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Thread: Health Reform Sausage Making

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    Banned Eric Stoner's Avatar
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    Default Health Reform Sausage Making

    There are currently three (3) bills in Congress that address health insurance reform: the House version and two Senate versions. One is the Baucus Bill and the other is the Ted Kennedy legacy from the Health, Education, Labor and Pensions Committee aka "HELP". Of the three, only the Senate Finance Committee Bill ( the "Baucus Bill" ) meets Obama's criteria of not boosting the deficit or costing more than $900 billion over ten years. Actually it really doesn't but it says it does.

    After the House and Senate vote on the three versions, they will go to a Conference Committee and we will probably get something that WILL increase the deficit; WILL cost at least a $ 1 trillion over the next ten years ; do nothing to reform the tort system and reduce malpractice costs; and result in raised taxes and reduced services. Here's Why.

    I'm going to focus on the Baucus Bill because it is the most likely framework for what we're actually going to get because it has the broadest support and in some respects is the least bad. As I will demonstrate, that's not saying much.

    1. The subsidies are too low to make insurance affordable for many middle class people. A family of three making less than $50,000 per year will have to pay up to $4,370 for a policy that still requires them to pay the first $1000 in health care costs and then just reimburses 80% of any overage. Most people in this strata are just scraping by now. They can't afford the premiums or the fines for not buying insurance.

    2. It doesn't take effect until July 1, 2013. Afaic that's a good thing because it enhances the chances of repeal.

    3. There is an inadequate penalty for employers of more than 50 workers who do not provide insurance coverage for their employees. There is nothing to deter them from ending insurance for their workers. Those workers would have to buy their own. Many would qualify for affordability subsidies and that would drive costs through the roof. Remember I said that: " it SAYS it reduces costs but really doesn't". ^^^ Since in most cases the penalties equal the subsidies to low and middle income workers, it is effectively a tax on hiring them. One proposed solution is to slap a tax on the ENTIRE company payroll. Just what we need ! Another disincentive for employers to hire new workers and another incentive for unions to accept lay-offs rather than agree to to givebacks. They already prefer lay-offs because in most states, laid off workers can't vote in union elections.

    4. The plan contains an administrative timebomb certain to become a disaster for State budgets and also for NYC's. Under the Baucus Bill low income families could be covered under Medicaid ( partly funded by the states and partly funded by NYC); SCHIP; state insurance exchanges or a newly created " Basic Health Plan". Who qualified for what would depend on state rules and family income. Changes in income would affect eligibility. To escape the inevitable confusion and bureaucratic maze it is proposed that Medicaid be expanded. States and state taxpayers have to pay for a substantial part of that and in the case of NYC, the local taxpayers have to cover 25% of the cost.

    All of the aforementioned bills contain variants of "Quality Adjusted Remaining Years". The cost of a procedure is amortized over the remaining years of Average Life Expectancy. If you're 59 and need a hip replacement that costs $100,000 that averages out to about $5,000 per year of your remaining 20 years and under QARY you'll get a new hip.. At some point there is going to be a cut-off regardless of your overall health so that if you're 79 and need that operation, your PRIVATE insurer will NOT be permitted to cover it because all the bills in one way or another will require private insurers to follow the QARY guidelines. The Bill's cuts in Medicare ASSURE you won't get one. If you have private insurance or can pay for it yourself, you probably still won't get one unless you get it overseas.. What ? How can that be ??? Because ALL doctors will be required to list ALL of their patients and ALL of their services into at least one of 7500 different diagnoses. The top 10% of doctors in each group, the ones who billed the most , will get fined and have their reimbursements reduced. Thus they will be discouraged from seeing patients who need them. Good doctors who develop good reputations will be punished for their success and NOTHING wil be done to reduce the cost of their malpractice insurance. Even patients who can afford to pay out of their own pockets won't be seen because that will almost certainly bump the doctors that see them into the "overbilling zone" where they will be fined and have their Medicaid and Medicare reimbursements reduced.

    All insurers will get fined for spending too much per QARY. We will probably join Europe and Canada in banning expensive drugs like Avastin. It's a good, effective treatment for colon cancer but it costs $49,000.

    Care for the elderly will be reduced and the costs on young people will be dramatically increased. The needs of the community will trump individual rights.More and more, the current generation of people under 30 is less and less likely to live better than their parents. So called Health Care Reform is just another reason why.
    Last edited by Eric Stoner; 10-16-2009 at 07:01 AM.

