Reconciliation

[Arathena]

When we were in the US, almost all of our medical bills ended up going to collections before the insurance paid their portion to the hospital (which typically took between 15 and 18 months). I can't understand how a hospital can continue to function with that sort of financial disaster going on around it.

Over here the health insurers are electronically linked to the hospitals so they pay directly when you settle the bill on the way out. Surely that sort of thing is creeping in over there too?

Dd

Electronics are probably speeding up the process, but it must be remembered that it is an industry of usurers, profiting by denial of payment. With the practices of frivolous claims denial and recission remaining legal, it is firmly profitable for the insurance agency to delay payment as long as possible, with the ultimate goal being not to pay at all. It is a slightly older study, but :chasing payment represents over a quarter of all healthcare employees, nearly half of all employee time at the small businesses that are doctor's practices, and approximately one third of all health care expenses, including about one quarter of total income at doctors practices.

[Kulaf]

No one is going to sue anyone for 50 bucks. Are you sure they are not just threatening to send the bill to collections? It would cost them thousands to sue you for 50 dollars.

You obviously don't know much about lawsuits, but that's ok neither did I before any of this. And yes, I was sued for $50, and I'll tell you how that works. And yes, I know what it means to be sued, and there is absolutely zero confusion over what does and what doesn't constitute a lawsuit. When somebody knocks on your door and hands you a court summons that says you're being sued (they usually say "good luck" just like you were in Vegas) and an itemized list of for what and how much, you're being sued.

Here's how it works:

(DISCLAIMER: I AM NOT AN ATTORNEY SO I AM/COULD BE FULL OF SHIT)

You owe some company $50 (or they say you do). That company doesn't think it's going to get its money so it sells that debt to a debt collector for pennies on the dollar, sometimes in bulk.

Now if it's an attorney who buys the debt (or they hire an attorney), they can only legally come after you for what you supposedly owe, which in this case is $50. But that's not their primary motivation because the real goal is inflated attorney's fees. So a $50 lawsuit might show a total that adds up to $2,000. So in reality you're being sued for $2,050 or whatever the number is. They might (out of the kindness of their heart) settle for a lower number, but it'll never be the original amount you supposedly owed. Whatever number they get will be worth their time or they won't settle - they'll proceed with litgation.

EDIT: Oh and as far as I know (again, not being an attorney) it is illegal under the FDCPA for a debt collector to threaten to sue somebody as a means to coerce them into paying up. There's lots of stuff they can't say, but debt collectors are pretty brazen these days because most people are either scared/ashamed to fight back so they get away with lots of stuff they shouldn't get away with.

All of the states that I have lived in only allow small claims to include actual damages + the court filing fee which is usually somewhere between $75-150. Your state might be different. If you got served anything other than that the judge would toss our the extra fees and it was just another collection tactic. I usually don't consider a small claim filing being "sued" but that is a matter of semantics.

[Freecare Spiritwise]

The thing that gets me is not so much that they pick a fight with people, but that they kick you when you're down, when you're lest likely to defend yourself. I guess it's natural selection for the lions (insurance companies, attorneys, etc.) to cull the weak ones (sick people) from the pack, but I thought we were a more civilized society than that.

Also, the medical providers that go straight to collections and ask questions later aren't having to get their hands dirty.They're pretty far removed from all the devastation they cause.

At least I'm in good company. My doctor's wife has been fighting cancer and him and I are in the same boat financially - fighting these motherfuckers on all fronts. People think the affluent are fine because they have decent health coverage but unless you're filthy, and I mean filthy rich, then we're all one good illness away from financial ruin. But we're more likely to put up a better fight so that's saying something.

So my rant had a purpose. Does "healthcare reform" address any of this or is it some superficial "feel good" thing so that lawmakers can sleep better at night telling themselves that their constituents aren't being fucked over? That's what I'm trying to find out.

