BS: US Health Care Reform

Subject: RE: BS: US Health Care Reform
From: Riginslinger
Date: 22 Sep 09 - 09:20 PM

Well, Don, we finally agree on something.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 12:31 AM

The Senate Finance Committee was barely an hour into its consideration of health-care reform on Tuesday morning, but Sen. Jim Bunning (R-Ky.) already knew where he stood.

"I do not support a government takeover of the health-care system," he railed. The proposal "confiscates more money from the taxpayers," he went on. "It tramples on American freedom and liberties."

After this vigorous display of open-mindedness, Bunning was spent. About an hour later, spectators noticed that the senator, who had been resting his chin in his hand, had fallen fast asleep. As giggles rippled through the chamber, an aide shook Bunning, who woke with a start.

Bunning's nap was a fitting comment on how he and his Republican colleagues had received the efforts of the committee's chairman, Max Baucus (D-Mont.), to craft a bipartisan compromise on the mammoth legislation. Baucus made major concessions to Republicans: He dropped the "public option" for a government-run health plan; he tossed aside the mandate that employers provide health coverage; he cut the bill's cost and made sure it was all funded by revenue from within the health-care system; he stipulated that government funds would not go for abortion or to illegal immigrants; and he included efforts to curtail medical malpractice awards.

Subject: RE: BS: US Health Care Reform
From: DougR
Date: 23 Sep 09 - 01:09 AM

Beardedbruce: I doubt that you watched ALL of the Sunday talk show programs Obama appeared on, but I wonder if you might have seen the montage shown of those shows (I believer on Fox News). If you did, did you notice how much his nose grew from start to finish?

DougR

Subject: RE: BS: US Health Care Reform
From: Little Hawk
Date: 23 Sep 09 - 01:46 AM

He hasn't matched Richard Nixon in that regard yet, Doug! (grin)

pdq - Yes, I am well aware of the depredations of the Aztecs on the other Indians in what is now Mexico, the depredations of the Spanish on all the Indians they encountered, and the depredations of the Mexicans on the Indians in Mexico. Vicious business. However, it's sort of a separate issue from what I was originally talking about which was the wars between Mexico and the USA.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 02:48 AM

In defense of the insurance industry


LOL

Subject: RE: BS: US Health Care Reform
From: Don(Wyziwyg)T
Date: 23 Sep 09 - 05:49 AM

""Democrats aren't the first to propose that individuals be required to carry health insurance and fined if they refuse.""

I must admit that I foresee problems with this concept.

Let's say CarolC and JtS suddenly find they miraculously have sufficient cash for the premium (monumentally unlikely in itself), and like good little Americans, they do as they've been told,and approach an insurance company for cover.

Company replies "You both have pre-existing conditions, P*SS OFF!"

So do all the other companies they try.

They still have no cover........WHO PAYS THE FINE?

I'd really like to know.

Don T.

Subject: RE: BS: US Health Care Reform
From: Riginslinger
Date: 23 Sep 09 - 08:34 AM

My understanding of the various proposals put forward is, one of the caveats precludes refusal to insure, or dropping someone, because of a pre-existing condition.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 09:40 AM

And rate setting will be subject to controls as well. And subsidies are provided according to a formula based on income. These are some of the reasons the exchanges will take four or more years to fully implement.

Subject: RE: BS: US Health Care Reform
From: Don(Wyziwyg)T
Date: 23 Sep 09 - 10:13 AM

There have been a number of posts on here telling of premiums of $1000+ dollars per month, for private medical care, and the people who are paying (or having their employers pay for them) those premiums are complaining about the tax they might have to pay to support a national system.

In the UK, with less than half the population in full time employment, when I was paying income tax and National Insurance contributions, I was paying out about £35 ($60-70 approx) per month National insurance. My income tax payments varied between £120 and £170 ($200-300) per month.

Every man, woman, and child in the country gets medical care without payment at point of need. The only things I paid for were prescriptions, teeth, and specs.