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    Default Re: Health Reform Sausage Making

    The head of AFSCME, Gerald McEntee is freaking out. In two op-eds in USA TODAY and the WSJ he points out that his members often accepted lower wage rates in exchange for comprehensive and expensive health care plans. All three proposed health care reform bills will sock his members with a tax increase based on their "Cadillac" health coverage.
    Last edited by Eric Stoner; 10-19-2009 at 12:29 PM.

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    Default Re: Health Reform Sausage Making

    ^^^ they don't need to worry about selective taxation of their 'Cadillac' health insurance plans ... because after the national health care program has been in operation for a couple of years EVERYBODY's health insurance premiums will rise in cost to the 'Cadillac' tax threshold !

    the Denver Post explains the hows and whys of this 'unintended' consequence ...

    (snip)"At issue are what insurance companies consider absurdly low penalties for people who choose not to buy health insurance.

    Their concern: People will buy insurance only when they desperately need it, such as after they're diagnosed with cancer or heart disease.

    Healthy people might choose to pay the penalty, now proposed at a few hundred dollars per year, because it is far less expensive than buying insurance.

    Insurance companies, under that scenario, would end up spending more to treat patients than they would receive in premiums. Rates would rise even faster than they do now. "People would come in, pay premiums for a few months while they were getting their cancer treatments," said John Martie, president and general manager of Anthem Blue Cross Blue Shield of Colorado. "If enough people did that, the whole system would collapse.

    "I would hope it wouldn't get that far. Ultimately, it would lead to rationing of care."

    In the health care bill passed Tuesday by the Senate Finance Committee, adults who do not purchase health insurance would face an excise-tax penalty of $200 a year starting in 2014 and rising gradually to $750 in 2017.

    The tax would be prorated if an individual has health insurance for part of a year.

    The insurance industry incited an immediate and passionate backlash after saying the Senate bill would cause insurance premiums to increase."(snip)

    from


    Laying out the 'unintended consequence' angle ...

    Right now health insurers are NOT required to write new insurance policies that cover pre-existing conditions. Thus if an uninsured American winds up being diagnosed with cancer, they will NOT be able to obtain insurance coverage and will face a choice of spending hundreds of thousands of dollars out of their own pockets for treatments or relinquishing everything they own in order to qualify for MedicAid coverage. Because of this large downside economic risk, many healthy Americans actually purchase medical insurance coverage as a CYA measure, in essence guaranteeing the availability of ongoing future health insurance when the day arrives that they ARE diagnosed with cancer. This also means that those healthy Americans wind up paying several thousand dollars more per year in health insurance premiums than they consume in insured health care expenses - with the surplus used to fund insurance payouts for the one out of 30 people insured by the same health insurance company who have just been diagnosed with cancer.

    But under the National Health Care bill, insurance companies will not be allowed to refuse coverage to Americans with pre-existing conditions. In real world terms, this means that healthy Americans who were formerly spending $3-$4-$5000 ( or whatever) a year for health insurance coverage and consuming a few hundred dollars a year worth of routine medical costs now have the option of dropping their insurance coverage in favor of paying the $200-$500-$900 ( or whatever) IRS penalty and paying the few hundred dollars worth of routine medical costs out of pocket. Then when the day arrives that they are diagnosed with cancer, because coverage of pre-existing conditions can no longer be denied, they can sign up for health insurance, pay their $3-$4-$5000 ( or whatever ) in health insurance premium, and promptly run up hundreds of thousands of dollars worth of medical bills for their cancer treatments. But if a large percentage of healthy Americans choose to do this, i.e. choose to pay out of pocket until they are seriously ill, it will either bankrupt the health insurance companies or cause future health insurance rates to increase to the point necessary to pay for 1 out of 3 ( instead of 1 out of 30) insured persons requiring hundreds of thousands of dollars worth of treatments for very serious health problems.

    ~
    Last edited by Melonie; 10-19-2009 at 12:37 PM.

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    Default Re: Health Reform Sausage Making

    ^^^ Thank you Melonie. And somehow all that just flew over the Nobel Prize winning head of Paul Krugman, among many others. See my "Alternate Universe of the N.Y. Times" thread. Obama threw a hissy fit in his Saturday radio address accusing the health insurers of being callous and greedy when its obvious they have a number of legit concerns.