Sweet, at least they "reformed" the one tool that people who have no other recourse can use - bankruptcy. Sweet Mary and Joseph, at least they got that reformed.

[Freecare Spiritwise]

All of the states that I have lived in only allow small claims to include actual damages + the court filing fee which is usually somewhere between $75-150. Your state might be different. If you got served anything other than that the judge would toss our the extra fees and it was just
another collection tactic. I usually don't consider a small claim filing being "sued" but that is a matter of semantics.

Uh, yeah, just another collection tactic. Good one. Yeah I guess it's a pretty good tactic where 95% of people don't show up in court and the judge rubber stamps a default judgment and the person gets their wages garnished for 1/4 of their income.

That's a pretty good "tactic" against people being "sued". Thanks for the education. Now I can fire my attorney.

[Kulaf]

Not sure what good your attorney is doing you for cases like that. You are still required to appear unless he is just rubber stamping checks to settle.

[Partha]

The thing that gets me is not so much that they pick a fight with people, but that they kick you when you're down, when you're lest likely to defend yourself. I guess it's natural selection for the lions (insurance companies, attorneys, etc.) to cull the weak ones (sick people) from the pack, but I thought we were a more civilized society than that.

Hahahahahahaahahahahahahahahaahahhahahahahahahahaahaha

Er, no, we never have been.

Hahahahahahahahahahahahahahahahahahhahahahahahahahahah

[Ddrak]

So my rant had a purpose. Does "healthcare reform" address any of this or is it some superficial "feel good" thing so that lawmakers can sleep better at night telling themselves that their constituents aren't being fucked over? That's what I'm trying to find out.

If they kept the public option, it would have been a lot better. Having to compete with essentially a non-profit organization that really only has the inefficiencies of government against it would make the insurers think carefully about pissing off their customers.

It's also why they are lobbying so hard against a public option.

Dd

[Embar Angylwrath]

So the "Slaughter Solution" has been getting more play in the House, as nervous Dems want to distance themselves from actually voting on the bill. The thing is.. its an unconstitutional move, and both Slaughter and Pelosi know it, since they filed an amicus brief with the Supreme Court in 1998 challenging the line-item veto case. They KNOW it won't pass Constitutional muster. They KNOW the SC will overturn the vote. So why are they doing it?

Because they know they can't get enough votes to pass it "up-or-down" as Dems have been howling for (here's your chance, stand up and vote!). This gives them the political position of saying "well, we tried, we voted, but the SC just didn't see it our way". That means they can say they didn't vote on the vote they voted on, but no harm no foul anyway. Brilliant political move by Pelosi to give her caucus cover, and also claim that they did vote, but the SC was the bully.

Here's a Politico read on the details.

http://www.politico.com/news/stories/0310/34508.html

Why all the parlimentary convolutions when Dems said they want an "up-or-down" vote? Why all the worm twisting? Partha? Lurker? Care to comment on why the Dems won't vote "up-or-down"? Why the need for an avenue of denial?

[Lurker]

This gives them the political position of saying "well, we tried, we voted, but the SC just didn't see it our way". That means they can say they didn't vote on the vote they voted on, but no harm no foul anyway. Brilliant political move by Pelosi to give her caucus cover, and also claim that they did vote, but the SC was the bully.

Heh. Did you come up with this on your own? You really believe Pelosi's plan is to pass reform and have it overturned by the SC on constitutional grounds so they can say they tried? Isn't the more simple and realistic conclusion that Pelosi would rather have one up-or-down vote that passes both bills rather than two votes?

As for the Politico article, I don't know why they are focusing on a 1998 ruling on the line-item veto which has nothing to do with passing a bill through a self-executing rule. The ruling applies to changing the text of legislation, not the method for passing legislation. There is nothing unconstitutional about self-executing rules. From the article...

Yale Law School professor Jack Balkin agreed that, under the precedents, “the House has to step up and take responsibility for passing the same text as appears in the Senate bill.” But, he said, “if they do that, then the precise mechanism (two bills or use of a self-executing rule) isn’t as important.

