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Health care reform bill and my current insurance

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Here are some common questions about how the health care reform bill will affect those who have employer-sponsored health insurance.  The answers are offered by the White House, but edited by foodconsumer.org to simplify the message. 

The main message is that if you like it, you can keep your insurance plan and your doctors. But the bill can strengthen your plan and protect you from insurance company abuses.

Will my premiums or costs go up because of health care reform bill?

No.

According to the independent and non-partisan Congressional Budget Office, people who get insurance coverage through their employers today will likely see lower premiums.

The new law will lower the insurance rates by reducing administrative costs, increasing competition between insurance companies and creating a larger pool of insured Americans.

The bill will save you money because if without the new law, in ten years, health care spending for each employee at an average big company will be $28,530.

Will my coverage at work change?

No. If you like the health plan you have, you can keep it. 

The health reform bill does not require you to change your coverage. What the bill does is strengthen the coverage you get at work by making it easier to understand and adding some clear rules to rein in the worst insurance company abuses.

Under the new law, the language explaining what’s in your plan need to be simple and clear so that you know your exact benefits or coverage.

Insurance companies are not allowed to place a lifetime limit on the amount of care they pay for. And in some cases insurance companies with excessive overhead costs are required to give you a rebate.    And, if your adult children are living at home up to age 26 they can be covered under your family policy.

Will the government take my choice of doctor away?

No.

The health care reform bill does not interfere with the choice of doctors you have today.  The new law does not require you to change the coverage you have at work today. 

What does the new law require the insurance companies to do with all the confusing forms?

Health reform bill requires health plans to use clear and plain language on insurance forms so that you can easily understand what benefits and what doctors are covered in your plan. And, standardized forms will be used to reduce the confusing and overwhelming paperwork that all Americans have to confront today.

What consumer protections will I get this year?

Beginning in September 2010, insurers will be prohibited from placing lifetime limits on what they will pay for your medical care, and they can only apply restricted annual benefit limits. Insurers will no longer be able to arbitrarily cancel your insurance policy when you get sick, except in cases of fraud.

Insurance companies will be prohibited from denying coverage to children with pre-existing conditions. This applies to all new and existing employer plans. 

Beginning in September 2010, all new group health plans must provide coverage for preventive services.  Recommended prevention and vaccination services will be covered without any deductibles or copayments. Plans must also have a straightforward and independent appeals process so you can appeal decisions by your health insurance plan. 

Beginning on January 1, 2011, insurance companies will be required to spend most of your premium dollars on your care, not on profits and overhead -- 80 percent in the  group market and 75 percent in the individual market -- and rebate any excessive overhead to enrollees.

Similarly, starting in plan year 2011, insurance companies that jack up rates will have to disclose requested premium increases publicly.  If that rate increase is found to be unreasonable, the insurer may be prohibited from competing for your business in the new state-based exchange that will begin operating in 2014.

I’m a parent, how will the health care reform bill affect coverage for my children?

You can get coverage for your child if he or she has a pre-existing condition, and adult children can stay on family policies until age 26.

Beginning in September 2010, it will be illegal for health insurance companies that cover children to deny coverage to your child based on a pre-existing condition.   This applies to all new employer plans, new plans in the individual market, and existing employer plans.

Beginning in September 2010,  insurers will be required to permit children to stay on family policies until age 26.  This applies to all plans in the individual market, new employer plans, and existing employer plans, unless your adult child has an offer of coverage through his or her employer.  This requirement will take effect the next time your plan comes up for renewal.  Adult children who are on their parents’ plan now but who lose that coverage when they graduate from college will have the option of rejoining their parents’ policy in the new plan year beginning n September 2010.  Those whose parents work at self-insured companies will also be eligible if they do not have an offer of employer-sponsored insurance.  Both married and unmarried dependents qualify for this dependent coverage.  Beginning in 2014, children up to age 26 can stay on their parent’s employer plan even if they have an offer of coverage through their employer.

