Impeding changes to our Health Care system

[TheMercenary]

The most important thing any of you can understand is that there is no LIMIT on what the insurance companies can charge you or pass on to you in the form of deductables.

NO PLAN in Congress at this time fixes the problems with healthcare in America today. None of them.

Look at how they bought the Senate vote frome LA. It is all frigging smoke and mirrors. You are about to butt screw your grand children.

Originally Posted by Clodfobble

I'm confused. If a person currently has health problems and no health insurance, in all likelihood they'd save money by jumping onto a government plan. It's the people who have no coverage and aren't sick that are getting sucked in against their will...

Clod...it is not jumping into a government plan.

Those w/o insurance would have the opportunity to purchase through the Insurance Exchange administered by the government, but with plans offered by the private sector.

To participate in the Exchange, insurance companies would be required to offer 4 plan levels, from basic to premium, priced accordingly....envision those companies competing for those millions of new consumers through more competitive pricing than presently exists. The public option would simply be one more plan to further drive competition.

The added benefit for those currently with insurance is that companies participating in the Exchange would be required to offer the same more competitive pricing to employer-based plans.

As to mandated those who have no coverage arent sick, consider that 1) insurance is not just for the sick, but as a safeguard against an unanticipated medical emergency and 2) when they many of those uninsured now get sick and go to the emergency room for routine treatment or face a catastrophic medical emergency and renege on the bill, then the rest of us pay for it in higher premiums.

Originally Posted by classicman

Me too, The problem is that I'd bet most of those who voted for this don't know the answer either.

If I know the answer, I dont think it is unreasonable to think that most members of Congress do as well.

[Clodfobble]

Redux, you've been on the defensive for too long. I'm in favor of health care reform.

But you still didn't explain the thing that was confusing me. The news article stated that

Many middle-class families who'd be required to buy coverage would still find the premiums a stretch, even with government aid. A new federal fund to provide temporary coverage for people with health problems would quickly run out of cash.

These two sentences seem to be non-sequiturs to me. Say you have a hypothetical middle class family, the Smiths, and they currently have no insurance (thus, they fall into the category outlined in sentence #1, those who would be required to now purchase coverage under the new plan. If the Smiths have no health problems, then yes, for them, right now, they will be paying more money and that will presumably make them sad. (Forget whether it's better for them in the long run, because that's not important right now.) But sentence #2 starts talking about people with health problems. If the Smiths have health problems, and have no insurance (as we inferred from sentence #1,) then they are currently paying a shit-ton out of pocket for their medical expenses. The new government plan that they are "required" to buy into will be a good deal for them, because it in all likelihood will cost less than their current health problems are costing them.

So why do we need a temporary fund to give these people coverage, when they will already be able to buy the coverage for less than they're currently spending on their health problems? Unless the assumption is that they have no insurance, and are not treating their health problems in any way, and also have no intention of getting them treated under the government plan either. In which case letting them continue to choose to live with their health problems doesn't seem to require a special federal fund.

The temporary fund is to assist those family on the cost of premiums until the Insurance Exchange is established and the more competitively priced plans by private insurance companies who chose to participate in the Exchange are in place...a period of probably 2+ years to write regulations, put those regulations out for public comment, revise the regulations.....

The mandate to purchase insurance wont kick in until the Exchange is in place, so no one will be forced to buy insurance until that time....so many folks currently w/o insurance will not see immediate relief.

Neither bill is an overnight fix...the temporary funds will help.

I'll try to keep the defensiveness to a minimum, even with the massive misinformation campaign in place, much of which is perpetuated and regurgitated here on a regular basis.

[Urbane Guerrilla]

Originally Posted by Redux

I'll try to keep the defensiveness to a minimum, even with the massive misinformation campaign in place, much of which is perpetuated and regurgitated here on a regular basis.

I'm afraid the misinformation is being regurgitated by you, Redux. You're working from the flawed assumption that 1) it will work, and better than the VA does, 2) that it will not eviscerate the dollar when the inflation they're buying at length arrives, and 3) that a bureaucracy will be a less expensive means of determining medical need than the patient-doctor relationship now. Bureaucracies do not save money or generate wealth. Only the private sector can do that.

We question these three points through actual experience of government programs, Redux. Oddly, for a man of your parts, you believe in the efficacy of all of them. There is a disconnect between your raw intellectual powers and your politics and social values which I cannot fathom, nor credit. Perhaps you have no experience of government.