If the House does use self-executing rules (or the Slaughter Solution, or deem-and-pass, or whatever you want to call it), they would be passing the same text as appears in the Senate bill. The only difference being a single up-or-down vote instead of two. And in another edition of IOKIYAR, it's a common procedure that Republicans have employed often over the years and it is not unconstitutional.

So the main problem I have with Pelosi using a self-executing rule to pass the Senate bill and the reconciliation bill is that it gives the anti-reform crowd another nontroversy to scream about. But if it wasn't this it would be something else. So fuck them.

[Embar Angylwrath]

As to your first question, yes, that's my take on Pelosi and Slaughter, especially since they argued against what they are trying to do. It makes no sense except as a CYA move. And you dodged teh question about why dems aren't lining up for the dinner they clamored for.. Gibbs, Pelosi, Obama, Reid, Emanuel, Axelrod.. all clamored for "up-or-down" vote.. ad nauseum. Yet now, when offered a chance to do so, the Dems balk and try to vote by not voting. Now THATS the courage Obama wants! As to simple and realisitc.. you mean simple and realisitic like just voting on the bill... that simple and realisitic? If you're saying simple and realisitic is just standing up and voting on a measure that controls a trillion dollars... having your name associated with that vote... being held accountable to that vote... and not trying to dodge responsibility for that vote.. then yes, I agree. Simple and realisitic is the way to go. One has to wonder why when voting on a bill of this magnitude, of this consequence, of this historical proportion, Dems don't want to be "officially" associated with it. Its cowardice Lurker, you know that.

As to your laymans opinion that this is consitutionally sound, seems like a Standford professor in Constitutional law disagrees.

http://www.americanthinker.com/blog/201 ... t_193.html

I listened to an interview with him today, he was very fair-handed, non-partisan, and explored what this all meant, why its unconstitutional, and how it may not matter anyway. (Something about the SC not getting involved once the Pres has signed a law into effect). And I'm glad to see your response, you just confirm that Constitution be damned as long as you get your way.. something you screamed about the other side when they were in power.

[Lurker]

Courts have already ruled that passing bills through self-executing rules is not unconstitutional. The Republicans have used the process often.

the Dems balk and try to vote by not voting. Now THATS the courage Obama wants!

If they use this procedure they will be voting once for both bills instead of individually. Boo hoo.

As to your laymans opinion that this is consitutionally sound, seems like a Standford professor in Constitutional law disagrees.

I quoted the Yale Law School Professor from the article you linked who said that self-executing rules are fine. Seems everyone has an opinion.

And I'm glad to see your response, you just confirm that Constitution be damned as long as you get your way.

Try reading. I said it was constitutional.

Hopefully Pelosi holds two votes. Then you can move on to the next nontroversy... maybe about how many pages the bill is.

[Embar Angylwrath]

Sorry for the second post...

The issue here is there are really two bills. One from the Senate. And one from the House. Two bills, not one. A bill that "deems" another bill to be passed, and the Senate bill. In order for a bill to pass into law, both versions of the bill have to be exactly the same. Exactly.

So when the House votes to "deem" another bill as law, that's not the actual vote on the bill. Its a vote on the "deeming" of the bill. Not the same as voting on the bill, and therefore the bill was never voted on by the house (which is the EXACT argument House members will use, they NEVER voted on the bill).

This is in direct conflict with the Constitution. Both chambers of Congress must present to the President a bill with language both chambers of Congress have voted on, and passed. Absent that, its an unconstitutional law. In fact, its not a law at all.

[Partha]

As to your laymans opinion that this is consitutionally sound, seems like a Standford professor in Constitutional law disagrees.

Wingnut disagrees with President! Clearly a shocker.

[Lurker]

Wingnut disagrees with President! Clearly a shocker.

He also ignored that I quoted a Yale professor from his own link.