I'm retired now, and paying no tax or insurance. I still get the same treatment, except now my prescriptions are free also, and I get free eye tests.

It seems to me ridiculous that a whole nation would want to go on paying rip-off premiums to insurers who spend most of thir time looking for ways to stiff patients out of their rights under the contracts.

I paid, all through my working life, in tax AND insurance, about a quarter of what a working American pays for insurance alone. And that doesn't even cover all his treatment, and often, if they can find a get-out clause, doesn't cover any.

Those corporate guys sure have you all by the short and curlies. Even P.T.Barnum didn't have a clue just HOW MANY suckers there are in the US.

Don T.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 10:46 AM

In 2008, the average premiums for employer-sponsored health insurance were $392 for individual coverage and $1057 for family coverage. The average premium being paid for an individually purchased health insurance plan was $159 ($1,908 over 12 months) for an individual and $369 ($4,428 over 12 months) for a family.

2009 rates were up 5%

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 11:00 AM

I don't think the Baucus plan has rate controls. That's one of the problems I have with that plan. I really hope that one doesn't go through in its current version (without a public option). That could be financially ruinous for us, depending on how they do the subsidies. I hate that that one is such a gift to the insurance companies. That one is bad also because it forces the insured to pay a lot of out of pocket expenses on top of the premiums. If that plan goes through as is, the number of bankruptcies related to health care costs is going to rise.


I don't think those averages for individually purchased insurance can possibly be accurate. It costs a lot more to purchase insurance individually than it does to be insured through an employer.

The last year we had insurance, we paid about $12,000 for the year. It would cost us a lot more now.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 11:01 AM

Side by side comparison of:

(1) Baucus' Senate Finance Committee America's Healthy Future Act of 2009;

(2) The Senate HELP Committee Affordable Health Choices Act; and,

(3) The House Tri-Committee America's Affordable Health Choices Act of 2009 (H.R. 3200)

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 11:09 AM

I was wondering about rate controls, Carol.

I probably got those avergae premium rates from Kaiser Family Foundation materials. googlable question.

Out of pocket expenses are key to cost control. They have to be careful on low income folk there, though, as you say. I think all of the proposals have annual caps on out of pocket. If everybody gets free free free all the time the cost consciousness has to be shifted away from the physicians and patients and to you know who.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 11:17 AM

Reasonable out of pocket may help cost control, but what they are proposing is not reasonable. It's just a gift to the insurance companies.

If we have to pay the amount I heard being thrown around about the Baucus bill, the premiums alone will break us. Having out of pocket expenses on top of that will insure that we will not be any more able to afford medical care than we are right now. So on top of not being able to get medical care, we will also be bankrupt from the premiums.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 11:20 AM

Also, high out of pocket expenses will cause costs to increase rather than decrease, because they will be a disincentive for people to get preventative care, and they won't get care until their health problems are a lot more expensive to treat.

Subject: RE: BS: US Health Care Reform
From: Amos
Date: 23 Sep 09 - 11:39 AM

survey by the Kaiser Family Foundation found that, once again, health insurance premiums rose faster last year than either wages or general inflation. A study by the Treasury Department found that almost half of all Americans below Medicare age have gone without insurance at some point over the last decade.

The Kaiser study, conducted jointly with the Health Research and Education Trust, an affiliate of the American Hospital Association, found that the average premium for a family policy offered at work rose above $13,300 in 2009 — up from $5,800 in 1999. The average employer paid more than $9,800 of that, while the workers contributed more than $3,500. The workers were also hit with larger co-payments and deductibles, while their policies often offered fewer benefits.

The premium increase this year was a relatively modest 5 percent, far below the 13 percent rate in two previous years. But that still far outpaced a 3.1 percent growth in wages and a small decrease in inflation. Absent meaningful reform, worse is sure to come.

Kaiser estimates that, if increases revert to the average of the last 10 years, health insurance premiums in 2019 will average a whopping $30,800, which it calls "a very scary number." More immediately, a fifth of the employers surveyed said they are very likely to increase the amount that employees pay for premiums next year.

