov't teat. End of story.

Interesting insight, wolf.

But I would guess, I'm not an expert, that these guys know what they are getting into by agreeing to offer MA. Are you forced to offer MA? Does everyone HAVE TO offer it? That would be different. But if they agree to offer a quasi-gov't program (it's not private if its part of Medicare) then they have to deal with the gov't regs.

But martin, is the gov't entitled to see the material sent to said customers regarding changes to MA?

It's a downward step for you, honestly.

Nope. It's all too typical of crthns. He doesn't know the first thing he's talking about and then engages in circular 'logic' when others call him on the carpet. He's been doing it on this site for years.

Oh please, you're still continuing this gibberish? Despite your UTTER FAILURE to provide any examples proving your point?

Posted by mightysamurai 2009-10-06 18:45:21

And don't forget whats_up, who has made the same statement and then suffered… what did they call it… EPIC FAILURE!!!!!!

But martin, is the gov't entitled to see the material sent to said customers regarding changes to MA?

Posted by D-Vega

2009-10-06 17:47:43

Yes they are entitled to review such marketing materials, but the point I was making is that the act of sending a letter to your own customers about possible upcoming plan changes isn't a violation of any agreement with the feds, as WU was saying. His appeal to authority on both this issue and the HIPAA issue were just flat out wrong, and further, those appeals to authority were couched in the selfsame "boogey-man" scare tactics of which he is so fond of accusing those on the right of using.

You know that I was CHRO at a mid-sized HMO which handled Medicaid recipients. We also carried a Medicare Advantage plan for a couple of years. For both plans, we normally did seek preemptive review of our mailings from various state and federal regulators, but they didn't have the power to summarily stop any particular piece of communication. They could suggest changes to wording and content of those communications, which we might or might not adopt, and they could threaten that ominous "this is going on your permanent record for next contract renewal time". But they couldn't really stop us from telling our customers what we wanted to tell them. And besides, Vega, we had an affirmative obligation to notify our customers (policyholders) of any changes or planned changes to their plans. In the case of Medicare Advantage, the feds had to have signed off on those alterations to the plan before we could communicate them to our members, so they already knew what we were going to tell them.

This AG in CT is just making political hay out of something which in the normal course of business is a regular and normal occurrence. Dare I say it – it's a political witch hunt and nothing more.

Of course, you are ignoring the fact the government forced the teat into their mouth to begin with, way back when it muscled its way into the healthcare business to begin with (it's called "Medicare").

Posted by CoolCzech

2009-10-07 09:06:58

CC,

No one forced Humana to take Medicare Advantage seniors, they choose to because of the nice big government subsidy that they got, in the end they just dont want to lose that.