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Subscribe to comments feed Comments (42 posted):

M on 04/11/2010 15:03:12
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Will taxes increase due to healthcare? Can a doctor refuse services for Medicare? And can they refuse services for any government services? Will the President ask for a VAT to support healthcare?
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robert miller on 04/11/2010 15:07:25
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Sound great Thank you all of the people in Wasington that voted yes on this bill.
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dave on 04/11/2010 15:22:26
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I want gov ins (welfare) best ins there is
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joe on 04/11/2010 15:28:38
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Ah and if you believe that I can sell you the Brooklyn Bridge for a nickel. The budget office has never gotten a forward looking budget estimate even remotely correct. Let me get this right. I'm a health insurer. It is now MANDATORY for you to buy my product. Its also MANDATORY for me to take already sick patients who will costs hundreds of thousands to care for. Oh ya I can't charge them more than I charge a healthy person. Hmmmm. Massachusetts has the same plan. Their rates go up 17% per year. Just a side note. STATES WITH MANDATORY AUTO INSURANCE HAVE A 25% HIGHER PREMIUM THAN STATES WITHOUT MANDATORY AUTO INSURANCE. The key factor "MANDATORY". Mandatory anything = price gauging! BECAUSE YOU HAVE TO BUY IT! Oh how wonderful it is to be naive. It is the LEGAL obligation of CEO's of publicly traded companies to maximize profits for shareholders. This creates the exact opposite scenario as this rosy articles painting of mandatory private health INSURANCE. Health CARE and Health INSURANCE are 2 very different concepts. The administration has done a wonderful marketing campaign making sure that the less than sharp general public cannot distinguish the 2.
Exactly the same way they made most of you people thing IRAQ and AFGHANISTAN were the same place run by the same people. GOOD LUCK!
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collin cherry on 04/11/2010 15:41:14
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It is difficult to imagine that underwriters across the country will leave premiums unchanged or move them down when adjusting for all the new mandates. It is also difficult to imagine that employers will absorb such increases without passing some through to employees. What other service or product's price has ever NOT increased when new costs are imposed or mandated?
Nothing in this new law keeps premiums from rising to account for new health plan costs or keeps physicians in a network if contracted payments fall too low.
Get ready for higher premiums, fewer businesses offering health insurance, and narrower networks of providers.
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RAHEl on 04/11/2010 15:49:20
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Well I just got a renewal from my insurance company and they raised my rate by $400.00 a month. SO they are ahead of the game It is not September yet and my insurance decision had to be in by May 1.
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mike smith on 04/11/2010 15:50:10
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Does anyone really believe this? Has the IQ of our country actually dropped that low?