Meanwhile, the Treasury Department's study highlighted how vulnerable Americans are to losing their coverage.

It found that, between 1997 and 2006, 48 percent of nonelderly Americans went without health insurance for at least one month, 41 percent lacked coverage for at least six months and 36 percent were uncovered for a year or more. That happened during a decade of strong economic growth. The number of uninsured is likely to be higher over the next decade, the study warns.

The argument for reform seems clear. Americans without insurance need guaranteed access to coverage. Those with insurance need a guarantee that they will not be dropped by their insurers and will be able to buy an affordable policy if their employers decide to drop coverage. And ways must be found to slow the rise in health care costs and ease the burden of paying for insurance. (NYT Ed.)

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 11:39 AM

If I understand Baucus (I don't), your peak exposure to premiums is 10% of income. If I understand HR 3200 (I don't), your peak exposure to premiums is 12% of income. I guess those are both subject to ongoing negotiations especially on subsidy questions. Out of pocket is on top of that?

Page 6 of that side by side is on subsidies.

For Baucus it says:
For those with incomes between 100-150% FPL, the cost-sharing
subsidies will result in coverage for 90% of
the benefit costs of the plan. For those with
incomes between 150-200%, the cost-sharing
subsidies will result in coverage for 80% of the
benefit costs of the plan.

(I don't know what it does for 200% - %400 FPL - nothing?)

For HR 3200 it says:

The premium credits will be based on the average cost of
the three lowest cost basic health plans in the
area and will be set on a sliding scale such that
the premium contributions are limited to the
following percentages of income for specified
income tiers:

133-150% FPL: 1.5 - 3% of income
150-200% FPL: 3 – 5.5% of income
200-250% FPL: 5.5 - 8% of income
250-300% FPL: 8 - 10% of income
300-350% FPL: 10 - 11% of income
350-400% FPL: 11 - 12% of income

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 11:52 AM

P.S. 200% Federal Poverty Level for family of four in 2009 is $44,100.

http://www.cms.hhs.gov/MedicaidEligibility/Downloads/POV09Combo.pdf

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 12:07 PM

Oops - The subsidies for HR 3200 continue on to page 7 of the side-by-side:

Provide affordability cost-sharing credits to
eligible individuals and families with incomes
up to 400% FPL. The cost-sharing credits
reduce the cost-sharing amounts and annual
cost-sharing limits and have the effect of
increasing the actuarial value of the basic
benefit plan to the following percentages of the
full value of the plan for the specified income
tier:
133-150% FPL: 97%
150-200% FPL: 93%
200-250% FPL: 85%
250-300% FPL: 78%
300-350% FPL: 72%
350-400% FPL: 70%

-----

So it is a lot stronger on the subsidies, but that's where they are hammering on Baucus this week.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 12:11 PM

Were more than 200% above poverty, but not enough above that 10% of our income won't be a really big hit. We're barely making it on what we're living on now. Having to pay big out of pocket expenses will put actually getting medical care out of our reach.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 12:11 PM

Out of pockets stay very low on low-income, but not for the wealthy, which is good.

It becomes clearer and clearer why WSJ likes Baucus so much more than HR 3200.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 12:20 PM

The Baucus plan was written by the insurance companies.

Subject: RE: BS: US Health Care Reform
From: heric
Date: 23 Sep 09 - 12:30 PM

Insurance companies win on both. You'd think they would prefer guaranteed federal subsidies over problem payers. It's probably rating mandates, or maybe physician pay cuts, that would move them towards Baucus.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 23 Sep 09 - 12:35 PM

The insurance companies do better under Baucus, because that plan precludes the possibility of any public option. At least HR 3200 allows for the possibility of one.