    If you'd permit me to don my aluminum pith helmet ( a tin foil hat is SO gauche ) for a minute, could it be that the bill is in fact designed to ENCOURAGE last minute enrollment ? Could it be that the sponsors KNOW what a disaster this would be for private insurers and that the "last men standing " would be Medicare, Medicaid annnnnnd ( drumroll please ) a PUBLIC OPTION ! ?

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    Default Re: Health Reform Sausage Making

    ^^^ not wanting to swing too far towards the political in Dollar Den, all I can say is that if private insurers are required by law to cover people with pre-existing conditions, SOME method of funding must be employed other than straightforward insurance premium charges. The obvious alternative is a 'public option' ( which may in fact wind up being implemented on its face via subsidized private insurance companies ), and the taxation of employers / employees / the self-employed to actually fund the health care costs incurred ... as is the case in every country that already has a form of national health insurance. And just as obvious is the gov'ts role of controlling health care costs to minimize diversion of tax revenues, via enforced shortages of facilities / diagnostic equipment / health care workers, via gov't pre-approval requirements prior to authorization of treatment etc.

    In point of fact, I can clearly see a situation developing that is analogous to Fannie Mae / Freddie Mac and private banks re home mortgages ... where the private health insurance company writes the new health insurance policies, but then passes on the actual health care cost risk to some new gov't agency a la a national level MedicAid that is also funded by US taxpayers in general ( and similarly makes US taxpayers responsible for losses incurred) ! Better yet, create a new G.S.E. for health insurance backing, which like Fannie Mae and Freddie Mac is able to pay millions of dollars to its executives as well as making millions of dollars worth of campaign contributions to senators and congressmen !!!

    PS tin and aluminum aren't good enough shielding anymore ! Try gold !

    ~
    Last edited by Melonie; 10-19-2009 at 12:54 PM.

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by Melonie View Post
    ^^^ not wanting to swing too far towards the political in Dollar Den, all I can say is that if private insurers are required by law to cover people with pre-existing conditions, SOME method of funding must be employed other than straightforward insurance premium charges. The obvious alternative is a 'public option' ( which may in fact wind up being implemented on its face via subsidized private insurance companies ), and the taxation of employers / employees / the self-employed to actually fund the health care costs incurred ... as is the case in every country that already has a form of national health insurance. And just as obvious is the gov'ts role of controlling health care costs to minimize diversion of tax revenues, via enforced shortages of facilities / diagnostic equipment / health care workers, via gov't pre-approval requirements prior to authorization of treatment etc.

    In point of fact, I can clearly see a situation developing that is analogous to Fannie Mae / Freddie Mac and private banks re home mortgages ... where the private health insurance company writes the new health insurance policies, but then passes on the actual health care cost risk to some new gov't agency a la a national level MedicAid that is also funded by US taxpayers in general ( and similarly makes US taxpayers responsible for losses incurred) ! Better yet, create a new G.S.E. for health insurance backing, which like Fannie Mae and Freddie Mac is able to pay millions of dollars to its executives as well as making millions of dollars worth of campaign contributions to senators and congressmen !!!

    PS tin and aluminum aren't good enough shielding anymore ! Try gold !

    ~
    Great idea ! I'm having my pith helmet gold plated as we speak. It comes in handy every time Obama goes on T.V. and brags about how many jobs he's "saved".

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    Featured Member Laurisa's Avatar
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    Default Re: Health Reform Sausage Making

    I read about twenty pages of the Baucus Bill. I typed in specific words so I could read about parts of the bill I was most interested in. It was horrifying.

    This is my idea for healthcare reform:
    Melonie posted a great thread proving that the "40 million uninsured Americans" were nothing more than some illegal aliens and healthy Americans who chose not to insure themselves. I understand that there are people who make too "much money" to qualify for Medicaid--but still can't afford health insurance premiums with their income. I also understand that social security is diminishing and Medicare needs to be funded and regulated better. People with pre-existing conditions are being denied health insurance and are faced with thousands (and sometimes millions) of dollars worth of unpaid medical bills.

    I suggest a public option that is available to those who need it. (Similar to the idea of Medicare--you can get it if you are disabled or over age 65). People would only qualify for this public option if they had an illness, disease, or needed treatment that made them unable to get private insurance. The public option could not turn them away because of a pre-existing condition, solving their problems.

