Obama Slams Health Care Critics For Spreading "Outlandish Rumors"

[Exterminator]

You go right ahead and keep believing that.

Why don't you go bone a chicken or make some noodles or something and stay out of the grown-ups' conversations.

[me]

Why don't you go bone a chicken or make some noodles or something and stay out of the grown-ups' conversations.

You mean you're finally going to start conversing like an adult?  Unbelievable...truly unbelievable

[Exterminator]

You mean you're finally going to start conversing like an adult?  Unbelievable...truly unbelievable

I'm still waiting for you or Henry to tell us all why you think factcheck is lying.  Now's your chance to prove you're not just an old, senile wind-bag.

[Henry Hawk]

I'm still waiting for you or Henry to tell us all why you think factcheck is lying.  Now's your chance to prove you're not just an old, senile wind-bag.

the bill says.....enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment......I think it is pretty clear...that is DIRECTLY from the bill...........say what you want or factcheck can say what they want...........they WANT to enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment...I personally do not think I want a law, stating Gov can have access to my account without my consent....

[Exterminator]

the bill says.....enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment......I think it is pretty clear...that is DIRECTLY from the bill...........say what you want or factcheck can say what they want...........they WANT to enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment...I personally do not think I want a law, stating Gov can have access to my account without my consent....

Are you an insurance company or a health care provider?

The legislative summary says the intent in the section is "to adopt standards for typical transactions" between insurance companies and health care providers.

Which part of this are you having difficulty understanding?

[Henry Hawk]

Are you an insurance company or a health care provider?

The legislative summary says the intent in the section is "to adopt standards for typical transactions" between insurance companies and health care providers.

Which part of this are you having difficulty understanding?

That may be what the summary says or "intends"..(carefull with that word).......but the BILL itself says EXACTLY what I stated.....and mentions NOTHING about insurance companies and healthcare providers....it says enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment...

[mr. willy]

44% Favor Health Care Reform, 50% Oppose
Monday, October 12, 2009
Forty-four percent (44%) of voters nationwide now favor the health care reform plan proposed by President Obama and congressional Democrats. That's little changed from a week ago. The latest Rasmussen Reports national telephone survey finds that 50% are opposed to the plan.

The numbers have been remarkably stable throughout the debate. Currently, 23% Strongly Favor the legislative effort and 39% are Strongly Opposed.

http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform
 

[Exterminator]

That may be what the summary says or "intends"..(carefull with that word).......but the BILL itself says EXACTLY what I stated.....and mentions NOTHING about insurance companies and healthcare providers....it says enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment...

Oh for pete's sake, are you freaking serious?

[Henry Hawk]

Oh for pete's sake, are you freaking serious?

why are you being so difficult on this........it is plain and simple what it says.........IF it means something else, then they should say it in the Bill....seriously all of this is my point...........it is obviously not clear to everyone..........but, it reads very clearly in the bill on page 59.......maybe then need say what they mean then....it would NOT be that difficult would it?  I think THEY know exactly what they 'INTEND'....

[me]

why are you being so difficult on this........it is plain and simple what it says.........IF it means something else, then they should say it in the Bill....seriously all of this is my point...........it is obviously not clear to everyone..........but, it reads very clearly in the bill on page 59.......maybe then need say what they mean then....it would NOT be that difficult would it?  I think THEY know exactly what they 'INTEND'....

Guess we know now that all they are reading is the summaries and not the actual bill which takes on a whole different tone.  It also explains why they think they understand it, they haven't seen the legal jargon in the actual bill which changes the entire thing and makes it differ from the summary.  In essence they're reading the headline and not reading the article accompanying it.

[Henry Hawk]

Guess we know now that all they are reading is the summaries and not the actual bill which takes on a whole different tone.  It also explains why they think they understand it, they haven't seen the legal jargon in the actual bill which changes the entire thing and makes it differ from the summary.  In essence they're reading the headline and not reading the article accompanying it.

but yet all we do is parrot Rush Limbaugh....who we don't even listen too...

My view is IF this is such a great bill..........THEN PASS IT!!!..............What are they waiting on?

[Bo D]

Guess we know now that all they are reading is the summaries and not the actual bill which takes on a whole different tone.  It also explains why they think they understand it, they haven't seen the legal jargon in the actual bill which changes the entire thing and makes it differ from the summary.  In essence they're reading the headline and not reading the article accompanying it.

Who is this "they" you speak of? On the other hand, I haven't seen you quote directly from the bill, choosing instead to post your ridiculous claims that you read in an e-mail from somebody.  Sometimes I think you need some good English wine. The DO grow grapes there, you know.