Subject: RE: BS: US Health Care Reform
From: TRUBRIT
Date: 24 Sep 09 - 12:06 AM

Too tired to read the whole thread - sorry. I received a letter the other day from the doctor who did my colonoscopy about three years ago -- telling me it was time for another one and please call and set it up.
Well, I cried when I had to have it and found it invasive and gross and didn't want another one.
I called my doctor and asked if I needed a colonoscopy -- was put on hold - had to wait a while but two days later, doctor's minion called me back -- says no colonoscop necessary for 3 years....mine was fine and there is no risk for three years......WHAT DO COLONOSCOPIES COST???????? How many people just book another one and don't question it.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 24 Sep 09 - 12:19 AM

I think a more pertinent question for the purpose of this thread might be, how much money are we spending on people who don't get colonoscopies until their illness is so advanced, it costs a lot more money to treat than it would have had they gotten the procedure done sooner, and for how many of those people is the reason they didn't get it done sooner is because they had no insurance?

Subject: RE: BS: US Health Care Reform
From: heric
Date: 24 Sep 09 - 12:28 AM

I was thinking along the same lines. Americans have a preference for overtreatment, naturally. (That's why we have, e.g., far better cancer detection and survival than the UK, despite all the hubris.) But that's expensive. So much being paid for the majority while not steering adequate funds to the underserved. It's not right, and it's not sensible policy.

Subject: RE: BS: US Health Care Reform
From: TRUBRIT
Date: 24 Sep 09 - 12:34 AM

I totally agree - if I did not have excellent health insurance I would not have had the first colonoscopy -- it just pisses me off that a large number of people probably got that letter and booked the appointment....

Subject: RE: BS: US Health Care Reform
From: Don(Wyziwyg)T
Date: 24 Sep 09 - 09:11 AM

And an even larger number didn't get any letter.......AND DIED!

Don T.

Subject: RE: BS: US Health Care Reform
From: Don Firth
Date: 24 Sep 09 - 02:40 PM

This is a most serious subject. But a brief aside for a bit of levity if I may:

A few friends and I were sitting around eating some Chinese take-out. One woman opened a fortune cookie, read the message, and burst out laughing. "It says 'You have an inner beauty.' That's what they told me after my colonoscopy!"

Don Firth

Subject: RE: BS: US Health Care Reform
From: Riginslinger
Date: 24 Sep 09 - 05:52 PM

I'd call that dark humor!

Subject: RE: BS: US Health Care Reform
From: beardedbruce
Date: 28 Sep 09 - 11:53 AM

The Health-Care Ego Trip
   
By Robert J. Samuelson
Monday, September 28, 2009

What's driving the great health debate of 2009 is not a popular clamor for universal insurance. "Many Americans are balking again at the prospect of health care reform," writes pollster Andrew Kohut of the Pew Research Center. A new Wall Street Journal poll found 41 percent of respondents opposed to President Obama's proposals and 39 percent in favor (the rest were undecided). The underlying driver is politicians' psychological quest for glory.

"My colleagues, this is our opportunity to make history," Chairman Max Baucus implored last week as the Senate Finance Committee opened consideration of his bill. Politicians, in their most self-important moments, see themselves as instruments of national destiny. They yearn to be remembered as the architects and agents of great social and economic transformations. They want to be at the signing ceremony; they want a pen.

Ordinary Americans are rightly suspicious of this exercise in collective ego gratification, which has gripped Obama and many of his congressional allies. Even when the goals are worthy -- as they are here -- the temptation to exaggerate, simplify and sugarcoat often proves irresistible. Baucus's promotion of his handiwork is a case in point.

One study "found that every year in America, lack of health coverage leads to 45,000 deaths," he told the committee. "No one should die because they cannot afford health care. This bill would fix that."

There was more. "These reforms would give Americans real savings," Baucus said. The Congressional Budget Office "tells us that the [insurance] rating reforms and exchanges in our proposal would significantly lower premiums in the individual market." As well, the bill wouldn't increase the budget deficit and "starts reducing the deficit within 10 years."