No, no: we'll all live much better once we minimize government involvement in our lives down to the barest-bones necessary minimum, which is far lower than what you seem to prefer. Privatization is salvation.

[classicman]

Originally Posted by Urbane Guerrilla

I'm afraid the misinformation is being regurgitated by you, Redux. ~snip~ Perhaps you have no experience of government.

Originally Posted by Urbane Guerrilla

I'm afraid the misinformation is being regurgitated by you, Redux. You're working from the flawed assumption that 1) it will work, and better than the VA does, 2) that it will not eviscerate the dollar when the inflation they're buying at length arrives, and 3) that a bureaucracy will be a less expensive means of determining medical need than the patient-doctor relationship now. Bureaucracies do not save money or generate wealth. Only the private sector can do that.

We question these three points through actual experience of government programs, Redux. Oddly, for a man of your parts, you believe in the efficacy of all of them. There is a disconnect between your raw intellectual powers and your politics and social values which I cannot fathom, nor credit. Perhaps you have no experience of government.

No, no: we'll all live much better once we minimize government involvement in our lives down to the barest-bones necessary minimum, which is far lower than what you seem to prefer. Privatization is salvation.

More than 200 mllion people will retain their employed-based privately-administered health insurance.....with added protections and benefits - no more denials for pre-existing conditions, annual caps on out-of-pocket expenses which will eliminate the number cause of personal bankruptcy in the country, etc. No single payer system, no socialized medicine...no such bullshit.

The Insurance Exhange is not based on a VA model, but on the FEHB model where private insurance companies will compete for the uninsured by offering a range of plans, with premiums priced respectively.

Read the legislation...not the Merc/tea bag talking points.

[TheMercenary]

There are no controls on what the employer based plans can charge you in premiums. There are no controls on what the employer based plans can charge you for deductables. It is not bull shit or "Merc/tea bag talking points" ala Reflux.

[TheMercenary]

After Saturday’s procedural vote in the Senate, health care legislation will finally move forward to a full floor debate and transparent amendment process. With that in mind, it is important to analyze some of the most troubling aspects of the Senate health care legislation, particularly the increase in the payroll tax that many are calling the “Medicare AMT (Alternative Minimum Tax).” Putting aside for a moment the other problems with increasing the payroll tax, the current proposal is not indexed for inflation. This means it will hit an increasing number of middle class families each year, just like the Alternative Minimum Tax does today. This is a big deal, but we’re getting ahead of ourselves. Let’s start at the beginning.

In an effort to raise money to finance $841 billion in new health care subsidies, Senate Democrats propose increasing Medicare’s Hospital Insurance (HI) payroll tax. This tax increase is billed by supporters as something that “will not only help fund health care reform, but will also extend the solvency of the Medicare Trust Fund.” With this one sentence, Senate Democrats not only perfectly capture the absurdity of current “trust fund” accounting conventions, but also signal a total lack of seriousness when it comes to offsetting the new costs associated with health “reform.”

The HI tax was originally set at 0.35% when it was established in 1966 as a new payroll tax to fund Medicare. Since then, the tax has increased more than eight times over to the current combined rate of 2.9%. As fast as the tax rate has risen, its growth has been unable to keep up with the increase in the wage base to which the tax is applied. In 1966, the HI tax applied only to the first $6,600 of wages. In 1991, the HI taxable maximum earnings base was raised to $125,000, and in 1994 the cap was eliminated entirely.

Revenues from the HI tax are “deposited” in the Medicare Part A Trust Fund, which is running a $20.5 billion deficit (p. 56 of pdf) in 2009. The Trust Fund is expected to continue to hemorrhage money for the next seven years until 2017 when it is expected to be bankrupt. Should Congress elect to keep the program running beyond this date (a safe assumption), the cost to the rest of the budget is estimated to be over $13 trillion in present value. This is the money Congress would need to invest today to keep Medicare Part A solvent over the 75 year window. And this figure does not include the additional funds that would be necessary to close the even more gaping holes in the other parts of Medicare, principally Part B (doctors’ visits) and Part D (prescription drug coverage), which are actually several times larger than the Part A deficit.