[Palehorse]

Some of you are just one serious medical incident from joining the couple in the following story; in fact we ALL are. Lose your job, lose your coverage, and you will become just another statistic; homeless, jobless, and invisible to people just like yourselves. You'll understand then but by then it will be too late.


http://www.cnn.com/2009/HEALTH/10/13/cancer.insurance.finances/index.html
WEST PALM BEACH, Florida (CNN) -- Leslie Elder's eyelids fluttered open, and through the fog of pain medication, she saw the emergency room doctors pull back the curtain in her room.
Leslie and Jim Elder say they were forced to cancel their health insurance.

Leslie and Jim Elder say they were forced to cancel their health insurance.

She could tell that the news was bad.

"They didn't have to say a word. I knew from their faces that something wasn't right," said Elder, 60, who hours earlier had stumbled into the ER with a stabbing pain in her abdomen. "Then one doctor said, 'Your right kidney ... it's breaking apart. You have a tumor ... and you also have a tumor in your left kidney.' "

The words "You have a tumor" were not new to Elder; her grim financial situation was.

Elder had cancer twice before -- in 1988, doctors found a tumor in her right breast, and in 2001, they found one in her left breast -- except back then, she was insured. By the time she learned that she had kidney cancer in September 2005, she was uninsured.

"All I could think of was 'Oh, my god, I'm going to go broke. We'll be living in a cardboard house,' " Elder said. " 'How am I going to do this?' It was the most honest feeling of powerlessness."

Insurance conflict

Elder and her husband, Jim, say their health insurance carrier, Nationwide Insurance, forced them into an impossible situation by raising the rates on their policy over several years. Eventually, they were forced to cancel.

"Nationwide denies any inference that the company inappropriately raised rates for the coverage that was provided from 1987 until the time the Elders canceled the policy," spokeswoman Liz Christopher said in a statement.

The Elders are broke and on the cusp of bankruptcy because of medical bills, and they're not alone. A study published in the June issue of the American Journal of Medicine found that in 2007, 62 percent of personal bankruptcies were because of medical debts. The same study indicated that in 1981, only 8 percent of bankruptcy filings could be traced to medical bills.

"Health insurance premiums track directly with the underlying cost of medical care," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, which represents 1,300 health insurance carriers in the United States. "As the cost of providing care increases, premiums increase accordingly."

The Elders boil it down to health insurance companies putting profits ahead of human life. Video Watch more on the Elders' struggle »

"The insurance companies are choosing who will live and who will die," Leslie Elder said.

Nationwide Insurance says it did not break any law by increasing the Elders' insurance premium.

"Health insurance rates were and are highly regulated by various state insurance departments, and any premium increases for the Elders and other policyholders would have been made in full compliance with state laws in effect at that time," Christopher said.

The Florida Department of Insurance Regulation, which oversees companies like Nationwide, said in a statement, "There is no law that limits the amount of rate requested by an insurer." Insurance officials add that their office reviews all rate requests, ensuring that the requests are not excessive or discriminatory.

The Elders bristle at the notion that their experience could be cast as anything but "excessive" and "discriminatory."

Health care bills before the Senate and House are designed, in part, to rid the market of health care discrimination, especially as it relates to pre-existing conditions like Elder's cancer.

Zirkelbach says the industry agrees with removing pre-existing conditions from consideration for pricing policies but stresses that reform should not come by way of raising taxes or cutting benefits for other programs like Medicare.

The Obama administration has said repeatedly that health care reform would not cut benefits or raise taxes.

The Elders are not hopeful that health care reform -- even if it excludes pre-existing condition clauses from health insurance policies -- will help them any time soon.

According to the bill currently before the House, it will be 2014 before self-employed families like them will actually have access to health insurance. By then, Elder will be near eligibility for Medicare.

While the debate in Congress continues, Elder says she is waiting anxiously -- waiting for reform, and for her cancer to come back.

A contentious relationship

The Elders did not always have such a contentious relationship with their health insurance carrier, and they were not always broke. In fact, before their insurance troubles, they were solidly middle-class business owners.

However, in 1988, things began changing. It was the year of Elder's first breast cancer diagnosis. When the family's plan required payment of a $250 deductible and a 20 percent share of the costs of medical care, the Elders could afford it.

Years after that first diagnosis, things started getting shaky. Jim Elder says the premiums crept up slowly at first and then more dramatically.

"You do ask why, why, why," Jim Elder said. "Why are we stuck with all these huge bills when we're supposedly covered?"

A recent Kaiser Family Foundation study examining U.S. health insurance policies generally found that from 1999 to 2009, the average family premium more than doubled. The Elders say that over the life of their Nationwide Insurance policy, their premiums nearly quadrupled.