Folks, your costs are going up, a lot. This isn't even close to reality. But many believe anything The Obama says or that they hear on NBC...the rest of us make money on you fools ;)
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tom davis on 04/11/2010 15:58:35
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Insurance premiums will go up and quality of medical care will go down because: (1) Increasing demand by 30 million patients without increasing the supply of medical service providers will drive prices sky high (check any economics 101 book for the reasons why); (2) Insurance companies are going to have to sell low-cost insurance to people with serious medical conditions with tens of thousands of dollars per year in medical costs and therefore will have to raise everybody else's rates to make up the difference; (3) As a result of one and two above, the quality of medical care will decrease and as absolute proof of this (4) congress exempted themselves, the president and their staffs from the entire system. And if you believe the CBO numbers, keep in mind that in 1970 they predicted that Medicare costs would be $50B/year in 2000. The actual number was closer to $500B. They were wrong by a factor of 1000%. Not a very good track record.
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Kaci on 04/11/2010 16:08:36
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Hey Joe, if you're a healthcare insurer and you don't like the new laws, obviously you were only in the business to make money. You didn't give a damn about the families that went broke because they had a sick child that couldn't get insured, or the people that died because they were denied coverage for their illness. Where is your conscience? Obviously you only care about yourself and your stockholders. Boo hoo. You need to be in a different profession that doesn't pretend to care about your fellow man, like maybe a republican senator.
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Gerald Alsid on 04/11/2010 16:12:22
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It is ridiculous to think that premiums will decrease under this new health care plan. Why did Congress change the Medical Deduction percentage from 7 1/2% to 10%? The people who will spend the most for health care can now only deduct medical expenses that exceed 10% of their income (no longer 7 1/2%) - How does this help the taxpayer who has the most medical expenses? Obama said that no one would see their taxes increase - I think this qualifies as a tax INCREASE!
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Ron on 04/11/2010 16:20:10
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Hey Kaci! The point to ANY business is to make money.
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mark mohr on 04/11/2010 16:21:37
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Good luck finding a internist who takes new medicare patients. In Colorado Springs (500,00 people population) not a single internist will take a new medicare patient. I know because I tried and called every single one.. The physicians know they will be broke taking what the government wants to pay for services..
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RAHEl on 04/11/2010 16:48:54
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Insurance company are increasing their price now. They would have increased it anyway whether the Obama plan went through or not. I'm glad the plan passed.
They cannot deny health care because of pre-existing health issues and the un insured will get insurance.
Since I'm self employed I pay $1185.00 a month now for a family of three. I just received a letter for a renewal for the same coverage $1585.00. Now read this:Similarly, starting in plan year 2011, insurance companies that jack up rates will have to disclose requested premium increases publicly. If that rate increase is found to be unreasonable, the insurer may be prohibited from competing for your business in the new state-based exchange that will begin operating in 2014.
Okay so they'll jack o the price and blame health care reform? Give me a break. Health care cost was skyrocketing anyway.
That is why we need a single payer. Everyone pays their share and cost will go down. They scare people on government takeover bull.
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logan on 04/11/2010 17:41:31
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the sky is falling! the sky is falling! don't believe everything you hear from all the right wingers. their afraid of spending on anything unless it's a useless war.
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doc with a heart on 04/11/2010 18:11:28
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nothing is perfect, it is ok to extend coverage to more people, but at the same time, we have to "ration" or limited resource for the good of the whole society. Only that can at least contain the ever rising medical cost!!
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kaci on 04/11/2010 19:57:20
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Hey Ron! Yes, most people who start a business do it to make money. That's fine. All I'm saying is that certain companies should have a moral obligation to do what is right, not what will make more profit. If your company's actions can result in someone losing their life, going bankrupt, and/or affecting their overall quality of life, then show some humanity or get out of the business. Profit is one thing, GREED is another. Humanity should be a priority over greed.
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st68 on 04/11/2010 20:22:24
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I believe that eventually we will have universal health care in the country. I hope two things:
1. Those generally very intelligent people in college who typically have become doctors do not choose different, more lucrative careers, thereby enabling 2nd & 3rd tier students to become doctors.
2. Big pharma and those doing medical research are not as greedy as they've been made out to be, because I kinda like all the new drugs and medical devices that have been invented, and I would like to see that continue.
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on 04/11/2010 20:44:07
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This writer is delirious. Premiums will go up and choices will be limited. You can not understand the insurance market and think otherwise.

Must have been written by the Democratic Party leadership
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linda maine on 04/11/2010 20:45:25
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"Admin" claims to be the author of the article above. He is below stupid. Healthcare reform is a fraudulent as its name. Is is Government takeover of healthcare. That healthcare fraud uses 10 years of taxes to pay for 6 years of healthcare. Of course Obama will not save the 1st four years of taxes. He will spend it as soon as he gets it to pay for all of his pork spending and to hide his huge deficits. In 4 years, when it comes time to provide the healthcare, Obama will say so sorry, we have no money. Go appeal to the death panel to see if we want to spend any healthcare money on you. Oh, you are too old, too young, or too sick, so just go die, you selfish pig that wants to live a normal lifespan. Of course, Obama, the Senators, Congressmen and the government bureaucrats get a special federal healthcare that will still give them the best of everything. Anyway, "Admin" the author is an idiot and so are all the gullible people that support Obama, the liar.
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John Dohh on 04/11/2010 20:49:23
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Hey joe on 11/04/2010 16:28:38 You are telling me you are a health insurer and now that health insurance is mandatory your industry will be price gouging customers. You give the best argument for health care reform that I have heard. Price gouging people for a product that means life and death is the lowest practice I can think of. You make a strong argument for increased regulation or perhaps a public option to keep the insurance industry honest.
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John Gault on 04/11/2010 20:50:21
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The answers are offered by the White House...So the answers are assumed to be accurate and unbiased. LOL