Senate Democrats propose raising the HI tax rate by 0.5% to 3.4% on wages in excess of $200,000 ($250,000 for joint filers) beginning in 2013. The Joint Committee on Taxation estimates this tax increase will raise $54 billion over ten years. Given the scale of the Medicare funding deficit, some might argue that these additional HI revenues are necessary. But this is not what Democrats propose; this $54 billion would be used to finance entirely new health insurance subsidies for non-Medicare beneficiaries. The money just gets counted as though it’s deposited in the Medicare Trust Fund because the tax is deducted as part of the FICA line item on a worker’s paycheck.

While the person who devised this scheme has no doubt received hearty congratulations from the rest of the Senate Democratic caucus, the cynicism embedded in this strategy is breathtaking. Each dollar raised from the tax increase gets counted by the Joint Committee on Taxation as offsetting new health spending at the same time that very same dollar is treated by the Medicare Actuaries as being deposited in the Medicare Trust Fund. But if this sort of double counting is such a good idea, why stop at $54 billion? Why not pay for the entire health care reform bill through HI tax increases that also extend the solvency of the HI trust fund?

continues:
http://www.economics21.org/commentar...king-time-bomb

[TheMercenary]

A Year of Magical Thinking
The Democrats' health care dream is everyone else's nightmare.

Next time you run into a group of Democrats, offer to splash water on their faces. They've spent 2009 in a dream state, and it's time they wake up. They're convinced that they can subsidize health insurance for millions of people while also "bending the cost curve" of health care spending. They want to sign us up for the political equivalent of one of those three-step "eat more to lose weight" diets. Step one: Pile on the expenditures, regulations, taxes, and fees. Step two: Close your eyes. Step three: Pray it all works out in the end.

Sorry, it won't. Entitlements cost money, and they almost invariably cost more than the government's initial predictions. When you increase demand for a product and the supply remains fixed, the price rises. Thanks to the individual mandate, the Democratic health care bills lasso Americans into a heavily regulated health insurance oligopoly. All these new consumers will wander through the government-run "exchanges," buying the plans they can afford with taxpayer subsidies. As demand for health care increases, so will the cost.

The idea that expanding coverage will save the country money has always been a fantasy. True, the Congressional Budget Office found that, under certain assumptions that the authors of the legislation in effect required the CBO to make, the House and Senate health bills might not blow up the deficit over the next decade. But that won't happen in the real world. For one thing, doctors' reimbursements just aren't going to be cut 20 percent.

The situation with respect to the long-term deficit is even worse. The Lewin Group, the Peter G. Peterson Foundation, and the government's own Centers for Medicare and Medicaid Services have all said that Obamacare won't control costs in the long term. When the experts at Peterson and Lewin looked at the template for legislation now under debate in the Senate, they found that it "does not bend the total health care cost curve downward as a percentage of the economy."

Consider what's happened in Massachusetts since its 2006 health care reform went into effect. More people in the Bay State have health insurance--and costs keep on rising. RAND recently found that health care spending is growing 8 percent faster in Massachusetts than the state's GDP. To deal with this situation, the state government has had to trim coverage and raise taxes. Even the New York Times editorial board has admitted that Massachusetts hasn't figured out "how to slow the relentless rise in medical costs and private insurance premiums."

continues:
http://www.weeklystandard.com/Conten...7/267aexag.asp

[TheMercenary]

VAT?

http://www.washingtonexaminer.com/po...-73022217.html

[classicman]

Consider what's happened in Massachusetts since its 2006 health care reform went into effect. More people in the Bay State have health insurance--and costs keep on rising. RAND recently found that health care spending is growing 8 percent faster in Massachusetts than the state's GDP. To deal with this situation, the state government has had to trim coverage and raise taxes. Even the New York Times editorial board has admitted that Massachusetts hasn't figured out "how to slow the relentless rise in medical costs and private insurance premiums."

Is this the same Massachusetts they were telling us was so "successful"?

[TheMercenary]

Yes.

Originally Posted by TheMercenary

There are no controls on what the employer based plans can charge you in premiums. There are no controls on what the employer based plans can charge you for deductables. It is not bull shit or "Merc/tea bag talking points" ala Reflux.

I will be happy to discuss it further and in private (PM) with anyone else interested in an honest discussion of the health reform proposals.

[TheMercenary]

Go start a blog. Everyone will flock to you.