Health Care Reform Open Discussion

I’ve received some requests to open up a discussion and/or to post a few links on Heath Care reform as it appears we’re nearing the final stretch for this beast in D.C.

Normally, we stick to GA only issues here, but major events (national campaigns, game changing issues) often cause the comments to tend to spill over into other threads.

In an effort to let the folks in our online community express their feelings without destroying the GA specific discussions, I’m opening up this thread. Post what you like related to Health Care only, but keep it civil. Flame wars will get you in time out, while repeating partisan talking points from either side ad nauseum will just annoy most of us.

Have at it.

140 comments

  1. B Balz says:

    Gov’t aims to lower the Cost Curve on healthcare: GOOD or BAD?

    Senate Majority Leader Harry Reid of Nevada buried this anti-democratic poison pill designed to prevent any future Congress from repealing the central feature of the Healthcare Bill.

    Beginning on page 1,000 of the measure, Section 3403 reads in part: “. it shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment or conference report that would repeal or otherwise change this subsection.”

    In other words, if President Barack Obama signs this measure into law, no future Senate or House will be able to change a single word of Section 3403, regardless whether future Americans or their representatives in Congress wish otherwise!!

    Note that the subsection at issue here concerns the regulatory power of the Independent Medicare Advisory Board (IMAB) to “reduce the per capita rate of growth in Medicare spending.”

    That is precisely the kind of open-ended grant of regulatory power that effectively establishes the IMAB as the ultimate arbiter of the cost, quality and quantity of health care to be made available to the American people.

    And Reid wants the decisions of this group of unelected federal bureaucrats to be untouchable for all time.

    No wonder the majority leader tossed aside assurances that senators and the public would have at least 72 hours to study the text of the final Senate version of Obamacare before the critical vote on cloture. And no wonder Reid was so desperate to rush his amendment through the Senate, even scheduling the key tally on it at 1 a.m., while America slept.

    True to form, Reid wanted to keep his Section 3403 poison pill secret for as long as possible, just as he negotiated his bribes for the votes of Senators Mary Landrieu of Louisiana, Ben Nelson of Nebraska and Bernie Sanders of Vermont behind closed doors.

    The final Orwellian touch in this subversion of democratic procedure is found in the ruling of the Reid-controlled Senate Parliamentarian that the anti-repeal provision is not a change in Senate rules, but rather of Senate “procedures.”

    Why is that significant?

    Because for 200 years, changes in the Senate’s standing rules have required approval by two-thirds of those voting, or 67 votes rather than the 60 Reid’s amendment received.

    Reid has flouted two centuries of standing Senate rules to pass a measure in the dead of night that no senator has read, and part of which can never be changed. If this is not tyranny, then what is?

    DON’T SIT BY AND LET THIS HAPPEN IN THE DARK!!! FORWARD TO EVERYONE ON YOUR LIST!

    • polisavvy says:

      I thought that it was unconstitutional to have legislation that cannot be changed or modified by future Congresses. Did I just imagine that or is that the case? Any idea?

        • polisavvy says:

          The reason I even asked was because I thought that the government is suppose to be able to change and adapt to the changing times. If something in place that never can be changed or removed wouldn’t that be a little dumb? Think about the Voting Rights Act. That was changed and modified to adapt to the changing times. Had it not been allowed to happen, where would we be now? I’m just thinking out loud, I guess.

    • ByteMe says:

      At least you should attribute the diatribe to its rightful author. The Washington Examiner, Dec 23, 2009.

      And the annoying part, BB, is that the editorial is completely wrong. Completely. Wrong.

      The subsection in question is not the establishment of the board, which is there to provide recommendations on how to cut costs without rationing care, and those recommendations are to be brought up as a bill to change Medicare. It’s the intent that the House or Senate cannot change the recommendations made by the board, only vote them up or down… However a further paragraph states that 60 votes can overturn the requirement.