    I also suggest that they expand the eligibility requirements for the medicaid program. This will make government healthcare more affordable, and will allow more Americans access if they are too poor to afford private insurance. This would make up for the Americans who make too "much money" for medicaid, but still cannot afford private insurance. Medicaid's co-pays could be altered to help with the expansion of the program and the amount of new enrollees. Most people who are part of the medicaid program have $0.00 co-pays, especially pregnant women, and children. They could increase medical co-pays and set specific co-pay guidelines like normal insurance. Medicaid currently just sets a co-pay limit if one will exist, ($20.00). This means no matter if you visit your family doctor, or go to the ER, you have to pay $20.00. They could actually determine co-pays based on the service... (i.e. $20.00 for a doctor visit, $90.00 for urgent care, $120.00 for the ER). I understand taxes would have to be raised even with the new co-pay system, but it would be better than mandating insurance and penalizing people without it.

    I also propose that they implement a new system with the medicare program to weed out people who don't really need it. This can prevent misuse of the system and cut back on the waste. I don't know enough about medicare to suggest a specific course of action, but you get where I'm going with it.

    -Laurisa
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    Default Re: Health Reform Sausage Making

    ^^^ Laurisa, your intent is admirable. However, shifting to a 'public option' by whatever means still amounts to the necessity of taxing SOMEBODY in order to pay for benefits being provided to somebody ELSE whose own work efforts aren't able to cover the actual costs of their benefits ... on a permanent basis. The key thing to keep in mind is the fact you already pointed out, i.e. at some point later in life people with serious health problems are going to quickly rack up $250,000+ in medical bills. Under conventional health insurance, this $250,000 cost is 'covered' via 20-30-40 years worth of accumulated health insurance premium payments. Under the 'public option', the taxpayers will simply be presented with a $250,000 bill for however many millions of people are suddenly deemed eligible for 'public option' coverage, with those however many millions of people contributing nothing to the cost of their medical care either before or after racking up the $250,000 cost.

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    Default Re: Health Reform Sausage Making

    Nobody is going to be taxed to pay for the public option. The cost of the public option will be covered by premiums just like private insurance.

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by eagle2 View Post
    Nobody is going to be taxed to pay for the public option. The cost of the public option will be covered by premiums just like private insurance.
    Ooops. I was about to post a rebuttal but I remembered that I'm letting you have your own facts.

    For everyone else : If the "Public Option " does not collect enough in premiums to pay all the underwriters, claims people and mgt ; if they spend a little too much on office space and coffee machines, who is going to pick up the tab ? More importantly, if they are too generous and pay out too much and don't charge enough in premiums, who makes up the difference ?
    Last edited by Eric Stoner; 10-21-2009 at 11:23 AM.

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by Melonie View Post
    ^^^ Laurisa, your intent is admirable. However, shifting to a 'public option' by whatever means still amounts to the necessity of taxing SOMEBODY in order to pay for benefits being provided to somebody ELSE whose own work efforts aren't able to cover the actual costs of their benefits ... on a permanent basis. The key thing to keep in mind is the fact you already pointed out, i.e. at some point later in life people with serious health problems are going to quickly rack up $250,000+ in medical bills. Under conventional health insurance, this $250,000 cost is 'covered' via 20-30-40 years worth of accumulated health insurance premium payments. Under the 'public option', the taxpayers will simply be presented with a $250,000 bill for however many millions of people are suddenly deemed eligible for 'public option' coverage, with those however many millions of people contributing nothing to the cost of their medical care either before or after racking up the $250,000 cost.
    Good point Melonie. Keep in mind that was my attempt after ten minutes of thinking.

    I have to go to the ER right now , I'm waiting for my Grandma to come get me because I can't drive. (I drive a stick). I have a shooting pain down my right leg that is starting where my hip meets my pelvis. They want to make sure the baby isn't in distress and that I am okay.
    If you are willing to do for one year what other's won't, you can spend a lifetime doing what other's cant.


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    Default Re: Health Reform Sausage Making

    Leave it to Harry Reid, Nancy Pelosi and the rest of the dummies in Congress to make a bad situation worse. The Senate has inserted a "public option" into their bill jeopardizing the needed 60 votes.

    Many unions are having conniptions because their members will be heavily taxed on the health benefits that were won at the bargaining table.

    Seniors are flipping out over the cuts to Medicare.

    It's almost amusing to listen to all sides of the issue, all of whom want to protect their particular ox from being gored. Last in line seem to be the most important people in the whole process, patients and doctors. The trial lawyers have so far prevented even a hint of tort reform. Employers and health insurers still dictate coverage with just a few carriers in the mix for each state.

