Impeding changes to our Health Care system

Originally Posted by classicman

Hey Dux . . .

Whats the deal with this interpretation...

An interesting interpretation by the Chamber of Commerce, which is spending $millions, along with the insurance industry to oppose the bill.

But I would agree that more of the reforms are "insurance" reforms (particularly impacting small business, ie members of the Chamber of Commerce) but there are signficant provisions that focus on containing costs in the delivery system.

An issue that I think plays a major role in the end user/payor costs.

Does it say how? Won't they just pass this cost on somehow?

Yep it says how it will pay for the $900 billion cost...over 10 years.

In the House, its primarily from the 5.4 % surcharge on high income earners (over $500 K0 that will raise an estimated $500 billion over ten years...and the cuts in payments to Medicare Advantage providers who have been ripping off the system for years and getting an average of 15% over Medicare guidelines, but lettting addtional companies "bid" to offer the same services at a lower rate....expected savings about $150 billion.

That brings the revenue up to $650 bill out of the $900. The rest is less predicatable...including the taxes on medical devices, etc...but with tax credits to famlies up to 4 times the poverty level (about $88K...so many middle class families wont pay that tax)....and the least predictable of the remaining revenue is in the out years and from "savings" from greater efficiencies and technologies.....iffy.

The Senate takes a different approach with the tax on high end insurance plans, but it appears that will be modified to raise the level at which plans are taxed t0 the benefit of many middle class workers and add a 1% FICA tax on income over $200K.

Some have a problem with the top 1-2% of taxpayers bearing a large portion of the costs in new taxes. I dont have a problem with that at all.

This seems really confusing. Isn't $750 a bargain for every company? They quote the average cost of a family plan to be something like $12,000. I must be missing something here, but what?

What is accomplishes is to enable companies that are marginal in size (to big for the small pool and to small for cheaper policies provided through big companies) to end their own employer-plan and enter a plan with a larger pool of other small businesses....a bunch of companies pooling together can offer cheaper insurance that a single small/medium company alone....simply by having a greater number of people included, spreading the risk.

Oh an after attempting to read some of this bill, I strongly suggest anyone with any problems relating to insomnia to try reading it.

You have to be a policy wonk to really want to read the bill, but there are good section-by-section summaries.

My Voltaire reference..."the perfect is the enemy of the good"

Who doesnt want a perfect bill that provides both comprehensive insurance reform and reform of the delivery system...all w/o costs to taxpayers?

I'll take what I think is a good bill and build on that...because the political reality is that the perfect bill aint gonna happen......or "a half of loaf is better than none."

Will it work as envisioned? Probably not completely. No legislation this comprehensive plays out completely as planned...never has and never will. But IMO, it is a reasonable approach, with most costs covered, and a good chance that it will accomplish many of the goals.

Others disagree and neither side should be claiming they can predict the future. I dont think i have ever suggested it is a great bill (I have always said IMO, it is as good as I think it can be given the politics) or that it will be 100% successful and everyone will be happy and healthy. And, I have tried to explain it as I understand it.

And, IMO, it is bullshit for others to be screaming "failed" even before it is given a chance to succeed....or claiming that the "propaganda" or talking points are all on one side of the discussion here. That is dishonest to the point of being blatantly and purposefully ignorant (not referring to you).

Only time will tell.

Or..we can punt and put it off again as we have for the last 80+ years since Teddy Roosevelt first called for comprehensive health care reform for all Americans.