Enough Said.
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Tom nemou on 04/11/2010 21:33:57
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Who wrote this to expect that additional cost to insurance companies will not be passed thru to consumers must have little business sence
thanks google for promoting this nonsense I guess we now know what your white house meeting with Obama was all about
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white dude on 04/11/2010 21:34:29
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Americans are illiterate. They do not understand anything.
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GAB on 04/11/2010 21:38:27
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many U are n for a HUGE surprise. Of couse health care is going to increase.
Fewer Doctors w/more patients. This administration has very fuzzy math
They can't even understand it. How can we???
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John W. Adams on 04/11/2010 21:48:01
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Insurance will go up, quality of care will go down, most don't care, 47% of americans pay no tax, why should they care
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Chas on 04/11/2010 22:06:24
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The CBO estimates that the overall cost to the government will go down....
IF there aren't too many unforeseen circumstances (like young adults and/or businesses opting out to save money), and
IF congress enacts the cuts they say they will.
I hope the costs go down, but I just can't believe it. The CBO has been wrong, even very wrong, it its estimates before.
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What happened? on 04/11/2010 22:12:21
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Now can someone tell me whatever happened to "survival of the fittest"?

Insurance is a gamble. Like all gambling, the odds are suppose to be AGAINST YOU! If you are already sick, what person would bet that you won't get sick again? Health Care Insurance is a PRIVELAGE not a RIGHT.
So KACI you are saying Insurance companies are heartless? A business has employees, employees get paid when the business makes money. So you expect them to be moral, pay 1 million dollars to save a couple people's lives, and then take that 1 million away from its employees? So you save 5 lives and screw up 100 others? What is moral there? Is it moral to demand something for nothing?
I hate to tell you, but it is impossible to afford health insurance for everyone, especially the sickest people. Is it fair? NO, but life never was fair.
There may be a way to provide health care to more americans, which would be a good thing, but this is not a step in the right direction. This simply provides another way for people to take advantage of the system.
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An Old Doctor on 04/11/2010 22:13:37
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I've been in medicine 31 years. Dropped out of Medicare five years ago and never going back. Let's see here: you all think we'll work like slaves to go into practice with $200,000++ debt in our mid 30's, spend another $50,000++ annually being extorted to extinction by trial lawyers, and then sign up to be held liable by CMS (Medicare) for errors in billing and claims submission even though CMS "guidelines" exceed in length and complexity the US tax code, all while Medicare provides NO preauthorization mechanism for anything, pays less than the hard cost of delivering service for my services, denies far more claims then any commercial insurer, and cannot be changed without an act of Congress?? No thanks. I'll be working with people who value me, who in turn I value, not Obamacare freeloaders, who I don't mind telling after three decades of hard labor, missed Christmas mornings with my family, late nights, early mornings, no lunch, no bonus, no security, and no end of demands for uncompensated care: I'll be there for everyone else, but not ever for you.
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Common Sense on 04/11/2010 22:21:08
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Why is our life expenctancy only ranked 50th in the world? Because insurance companies give our premiums on investors instead spending it on our health. Thank you President Obama and Congress for reforming the insurance industry. This is the best country in the world and we should live long and prosper. It is common sense insurance reform and a victory not for Democrats but for the American People!
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A TAX PAYER on 04/11/2010 22:31:32
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THERE WILL BE FEWER DRS. LONGER WAITING FOR PROCEDURES.THE MANY PEOPLE ALREADY MILKING THE SYSTEM WILL HAVE NOTHING TO LOOSE. THE ONCEMIDDLE CLASS A FAST DIEING BREED AND THE ELDERLY HAVE A VERY GRIM FUTURE. SO THOSE OF US WHO HAVE WORKED OUR ASSES OFF ALL OUR LIVES,START BUYING AMMO WITH WHAT MONEY YOU CAN SPARE AND ILL MEET YOU ON THE FRONT LINES THE WAR IS HERE.
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Women's Cocktail Dresses on 04/11/2010 22:47:07
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If Canada and the UK and European countries can give free health coverage why can't one of the richest countries in the world ?

There's no reason why it can't be successful except for greed. Health is big business, the difference is in Canada an UK they don't try to cash in on it (at least not as much as the US).

UK is better than Canada because in the UK all medicines are $6 each regardless of what it is and the contraceptive pill is free. In Canada the medicine isn't automatically covered, you need separate insurance for that. In Canada for those without an insurance plan, you just get to see the doctor for free but you still die because you can't afford the medicine.
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Women's Cocktail Dresses on 04/11/2010 22:48:07
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If Canada and the UK and European countries can give free health coverage why can't one of the richest countries in the world ?