      • B Balz says:

        Byte, you are correct, it is a diatribe. As such, I did not acknowledge any author. The key change is how many votes will it take to overturn the requirement 60 or 66?

        So much misinformation is floating around it is extremely tough to figure out what is accurate. To wit: h/t RedState:

        To change the rules of the United States Senate, there must be sixty-seven votes.

        Section 3403 of Senator Harry Reid’s amendment requires that “it shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”

        The good news is that this only applies to one section of the Obamacare legislation. The bad news is that it applies to regulations imposed on doctors and patients by the Independent Medicare Advisory Boards. ”

        http://volokh.com/2009/12/22/entrenchment-provisions-in-the-health-care-bill/

        • ByteMe says:

          Please read the subsection before making assumptions based on a wrong editorial. Please also read the paragraph immediately before and after the clipped quote, which will put it into context that the editorial is missing.

          And, really, RedState is not exactly a quotable source for accurate information on anything except goats.

            • ByteMe says:

              I could post the entire subsection, but it’s too large for a blog comment.

              Here’s the text around the clipping:

              (3) LIMITATION ON CHANGES TO THE BOARD RECOMMENDATIONS-

              `(A) IN GENERAL- It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, or amendment, pursuant to this subsection or conference report thereon, that fails to satisfy the requirements of subparagraphs (A)(i) and (C) of subsection (c)(2).

              `(B) LIMITATION ON CHANGES TO THE BOARD RECOMMENDATIONS IN OTHER LEGISLATION- It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report (other than pursuant to this section) that would repeal or otherwise change the recommendations of the Board if that change would fail to satisfy the requirements of subparagraphs (A)(i) and (C) of subsection (c)(2).

              `(C) LIMITATION ON CHANGES TO THIS SUBSECTION- It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.

              `(D) WAIVER- This paragraph may be waived or suspended in the Senate only by the affirmative vote of three-fifths of the Members, duly chosen and sworn.

              `(E) APPEALS- An affirmative vote of three-fifths of the Members of the Senate, duly chosen and sworn, shall be required in the Senate to sustain an appeal of the ruling of the Chair on a point of order raised under this paragraph.

              The entire section starts like this:

              `Sec. 1899A. (a) Establishment- There is established an independent board to be known as the `Independent Medicare Advisory Board’.

              `(b) Purpose- It is the purpose of this section to, in accordance with the following provisions of this section, reduce the per capita rate of growth in Medicare spending–

              `(1) by requiring the Chief Actuary of the Centers for Medicare & Medicaid Services to determine in each year to which this section applies (in this section referred to as `a determination year’) the projected per capita growth rate under Medicare for the second year following the determination year (in this section referred to as `an implementation year’);

              `(2) if the projection for the implementation year exceeds the target growth rate for that year, by requiring the Board to develop and submit during the first year following the determination year (in this section referred to as `a proposal year’) a proposal containing recommendations to reduce the Medicare per capita growth rate to the extent required by this section; and

              `(3) by requiring the Secretary to implement such proposals unless Congress enacts legislation pursuant to this section.

              But really, you want to read it yourself to understand that the issue being raised in the editorial is a fake one that got no traction outside of the right wing blogs.

  2. kyleinatl says:

    Just to stay Georgia specific on insurace/healthcare access…
    In regard to the on-going debate related to HB 1184 and Cross-state Insurance sales

    Initial article by Dr. Ron Bachmann: http://www.talkgwinnett.net/index.php?option=com_content&task=view&id=1106&Itemid=1

    Rebuttal by Ken Mitchell from the AARP of Georgia:
    http://www.talkgwinnett.net/index.php?option=com_content&task=view&id=1114&Itemid=1

    Just an interesting debate I’m following, also Preston Smith’s SB 330 (ending lifetime and annual benefit caps and rescissions) and Judson Hill’s SB 453 (high risk reinsurance pool) are providing some awesome potential state health care reform alternatives.