If only all this were irrefutable. But Baucus's claims are shaky. It is questionable whether more insurance would save 45,000 lives a year. Unfortunately, just having insurance doesn't automatically improve people's health. Sometimes more medical care doesn't really help. Sometimes people don't go to doctors when they should or follow instructions (take medicine, alter lifestyles). Indeed, many people don't even sign up for insurance to which they're entitled. An Urban Institute study estimated that 10.9 million people eligible for Medicaid or the Children's Health Insurance Program in 2007 didn't enroll.

The 45,000 figure cited by Baucus is itself an unreliable statistical construct built on many assumptions. It's based on a study of 9,004 people ages 17 to 64 who were examined between 1988 and 1994. By 2000, 351 had died; of these, 60 were uninsured. The crude death rates among the insured (3 percent of whom died) and uninsured (3.3 percent) were within the statistical margin of error. After adjustments for age, income and other factors, the authors concluded that being uninsured raises the risk of death by 40 percent. They then extrapolated this to the entire population by two techniques, one producing an estimate of 35,327 premature deaths and another of 44,789.

This whole elaborate statistical edifice rests on a flimsy factual foundation. The point is not to deny that the uninsured are more vulnerable (they are) or that extra insurance wouldn't help (it would). The point is that estimating how much is extremely difficult. Advocates exaggerate the benefits. Remember: Today's uninsured do receive care.

What about lower insurance premiums? Here's the actual CBO analysis: "Premiums in the new insurance exchanges would tend to be higher than the average premiums in the current-law individual market -- again with other factors held equal -- because the new policies would have to cover pre-existing medical conditions and could not deny coverage to people with high expected costs for health care." The CBO added that it couldn't predict premiums because so many factors might influence them.

It's true, as Baucus says, that the CBO estimated that new taxes and Medicare savings would cover the costs of his original bill. But many Medicare "savings" are probably phony. Congress is likely to reverse them, as in the past. Put in that category about $200 billion in "savings" over 10 years from lower reimbursement rates for doctors (under the "sustainable growth rate" formula). Congress has repeatedly prevented those cuts from occurring. A separate $180 billion in "savings" from lower reimbursement for hospitals and other providers are similarly suspect. Together, these items provide about half the plan's financing.

Americans worried about this legislation may not know its details or may even be misinformed. Still, their skepticism is justified. Grandiose rhetoric obscures unflattering reality. The proposals don't force the major structural changes in the delivery system that might curb uncontrolled health spending, which is the central problem. The bills that Congress is considering might marginally improve Americans' health but would worsen the federal budget outlook and squeeze other public and private spending. Whatever bragging rights result will quickly erode in the face of the health system's continuing problems.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 28 Sep 09 - 11:58 AM

Yeah, it's just my ego that makes me want to have access to health care. Not wanting to die a premature death has nothing to do with it.

Robert J. Samuelson is a tit.

Subject: RE: BS: US Health Care Reform
From: Greg F.
Date: 28 Sep 09 - 12:44 PM

But Carol, Samuelson was born with a caul- he can accurately predict what Congress will do !

Ita a bit disingenuous to task Democrats for "unreliable statistical construct" and "flimsy factual construction" in the face of the unrelenting flood of Republican verbal dihorrhea with no basis in fact whatsoever.

Samuelsin has been a schill for the privitisation of Social Security for quite a while.

For a better look at where Samuelson is coming from CLICK HERE

Subject: RE: BS: US Health Care Reform
From: beardedbruce
Date: 28 Sep 09 - 12:57 PM

As usual, those who cannot argue the facts attack the people who bring them up.

The egos involved are those of the present administration, and Congress. I agree that they would rather see you dead than actually reform the medical care syetm in a way that would work, but not give them the power of life or death over you.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 28 Sep 09 - 01:02 PM

Since I'm the one who doesn't have access to health care, there really isn't anything the Democrats in Congress could do to make my situation any worse (except for passing the Baucus plan with no public option). If they pass a bill with a public option, they will be saving my life and JtS' life. Quite frankly, I don't give a shit what their motive would be for doing that, ego, or anything else, as long as they do it. And if they do, I will be grateful.