The Elders believe that their health insurance premiums soared higher than those of the average family because of Leslie's previous cancer diagnosis.

"What is the message here? Survive cancer but then go drop dead because we can't make any money off you anymore?" Leslie Elder asked. "[The insurance companies] figure, 'You're useless. Get lost.' "

Nationwide says, "While we're empathetic to the Elders' situation, we stand by the policy coverages provided to the Elders while they were customers."

To cope with high premiums, the Elders played a precarious, yet common, game. They increased their deductible to offset the high premiums. By the time Leslie Elder got breast cancer for a second time, in 2001, the family's deductible was up to $5,000.

What happened next would send shock waves through the Elder household.

"As I'm recuperating, I receive $21,000 of bills that I was responsible for," Leslie Elder said. Under the Elders' policy with Nationwide they did, in fact, owe so much, in part because of rising health care costs, and in part because their deductible was now so high.

She was stunned and confused -- not just about the bills but about how they were going to pay. What still confounds Leslie and Jim Elder: How the cost of medical care, and medical insurance, went sky high in just over a decade.
Health Library

Late in 2001, the Elders were scrambling for affordable coverage. They dropped their policy with Nationwide Insurance and signed up for a more affordable policy with Aetna, by starting a group policy including employees in a small business they were running at the time. Eventually, Aetna would increase the Elders' premium to nearly $1,000 per month. It was too much. In 2005, the Elders dropped their health insurance policy for the second time.

"I sat down and seriously thought about it for a long time and said, 'I'm not going to do this,' " Leslie Elder said. "I am not going to pay. Never mind 'I'm not going to'; there was no way I could."

In a statement, Aetna said that Leslie Elder's previous cancer diagnoses were not the culprit for the rate increase.

Although the company did not cite a specific reason for the increased rate, Cynthia Michener, an Aetna spokeswoman said: "There can be other contributing factors to rate increases for small business policies, including, for example, the aggregate cost of the entire pool of small business policies in the state."

Zirkelbach said, "Everybody who has health care coverage should have the peace of mind that their coverage is going to be there when they need it. We have proposed to eliminate pre-existing condition exclusions entirely so that everybody has peace of mind that coverage will be there, that they won't be paying based on their health status."

Through it all, there was one bright spot: A generous family member paid the more than $80,000 in hospital bills stacked up during Leslie Elder's 2005 kidney cancer treatment. Still, the family is struggling to pay down the bill of more than $21,000 from 2001.

Leslie Elder says that even if she could afford it, because of her pre-existing condition, she is "uninsurable." Without coverage, she cannot afford follow-up exams for cancer, so Elder has no idea whether her cancer has come back. In a strange way, she says, not knowing is better.

"I don't think I could bear to listen to those words again. ... 'You have cancer,' " Elder said. "I've said to my husband, if I start to get sick, just set me up with a nice pill cocktail on a beach, because nobody cares. That's the message you hear every day from insurance companies."

[Exterminator]

why are you being so difficult on this.....

Gee, I don't know; could it be because you are being ridiculous?

...it is plain and simple what it says.........IF it means something else, then they should say it in the Bill...

Actually, it does say it in the bill but you are either intentionally taking it out of context or you can't read well enough to get past the talking points your ilk keep spewing.

Here is the full text of the section from which you have conveniently plucked one sentence to try to use as a basis for your ridiculous stance and it is clearly discussing standardization of data transactions between business entities, not individuals:

SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.
(a) STANDARDS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS.—

(1) IN GENERAL.—The Secretary shall adopt and regularly update standards consistent with the goals described in paragraph (2).

(2) GOALS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS.—The goals for standards under paragraph (1) are that such standards shall—
''(A) be unique with no conflicting or redundant standards;
''(B) be authoritative, permitting no additions or constraints for electronic transactions, including companion guides;
(C) be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications;
(D) enable the real-time (or near real time) determination of an individual's financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;
(E) enable, where feasible, near real-time adjudication of claims;
(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;
(G) describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions; and
(H) harmonize all common data elements across administrative and clinical transaction standards.

(3) TIME FOR ADOPTION.—Not later than 2 years after the date of implementation of the X12 Version 5010 transaction standards implemented
under this part, the Secretary shall adopt standards under this section.