    Considering all the flack that Judson took last summer in regard to opposing Federal healthcare reform and the lack of options presented on the state level, it’s nice to see some legislation to address the lack of a high-risk safety net.

    • benevolus says:

      HB1184 is just eyewash. It just directs the Insurance Commissioner to open dialogue with other Insurance Commissioners to see if there is a way to facilitate this. I surely hope it doesn’t require legislation to get the Insurance Commissioner to undertake a project for the Governor.

      I am sure insurance companies are licking their chops over this. They get to sell deceptively marketed products to consumers who will have no leverage pursuing (the inevitable) disputes with a company in another state.

        • benevolus says:

          It’s really just a backdoor way to eliminate state mandates for coverage. As the AARP guy said, Georgia requires insurance companies to cover colonoscopies, other states don’t. But if those aren’t covered people don’t get them and therefore don’t find out they have a problem until much farther down the road, which is much more expensive to treat.

          Those mandates are usually there for a reason, and cheaper individual insurance policies does not equal less expensive health care.

        • Mozart says:

          “This bill is an example of how State can provide excellent, market based competition without a Federal mandate.”

          BB, you wouldn’t, by any chance, be a lobbyist with skin in that game, would you?

      • kyleinatl says:

        Not all of them are, Blue Cross/Blue Shield of GA testified against it citing unfair competition as BCBS is franchised in each state. Granted, I say pull out the violins for them…since they basically run Georgia’s insurance market currently.

  3. Is there a way that Georgia could decide not to particpate? Can we reassert our rights, under the 10th Amendment to the Constitution, as a state to tell the federal government…”thanks anyway, but we’ll pass?”

    • Andre says:

      Luke,

      Today, the Georgia Senate debated SR 794; the “Health Care Freedom of Choice Constitutional Amendment.” The bill provides that “no law or rule or regulation shall compel any person, employer, or health care provider to participate in any health care system” among other things contained in the legislation.

      It failed to received the two-thirds necessary to pass the state Senate. However, a motion to reconsider was made. Still, I don’t think there is a single Democrat state Senator who will vote for SR 794 which means that the proposed constitutional amendment is going nowhere.

    • seenbetrdayz says:

      Virginia has done so, and is the only state to pass ‘opt out’ legislation at this point, I believe.

      • Thanks Andre for the explanation. Do you or anyone here know if there are any “vulnerable” Democrat Georgia State Senators? If there is a national backlash of Obama-Pelosi-ReidCare, perhaps the momentum of this movement can be tied to these state Democrat Senators (because of their failure to pass S.R. 794) and they will suffer the same fate.

            • kyleinatl says:

              but to your point…
              I say Marshall is safe…Barrow may be in trouble though, as the suburban areas surrounding Savannah have pretty strong conservative ties. As my father said “I think we were the only folks in Richmond Hill to vote for Obama”.

        • Andre says:

          Honestly, there aren’t too many vulnerable state senators on either side of the aisle. However, if I were forced to lobby four Democrats for their votes on a constitutional amendment, I’d hit up J.B. Powell, George Hooks, Tim Golden and either Doug Stoner or Steve Thompson.

  4. ChiefofStaff65 says:

    Well, so glad we have a Democratic minority in the Senate who want to force healthcare even if we do not want it!

    Democrats: The alternative to intelligence and common sense.

    • LoyaltyIsMyHonor says:

      The last person to try and force “health care” on Georgians was none other than Judson Hill.

    • seenbetrdayz says:

      I think the plan now is to bypass a Senate vote altogether. It makes you wonder why we still have a bicameral legislature. We should simply play a game called “California Wins” and let the state who brings the most representatives to the fight carry home the prize.

      • Chris says:

        How is that different than the “Authorization to use Force” Bull-crap used in Iraq and Afganistan. Congress critters were too chicken shit to vote for “war”.

        • seenbetrdayz says:

          It wouldn’t say there’s much of a difference. Which is exactly why this “hereby” nonsense shouldn’t be used. The buck should stop here.