There's no reason why it can't be successful except for greed. Health is big business, the difference is in Canada an UK they don't try to cash in on it (at least not as much as the US).

UK is better than Canada because in the UK all medicines are $6 each regardless of what it is and the contraceptive pill is free. In Canada the medicine isn't automatically covered, you need separate insurance for that. In Canada for those without an insurance plan, you just get to see the doctor for free but you still die because you can't afford the medicine.
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David Smith on 04/11/2010 22:48:45
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Here is what the law should do: drive more docs into primary care, fewer into debt incurring specialities for which we already have too many practitioners.

Doctors who don't take medicare are exercising their right. I know lots of other physicians who will take Medicare. (That's not to say that Medicare doesn't need a kick in the pants - it does).

It will change the incentives for insurance companies - make no mistake, they'll make their money because they're smart and will figure it out. But the most egregious behaviors of the companies are curbed by the law.

The rest of you, get a grip. The existing system wasn't sustainable. The things that doctors are crying about today wasn't going to change prior to the law being passed. They'd be fighting over an ever smaller pool of patients who have insurance because fewer and fewer people could afford the coverage.

People who're complaining today seem to have an agenda - it's either greed, malice or ignorance. Nothing that they're writing seems to have any facts behind it ... Let's see how the law is implemented before we pass judgement.
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kumar on 04/11/2010 23:02:09
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This bill will not increase premiums, think about this way.
People who do not have insurance they goto emergency. Emergency room visit costs 1:50 ratio. Hence they charge more to folks with insurance.
My uncle do not have insurance, went to emergency, had a medical bill of 30k, he doesn't even read the letters came from hospitals. All that is charged to insurance. That burden won't be there any more.

Regarding increase in patient inflow, definetly quality of care would reduce. will get more doctors from other countries, my friend is indian, his two cousin doctors came to USA recently. that is not problem at all.

Finally republicans says why this bill mandates fine if insurance is not taken. Well my suggestion the bill can remove that mandate when right of treatment at emergency room for only people with insurance or pay your self.
ahhha you want free for visiting emergency room but not want to pay for insurance.....
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Jd on 04/11/2010 23:29:51
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No one but the old Doc has commented on Trial Lawyers or mentioned Tort Reform. How much of the $15 tooth brush, in the hospital, is product liability insurance? When we get out of bed in the morning we have to learn to accept some responsibility for our actions or inaction.
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Carla on 04/12/2010 00:05:43
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In my humble opinion, the world breaks down to those who say "I've got mine, now you get yours" and those who have a compassionate heart toward their fellow man. I've got friends and family in both camps. To Linda Maine you need only look so far as the fool I'm sure you voted for in 2000 and 2004 if you are truly concerned about the deficit. Two wars comprise 95% of that deficit. Obama didn't start those wars and he cannot simply end them. To "An Old Doctor" all I can say is thank the Lord for huge favors that you are not my 86 year old mother's physician. $200,000 in debt at the start of your practice and $50,000 per year for malpractice insurance. To quote someone above, BOO FREAKIN HOO. First off, just tell me there is not a Mercedes, BMW, Cadillac or some other luxury car sitting in your driveway right now and maybe I'll revise my opinion. Secondly, if you are so "concerned" with the amount of money your insurance company is charging you for malpractice insurance, then maybe you have a tiny inkling of what regular people are experiencing with their health insurance companies. Does the word "Greed" on the part of the insurance companies play a role here, you think?
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Cornel Cane on 04/12/2010 03:09:15
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To:An Old Doctor on 11/04/2010 23:13:37:

Common, cut the Bull shit doctor. How much are you making a year, by overcharging our people. I bet,You've been able to pay your school debt in less than two years. Tell me about your monthly expenses, the luxury you're living in, because you're overcharging for your services, under the old health care laws.
Your wages should be limited by law, like the cops, the teachers, the firefighters income. You're not doing more school than many of the people with a master degree. Just stop complaining man.
Obama should bring in doctors from England, Germany, Japan, or any other developed country, you name it, and pay them just a bit more than what they're making home. It will be way less than what our country is paying for its doctors.
People are choosing this job here in USA, because is making you rich in a few years, and not because they like the job or care for the sick.
Many of you think they're some kind of gods. You treat your patients with arrogance and greed is your disease.
Mr.Dr.God shut the ...door!
Quit being a dr. and get a job.
I've got no weekend for many years too. You're not the only one that has to sacrifice time and family time.
You're old, but not so smart it seems.
Or you believe that us, the"not Doctors people" are some kind of stupid animals, right?
Do you know the difference between a cardiologist and God?
God doesn't think he's a cardiologist!