Really, a person without insurance (and even one with insurance) would have to be a total idiot to buy the Republican propaganda on the subject of health care reform.

Subject: RE: BS: US Health Care Reform
From: Art Thieme
Date: 28 Sep 09 - 02:18 PM

CarolC,
If you read my previous posts, you know how much I thoroughly agree with you! Well said.

Art

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 28 Sep 09 - 02:26 PM

Thanks! :-)

Subject: RE: BS: US Health Care Reform
From: Art Thieme
Date: 28 Sep 09 - 02:28 PM

Years ago, I got a fortune cookie that said, "Psychics will put search dogs on the trail to your cadaver.

I never understood how it might come to fruition - until now possibly.

Art

Subject: RE: BS: US Health Care Reform
From: Greg F.
Date: 28 Sep 09 - 05:26 PM

As usual, those who cannot argue the facts attack the people who bring them up.

Not at all BeeBee-

1.I'm simply putting the man in context

and

2. Best way to refute the man is with his own words.

You lose.

Subject: RE: BS: US Health Care Reform
From: dick greenhaus
Date: 28 Sep 09 - 06:30 PM

I guess I'm proud to be a member of the only major country that doesn't think it can afford to keep its citizens healthy. Sorta makes one proud......I guess.

Subject: RE: BS: US Health Care Reform
From: beardedbruce
Date: 29 Sep 09 - 05:52 AM

"Since I'm the one who doesn't have access to health care, there really isn't anything the Democrats in Congress could do to make my situation any worse (except for passing the Baucus plan with no public option)."

Unless you get the fine for not having healthcare. That is what the present bills will do- charge you for not being able to afford the policy.

Subject: RE: BS: US Health Care Reform
From: Riginslinger
Date: 29 Sep 09 - 10:37 AM

Is that fine tax deductable?

Subject: RE: BS: US Health Care Reform
From: Greg F.
Date: 29 Sep 09 - 11:03 AM

Read THIS
it might just save your ass.

From that well-known radical leftist communist front organisation, the AARP.

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 29 Sep 09 - 11:47 AM

That's why I said unless they pass the Baucus bill without the public option. The Baucus bill as it is could be very bad for us (depending on the subsidies). We definitely couldn't afford it without a sizable subsidy, or without the public option. They need to pass a bill that isn't just a massive handout to the insurance companies.

Subject: RE: BS: US Health Care Reform
From: DougR
Date: 30 Sep 09 - 01:24 AM

Way to go, Greggie, I clicked on your blue clicky but the server was no where to be found.

DougR

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 30 Sep 09 - 01:31 AM

The clicky works for me. It's an AARP bulletin correcting the lies that the insurance industry has been peddling with the help of the complicit corporate media.

Subject: RE: BS: US Health Care Reform
From: DougR
Date: 30 Sep 09 - 01:31 AM

Greggie: I was referring to the Blue Clicky about the Samuelson article. As to AARP, it's my understanding that it has lost 60,000 plus members as a result of it's stand on government health care.

After today's vote in the Senate Finance Committee, the "Public Option" is a dead duck anyway. Interesting that the Democrats joined the Republicans to kill it. Where are the socialists when you REALLY need them?

DougR

Subject: RE: BS: US Health Care Reform
From: CarolC
Date: 30 Sep 09 - 01:47 AM

That's ok. The Samuelson article is crap anyway.

So far, I have refused to join AARP because I felt that they were working more for insurance and drug companies than for their members. I just might have to join now that they are finally standing up for their members.

The public option is not dead yet. It was only voted down in one committee. There are still several votes left on whether or not to have the public option. But don't let facts get in the way of a good fantasy.

Subject: RE: BS: US Health Care Reform
From: Greg F.
Date: 30 Sep 09 - 12:22 PM

Click Here Douggie. Sorry for the typo.

Don't know why not being able to access the article would trouble you, tho- you've never thought it necessary to actually read & comprehend something before spouting off in the past.