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    Default Re: Health Reform Sausage Making

    More and more the "public option" is coming into focus as specifically designed to destroy private health insurers. No governor with a brain is going to use the "opt-out" provision. The citizens of his or her state will be clobbered with taxes to subsidize those that do exercise the public option.
    Last edited by Eric Stoner; 10-27-2009 at 02:22 PM.

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    Default Re: Health Reform Sausage Making

    ^^^ yup this seems to be the gist of the 'opt-out'. Any public option costs which wind up being subsidized by federal income tax revenues will in fact be shared by federal income taxpayers of every state, regardless of whether or not any residents of their particular state are collecting such subsidies or are not due to 'opt-out'. This is the worst of all worlds scenario for taxpayers in states that do choose to 'opt-out'.

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by Melonie View Post
    ^^^ yup this seems to be the gist of the 'opt-out'. Any public option costs which wind up being subsidized by federal income tax revenues will in fact be shared by federal income taxpayers of every state, regardless of whether or not any residents of their particular state are collecting such subsidies or are not due to 'opt-out'. This is the worst of all worlds scenario for taxpayers in states that do choose to 'opt-out'.
    Melonie - No state is going to opt out. Opting out requires that the state provide an alternative to the " public option". What governor is going to want to put his or her state on the hook for millions if not BILLIONS of new expenditures with no way to pay for it ? Why would they do what the Federal government will be doing?

    Remember the 55 MPH limit ? When it was imposed to help save gas back around 1973-4 states could opt out and keep their old limits BUT they'd lose Federal Highway funds. All 50 states went along. A few Western states like Montana had a 55 mph limit BUT the fine for speeding up to the old limit ( ranging from 75 to 90 mph ) was $5. Under Carter in 1979 the Congress got tough and demanded that Montana and a few other states raise their fines for speeding or lose their Federal Highway Funds.

    With all the current plans , private insurers will have to take last minute enrollees who decide to get policies when they get sick or need an operation or an expensive drug. They won't be able to charge such people more. They will be limited in how much they can raise everyone else's premiums. How are they possibly going to stay in business ? The "last man standing" wil be the Federal Government .

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    Default Re: Health Reform Sausage Making

    get a load of this latest tidbit !!! Apparently one normally liberal media reporter took the time to do some math instead of eating pablum ...

    (snip)"As political pressure has reduced the price tag of expanding coverage to below $1 trillion over ten years, many observers assumed Democrats would react by trimming financial assistance for the middle class--that is, people making between twice and four times the poverty line, or between $44,000 to $88,000 for a family of four.

    The assumption was that if Democrats had to make tough choices about what to cut, they'd protect the the poor and most vulnerable. After all, they're Democrats.

    But now it appears that assumption may be wrong--or, at least, not entirely right.

    As recent work from the Center on the Budget and Policy Priorites has shown, the bill that the Senate Finance Committee approved actually offers substantially less protection for people making less than twice the poverty line. If the bill were to pass, the result could be significant financial hardship for people least equipped to deal with it:

    The greatest concern relates to people with incomes below 200 percent of the poverty line (below $36,620 for a family of three in 2009). The amounts that families between 133 percent of the poverty line (where Medicaid eligibility generally would end) and 200 percent of poverty would have to pay for insurance purchased through the health insurance exchanges would be as much as two to four times higher as under the Senate HELP Committee or House bills and would constitute a substantial burden for many of these households.

    The good news is that the bill from the Senate Health, Education, Labor, and Pensions Committee (HELP) is considerably more generous. And the Senate leadership must combine the two. (In fact, that process is supposed to wrap up today.)

    But providing assistance to the poor and middle class that's on a part with the Senate HELP bill would likely require allocating more money than the Finance bill sets aside. And that's something Senate leadership is already struggling to do, since much of the Democratic caucus seems more interested in scaling back the revenue measures already on the table, starting with the tax on high-benefit insurance plans.

    Indeed, the really scary part of this story is that, under pressure to make more out of less, the Senate Finance Committee has apparently put on the table a proposal that would scale back subsidies for the poor even farther.

    I say "apparently" because one reliable source, close to the process, tells me the idea isn't really under consideration. But two other sources (also very reliable) swear the proposal is very much in the mix. In fact, they say, the Finance Committee has actually sent the measure to the Congressional Budget Office for an estimate of how it will affect reform's bottom line.

    It seems to be serious enough that Center on Budget--which has gotten wind of this story, as well--has studied what the proposal would mean in practice.

