Healthcare Reform Primer
While trying to sort through the new healthcare plan, I thought I would try to summarize what I am reading. I have looked hard for resources that do not contain rhetoric and opinions about the issues, but have had a difficult time sorting through the numerous articles including summaries and quotes from the bill itself. I have found some sites that help me understand it and will try to learn a little more about it each day. Realize that any posts here, though attempting to be non-biased, come from a physician who owns a small business ( a medical practice with ~ 50 employees) and will be filtered through my experiences. I will separate out my opinions to the bottom of the post...that way, if you just want the facts without the rant, you can quit reading at the break in the page.
The first question is what happens now? The earliest changes will not be that noticeable. There will be a $250 rebate for Medicare patients who have hit a gap in their coverage. Insurance companies will not be able to exclude children from coverage due to pre-existing conditions. Also, there will be some tax credits for small businesses to help them obtain insurance for their employees. There will be a ban on insurance company limits for lifetime benefits and the companies ability to cancel policies. Before the end of the year, the government will put together a high-risk pool to help people with pre-existing conditions find coverage. Also, a 10% tax on tanning beds starts now.
Most of the components of the bill do not start until 2014, giving the government (mostly the Department of Health and Human Services) time to work on the details of implementation.
My opinion- In the past, we have had mandates from CMS (Center for Medicare and Medicaid Services) that had a specific timeline. There were associated penalties for not meeting their requirements. On more than one occasion, these involved significant computer hardware and/or software upgrades, costing quite a bit. When the deadline came, CMS had not upgraded, and extended the time until they could change their software. This puts businesses in a tough position. If you follow their guidelines, they can change their dates at the last minute. If you don't, they can proceed and you are left behind. Either way, there is a significant amount of time you are not able to send claims and receive payment. Larger institutions may have more flexibility to tolerate payment gaps, but small businesses do not. Our employees still want to be paid. My concern is that DHHS is in no way prepared for the increased responsibility of managing the proposal. They have trouble managing what they have now.
More posts as I continue my research. Next- who is to purchase insurance, where will they get it, and how will it be paid for?
The first question is what happens now? The earliest changes will not be that noticeable. There will be a $250 rebate for Medicare patients who have hit a gap in their coverage. Insurance companies will not be able to exclude children from coverage due to pre-existing conditions. Also, there will be some tax credits for small businesses to help them obtain insurance for their employees. There will be a ban on insurance company limits for lifetime benefits and the companies ability to cancel policies. Before the end of the year, the government will put together a high-risk pool to help people with pre-existing conditions find coverage. Also, a 10% tax on tanning beds starts now.
Most of the components of the bill do not start until 2014, giving the government (mostly the Department of Health and Human Services) time to work on the details of implementation.
My opinion- In the past, we have had mandates from CMS (Center for Medicare and Medicaid Services) that had a specific timeline. There were associated penalties for not meeting their requirements. On more than one occasion, these involved significant computer hardware and/or software upgrades, costing quite a bit. When the deadline came, CMS had not upgraded, and extended the time until they could change their software. This puts businesses in a tough position. If you follow their guidelines, they can change their dates at the last minute. If you don't, they can proceed and you are left behind. Either way, there is a significant amount of time you are not able to send claims and receive payment. Larger institutions may have more flexibility to tolerate payment gaps, but small businesses do not. Our employees still want to be paid. My concern is that DHHS is in no way prepared for the increased responsibility of managing the proposal. They have trouble managing what they have now.
More posts as I continue my research. Next- who is to purchase insurance, where will they get it, and how will it be paid for?
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