(4) REQUIREMENTS FOR SPECIFIC STANDARDS.—The standards under this section shall be developed, adopted and enforced so as to—
(A) clarify, refine, complete, and expand, as needed, the standards required under section 1173;
(B) require paper versions of standardized transactions to comply with the same standards as to data content such that a fully compliant, equivalent electronic transaction can be populated from the data from a paper version;
(C) enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;
(D) require timely and transparent claim and denial management processes, including tracking, adjudication, and appeal processing;
(E) require the use of a standard electronic transaction with which health care providers may quickly and efficiently enroll with a health plan to conduct the other electronic transactions provided for in this part; and
(F) provide for other requirements relating to administrative simplification as identified by the Secretary, in consultation with stake holders.

(5) BUILDING ON EXISTING STANDARDS.—In developing the standards under this section, the Secretary shall build upon existing and planned standards.

(6) IMPLEMENTATION AND ENFORCEMENT.—Not later than 6 months after the date of the enactment of this section, the Secretary shall submit to
the appropriate committees of Congress a plan for the implementation and enforcement, by not later than 5 years after such date of enactment, of the
standards under this section. Such plan shall include—
(A) a process and timeframe with milestones for developing the complete set of standards;
(B) an expedited upgrade program for continually developing and approving additions and modifications to the standards as often as annually to improve their quality and extend their functionality to meet evolving requirements in health care;
(C) programs to provide incentives for, and ease the burden of, implementation for certain health care providers, with special consideration given to such providers serving rural or underserved areas and ensure coordination with standards, implementation specifications, and certification criteria being adopted under the HITECH Act;
(D) programs to provide incentives for, and ease the burden of, health care providers who volunteer to participate in the process of setting standards for electronic transactions;
(E) an estimate of total funds needed to ensure timely completion of the implementation plan; and
(F) an enforcement process that includes timely investigation of complaints, random audits to ensure compliance, civil monetary and programmatic penalties for non-compliance consistent with existing laws and regulations, and a fair and reasonable appeals process building off of enforcement provisions under this part.
(b) LIMITATIONS ON USE OF DATA.—Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual.
(c) PROTECTION OF DATA.—The Secretary shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to subsection (a) are—
(1) used and disclosed in a manner that meets the HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service
Act), including any privacy or security standard adopted under section 3004 of such Act; and
(2) protected from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of
eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.
(2) DEFINITIONS.—Section 1171 of such Act (42 U.S.C. 1320d) is amended—
(A) in paragraph (7), by striking ''with reference to'' and all that follows and inserting ''with reference to a transaction or data element of health information in section 1173 means implementation specifications, certification criteria, operating rules, messaging formats, codes, and code sets adopted or established by the Secretary for the electronic exchange and use of information''; and
(B) by adding at the end the following new paragraph:
(9) OPERATING RULES.—The term 'operating rules' means business rules for using and processing transactions. Operating rules should address the following:
(A) Requirements for data content using available and established national standards.
(B) Infrastructure requirements that establish best practices for streamlining data flow to yield timely execution of transactions.
(C) Policies defining the transaction related rights and responsibilities for entities that are transmitting or receiving data.
(3) CONFORMING AMENDMENT.—Section 1179(a) of such Act (42 U.S.C. 1320d–8(a)) is amended, in the matter before paragraph (1)—
(A) by inserting ''on behalf of an individual'' after ''1978)''; and
(B) by inserting ''on behalf of an individual'' after ''for a financial institution.''
(b) STANDARDS FOR CLAIMS ATTACHMENTS AND COORDINATION OF BENEFITS .—
(1) STANDARD FOR HEALTH CLAIMS ATTACHMENTS.—Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and
Human Services shall promulgate a final rule to establish a standard for health claims attachment transaction described in section 1173(a)(2)(B) of the Social Security Act (42 U.S.C. 1320d–2(a)(2)(B)) and coordination of benefits.
(2) REVISION IN PROCESSING PAYMENT TRANSACTIONS BY FINANCIAL INSTITUTIONS.—
(A) IN GENERAL.—Section 1179 of the Social Security Act (42 U.S.C. 1320d–8) is amended, in the matter before paragraph (1)—
(i) by striking ''or is engaged'' and inserting ''and is engaged''; and
(ii) by inserting ''(other than as a business associate for a covered entity)''
after ''for a financial institution''.
(B) EFFECTIVE DATE.—The amendments made by paragraph (1) shall apply to transactions occurring on or after such date (not later than 6 months after the date of the enactment of this Act) as the Secretary of Health
and Human Services shall specify.

[Exterminator]

Guess we know now that all they are reading is the summaries and not the actual bill which takes on a whole different tone.  It also explains why they think they understand it, they haven't seen the legal jargon in the actual bill which changes the entire thing and makes it differ from the summary.  In essence they're reading the headline and not reading the article accompanying it.

No, you dullard, we're not.  It is you and Henry who are taking an individual statement out of context and trying to distort it to mean that which it clearly does not.