    A family of three earning $27,465 a year before taxes — that is, at 150 percent of the poverty line--would have to pay $1,318 a year for health coverage under a proposal that Senate negotiators are considering for a merged health reform bill that they would bring to the Senate floor. This is more than such a family would pay under either the Senate Finance Committee health bill or the bill that the Senate Health, Labor, Education, and Pensions (HELP) Committee approved, and represents a large amount for families that often have difficulty paying the rent and utilities and putting food on the table.

    This $1,318 premium charge, which would represent 4.8 percent of the family’s income, is nearly five times the $275 that the family would pay under the Senate HELP bill and $82 more than the $1,236 it would pay under the Finance bill.

    Those amounts may not seem like a lot of money, but keep in mind those are only the premiums. Co-payments and such are separate. More important, when you're supporting a family of four on $29,000, a few extra hundred dollars makes a huge difference."(snip)

    from


    My take on these latest proposals is that they simply add to the 'moral hazard' situation for anyone making the effort to earn more than 133% of the 'official poverty level'. Unless and until they are able to earn more than $45k a year, the actual additional costs + the lost 'equivalent cash value' due to social welfare benefit ineligibility essentially means that from $25k per year to $45k per year every additional dollar earned results in nearly a dollar 'lost'.

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    Default Re: Health Reform Sausage Making

    In their simplest terms, the various Congressional plans all propose to bleed Medicare. A program which is already insolvent . And they propose to expand Medicaid mandates when two of our largest and most populous states ( N.Y. and California ) are already bankrupt. And under at least two of the plans ( the House and Senate HELP versions ) private insurers will increase premiums 60%.

    Leaving aside the obvious divorce from reality with regard to Medicare and Medicaid, where is the promised 'reform" ? What is being accomplished ? All this because 12 million people don't have health insurance ?

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by Eric Stoner View Post
    Ooops. I was about to post a rebuttal but I remembered that I'm letting you have your own facts.

    For everyone else : If the "Public Option " does not collect enough in premiums to pay all the underwriters, claims people and mgt ; if they spend a little too much on office space and coffee machines, who is going to pick up the tab ? More importantly, if they are too generous and pay out too much and don't charge enough in premiums, who makes up the difference ?
    No, you're just making stuff up. You don't know that the government will pay for any short falls. If their revenue doesn't cover the cost, then they can raise the premiums or cut costs. That's exactly what the U.S. postal system does when it does not have enough revenue to cover its expenses, it raises its fees or cuts its costs. It doesn't go to the government to pick up the tab.

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    Default Re: Health Reform Sausage Making

    Quote Originally Posted by eagle2 View Post
    No, you're just making stuff up. You don't know that the government will pay for any short falls. If their revenue doesn't cover the cost, then they can raise the premiums or cut costs. That's exactly what the U.S. postal system does when it does not have enough revenue to cover its expenses, it raises its fees or cuts its costs. It doesn't go to the government to pick up the tab.
    Raise premiums ? Maybe.
    Cut costs ? Never ! Cats do not bark.

    Until the revenue increases and cost cuts ( O.K. we'll assume pigs will learn how to fly ) take effect, what will this public option entity do ?
    B O R R O W .
    From whom ? Uncle Sam
    And you REALLY think Congress will go along with the premium increases necessary ? That it won't subsidize the difference ? At least one of the plans has them throwing it on the states via Medicaid.

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    Default Re: Health Reform Sausage Making

    Pelosi has caved to the House Hispanic Caucus and so the House bill does cover illegal immigrants.

    A big problem for the "Blue Dogs" is that it also covers, or more correctly mandates that insurers pay for abortions.

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    Default Re: Health Reform Sausage Making

    yea, a wonderful example i.e. the US postal service.

    Well, let's see ... if health insurance becomes a de-facto monopoly a la the US postal service then yes insurance premiums could be increased across the board without risk of competitive disadvantage / bankruptcy. This of course would play right into my 'fundamental change' theory, with a gov't sponsored entity (or the gov't itself) actually assuming the risk and ( what remains of ) private health insurers devolving into acting as agents for that gov't sponsored entity.

    In the absence of the gov't assuming the actual financial risk of health care costs ( in a manner similar to Freddie / Fannie assuming the actual financial risk of home mortgages ), pricing power of competing private health insurance underwriters would be severely limited ... especially against a gov't insurance option. Of course the 'gold foil hat' crowd would tell you that this is the true intent of this bill from the git-go.

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