          We know what happens with this “I’m only doing it because they did it” attitude in reference to spending:

          “But the Democrats spent tons of money!” say the Republicans, while breaking spending records when in the majority.

          Then: “But the Republicans spent tons of money!”, say the Democrats, while breaking spending records when in the majority.

          No side is interested in undoing what the other does wrong, but they sure as hell are interested in <i/outdoing each other.

    • benevolus says:

      They’re not trying to force health care on us. They are trying to force health insurance on us. We already have health care forced on us. They’re just trying to figure out a better way of paying for it.

  5. Rambler1414 says:

    Any word on what Obama bribed Kucinich with to garner his support? Have we come up with a sexy name for it yet, ala the Missouri Compromise or the Cornhusker Kickback?

    • B Balz says:

      h/t Chicago Trib WDC “The Swamp”

      Pelosi (D-Calif.) will need 216 votes to win passage of the healthcare bill – and if all sitting members who voted yes on the first measure vote yes again this week she will have that vote.

      However, among 15 Democrats who voted yes on the first vote, leaders are concerned about losing a handful on the second vote, nine of those abortion-related,

      And among the 37 currently seated Democrats who voted no on the first round, there is a targeted of 16 who are publicly undecided and whom Pelosi hopes to flip to yes votes.

      Kucinich was among them.

      http://www.swamppolitics.com/news/politics/blog/2010/03/kucinichs_healthcare_vote_yes.html

      • polisavvy says:

        I thought that Kucinich just wanted to ride on Air Force Once (which he did a day or so ago). LOL! 😉

            • polisavvy says:

              True. I didn’t even catch that one, BBalz!! I wonder what all these goobers have been promised. I am sick to death of this whole damn thing, especially since once it begins, like the other entitlements in this country, it will never end. A really bad move on Congress’ part, in my opinion.

  6. Doug Deal says:

    A lot of true reform could have a great deal of broad support, but Congress is only interest in either extending its power or using issues as a club to batter the other side.

    How about abandoning this approach and start simple with things like decoupling health care from employment by fixing the tax code to favor private ownership? Incentivize price shopping by patients. Require full disclosure about the price and benefits of any test or procedure before performing non emergency care.

    There are a number of baby steps that many of us would agree to, but this Congress is about control and power grabs.

    • At this point, I think Obama could say scrap our plan, we’re just going to have an up or down vote on the exact plan that McCain campaigned on and the Republicans would still vote against it.

      I’m a Democrat and I’ve always been a big supporter of extending care to more people but very sympathetic to (when appropriate) using market and economic incentives to control costs and spur innovation. Unfortunately in this political climate, one party will completely turn on one of their ideas just because the other party adopts it and they then think it would benefit them if it passed.

      Take fixing the tax code. It is a great idea, but it’s too easy to demagogue it as “raising taxes”. I feel like ultimately the bill does this with the subsidies to individuals – leveling the playing field with a subsidy similar in value to what a corporation that provides health plans gets in tax savings. You may prefer to just scrap it and replace it with a tax deduction – but you run into two problems here: a $10,000 plan costs the same whether you make $200,000 a year or $30,000, but a tax deduction is worth 3x more to the $200k earner (because they are paying income taxes at 35% compared to 10 or 15%). So a lot of people wouldn’t think that was fair – so then let’s say the government just decides to give a tax grant at a specific value instead (each guy gets $4,000 block grant regardless of income). I think the market would conform to that price soon — isn’t that government control ultimately anyway? The truth is, large corporations in the 35% tax bracket are getting a big subsidy from the government as is when they offer insurance, and a small business or individual who doesn’t make more than $200k / year (almost all of us/businesses) just can’t get that same gov’t subsidy under current law. The subsidies will level the playing field. Sure I’d prefer a cleaner solution, but if the end result is the same, I’m glad to get there whatever way we can.