Man you've made me mad! I hope you're retired, cause you need it! After all this life of a leech, on our backs, sucking the vigor out of this people.

Health care is for all, and it should be free for every American!
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Where do they come from? on 04/12/2010 03:58:10
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hey carla.. when was the last time you worked over 60 hours in a week??

When was the last time you considered spending countless hours studying your ass off to GET INTO medical school let alone make it out of there alive???

Hey by the way Cornel, MAYBE 10% of the cost of surgery ACTUALLY goes to the freaking surgeon. And the way things have been lately, less probably makes it even near the doctor.

Then pricks like you have the nerve to say my back hurts and SUE a doctor that did nothing but good for you.

If being a Doctor is SO DAMNED easy, why aren't you a doctor? Clearly, it doesn't matter how much debt you get in at the start. Clearly, the doctors haven't worked hard, and don't deserve anything but a 40,000$ a year salary.

MAN YOU'VE MADE ME MAD! Have you ever had to worry about someone suing you for your house and home, just because their arm (that you perfectly operated on) didn't heal properly?

What seems freaking appealing at the IDEA of going to college for 6 or 7 years studying your ass off, spending 4 or 5 in residency (making LESS than minimum wage, working 70-80 hours a week), and then finally come into practice (still working 60 or more hours a week) after being in 200,000$ in debt? O, and don't forget about malpractice insurance.... you are right, doctors did get paid well.. if they didn't who would want to be a freakin doctor? I know who! a run of the mill IDIOT that can't tell the difference between a muscle and a ligament. THAT would be a surgeon I could trust. Smarter people will find different fields that pay better than doctors with less stress.

The health care in Canada? in UK? The one good thing they have done is lower the cost of medications, which are overpriced. But to get help in Canada you may be put on a waitlist for months. Not only that, Why are their better doctors in America if their healthcare systems are so much better???



The life expectancy is 50th because people gorge massive amounts of food and their arteries get clogged. GO FIGURE you can afford more food when your country is "rich".

I would be more sympathetic towards you if maybe you showed the slightest sign of sympathy to anyone else but yourself. Calling doctors and everyone else greedy? You are the one's asking for money, that you have done no work to receive. Moreover, I wouldn't be surprised if you were living from paycheck to paycheck, and instead of buying a health insurance plan, you go on a 7 day cruise.
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kaci on 04/12/2010 12:17:47
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Here's some 2008 salary figures of CEOs of Health Insurance companies. Can you say NOT GREEDY?

* Aetna, Ronald A. Williams: $24,300,112
* Cigna, H. Edward Hanway: $12,236,740
* Coventry, Dale Wolf: $9,047,469
* Health Net, Jay Gellert: $4,425,355
* Humana, Michael McCallister: $4,764,309
* U. Health Group, Stephen J. Hemsley: $3,241,042
* Wellpoint, Angela Braly: $9,844,212
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Houston Weight Loss Surgery on 05/21/2010 05:50:17
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Change incentives for insurance companies - make no mistake, it is better that the United Kingdom, Canada, UK, since all drugs is $ 6, which, whatever it is, and the contraceptive pill is free.missed Christmas morning with my family, late nights, early morning without lunch, no bonus is necessary guarantees, and no end to the need for uncompensated care: I'll be there all the others, but never
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Womens Cocktail Dresses on 10/12/2010 23:26:25
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Being a Canadian I don't understand what all the anxiety is about government funded healthcare. Yes our system isn't perfect but it's there when we need it, without costing us a fortune.
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Tom on 10/14/2010 18:49:50
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FYI, this article is wrong: my company just sent me an email saying that health insurance is going up by 14% for them and therefor 14% for me too.
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