The issue here is there are really two bills. One from the Senate. And one from the House. Two bills, not one. A bill that "deems" another bill to be passed, and the Senate bill. In order for a bill to pass into law, both versions of the bill have to be exactly the same. Exactly.

So when the House votes to "deem" another bill as law, that's not the actual vote on the bill. Its a vote on the "deeming" of the bill. Not the same as voting on the bill, and therefore the bill was never voted on by the house (which is the EXACT argument House members will use, they NEVER voted on the bill).

This is in direct conflict with the Constitution. Both chambers of Congress must present to the President a bill with language both chambers of Congress have voted on, and passed. Absent that, its an unconstitutional law. In fact, its not a law at all.

You're wrong. The article of the constitution in question says that the bill "shall have passed the House of Representatives and the Senate". It says nothing about voting. Courts have upheld that the House can set it's own rules on how to pass legislation. House rules allow two or more bills to be "passed" by a single vote. That's why both Democrats and Republicans have used self-executing rules in the past.

Of course, everyone has their own opinion. A Yale law professor agrees with me, a Stanford professor agrees with you, blah blah. Chances are we'll never know for sure for several reasons. Pelosi will never use the procedure if she thinks there's a chance it will be found unconstitutional since enacting health reform is her goal.

I don't think there is anything wrong with holding one vote but I hope Pelosi holds seperate votes. This is nothing but fodder for the anti-reform crowd.

[Embar Angylwrath]

Kucinich reversed himslef today and will vote for HCR. And in a very surprising turn of events, the Catholic nuns broke from official Church position and threw their support behind the current Senate bill. That's sure to cause some ruckus inside the Catholic church.

[Embar Angylwrath]

http://www.google.com/hostednews/ap/art ... AD9EG84VO0

Seems we'll all be paying more for health care under the Obama plan. So much for bending the cost curve. You don't hear that bandied about much anymore. Now, its all about expansion of coverage.. not about cost containment.

[Lurker]

Ha! I knew you'd misunderstand that article, or pretend to.

From the very second paragraph...

Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time.

In other words, it bends the cost curve. And that's just counting the cost saving measures that were actually scored by the CBO, not the dozens of provisions contained in the bill that health economists think will have bigger impacts on cost but were not adequately scored. I suggest you google an article in the WSJ called "Health Reform Passes the Cost Test" for more information on what this bill does to bend the cost curve.

And on the issue of premiums (which is a different issue but one you've conflated with health care costs from day one), everyone will see a decrease. For people in the individual market the decrease will be considerable for the same level of coverage, although some will choose to purchase better insurance when part of the premium is subsidized.

P.S. Eric Cantor thinks you're wrong about the "Slaughter Solution" being unconstitutional.

[Partha]

P.S. Eric Cantor thinks you're wrong about the "Slaughter Solution" being unconstitutional.

But which law school did HE go to?

/Embar

[Lurker]

As I said here and here, the Republican strategy to try and stop Reconciliation would fail. It was a "strategy" wholly aimed at fooling the ignorant and psyching out the House prior to passing the main reform bill. Senate Republicans did manage to get two tiny changes made to the reconciliation bill, the Senate passed it, and now it goes back to the House for a final vote which will happen tonight.

I'd like to think the Republican party or the talking heads would tone down the unhinged rhetoric now that reform is done, but there's little chance of that. The reality of reform and what the extreme right are saying about it will never cross paths.

Bruce Bartlett wrote today, "Rigid conformity is being enforced, no dissent is allowed, and the conservative brain will slowly shrivel into dementia if it hasn't already."

Based on what we've seen from the conservative movement in the last decade or more, how they are represented on the radio and their propaganda network on cable, how their elected officials looked at the reform legislative process as nothing more than a chance to destroy Obama, and how they've devolved into whiny hateful babies after it's passage, it's clear that it already has.

[Partha]

I love the part about them shutting down work past 2 because they're all WATB's.