      Now take incentivize price shopping by patients? Obama inserted some Republican HSA ideas into the new national changes, and I suspect we will begin to head down this path whether through that route or others, and for a lot of small businesses and individuals, I suspect the HSA route through the exchanges will be a popular one. Although I think a lack of incentives do lead to higher costs, I don’t think the problem is that Doctor A costs $150 and Doctor B costs $180 and people are picking B even though A is just as good as B. I think a bigger part of the problem is people choosing to go to the emergency room for a $1,000 sinus treatment when Doc in a Box at the drug store could have done it for $50, because they only pay $50 either way or because they don’t have insurance in the first place.

      Require full disclosure about the price and benefits of any test or procedure – sounds like what Republicans call rationing and death panels to me (or it isn’t too hard to get there with a few rhetorical flourishes and twists).

      Ultimately, I don’t see how you make anything happen without an individual mandate which is the most controversial part of this bill. I believe the Republicans inability (because of their base) to touch the individual mandate is the reason they didn’t do anything on health care in the 12 years they ran Congress. I also think that 10 years from now, the existence and popularity of the individual mandate (because it enables other popular reforms to work like eliminating pre-existing conditions) will create a framework that Republicans will ultimately propose their own reforms inside of.

      • B Balz says:

        So you took 3575 characters to say gridlock is a GOP problem?
        Kidding. Good post, I disagree.

        This Washington Post article poses a Pro and Con argument. Mr. Glen Whitman, an economist at Cal State Northridge thinks the individual mandate is a bad idea. So do I.

        http://articles.latimes.com/2010/feb/15/health/la-he-procon15-2010feb15

        Glen Whitman, an economist at Cal State Northridge:

        “The individual mandate is not a solution to problems in the healthcare system but a deceptive patch for problems created by other features of the proposed healthcare bill. In fact, it will exacerbate the real problem with American healthcare, which is that it is too expensive.

        “The point of the individual mandate is to balance the risk pool, but that’s not really what insurance is supposed to do. With car insurance, the idea is not that you want good drivers to pay for accidents caused by bad drivers. Instead, you want there to be pools of people with similar risk: bad drivers and good drivers who pay different premiums.

        “What the government is trying to do is transform insurance into a welfare system. In Massachusetts, it turns out that subsidies are needed in order to get people to comply with the mandate anyway. There are reasonable arguments for taxing the public and providing subsidies for specific people in need. But why should we re-engineer the insurance market to serve a function it was not meant to serve?

        “The biggest practical problem with the individual mandate is the political incentives it will create, which will continue to drive up healthcare costs. You can imagine the special interests lobbying to add not just oncology for cancer patients but hair transplants, chiropractic and acupuncture to the basic medical benefits package. If that sounds paranoid, keep in mind that state legislators have already passed 1,900 mandated benefits laws that cover these areas. These force everybody to buy Cadillac health insurance. Nobody can get a Honda Civic insurance policy, and that’s one reason health insurance is so expensive.

        “As for real solutions, subsidies would make more sense. But why not try making insurance affordable first? Let people buy health insurance policies across state lines, which would create a national insurance market while putting pressure on state legislators to repeal benefits laws.

        “We should also move toward a system where people use health insurance for catastrophic expenses while paying routine costs out-of-pocket. But President Obama’s plan would eliminate high-deductible insurance. That’s the opposite of what we should be doing. We need a greater variety of insurance options, not fewer.”

        [email protected]

        I don’t want to be told I have to have health insurance, I want to buy it because it is a smart thing to do.

        • benevolus says:

          Here’s the problem with that:
          “The point of the individual mandate is to balance the risk pool, but that’s not really what insurance is supposed to do.”

          That is exactly what insurance is supposed to do! Otherwise, what is the point? We would just pay for our healthcare as it is delivered.

          “With car insurance, the idea is not that you want good drivers to pay for accidents caused by bad drivers. Instead, you want there to be pools of people with similar risk: bad drivers and good drivers who pay different premiums.”

          That’s only a fair comparison up to a point. We CAN deny people car insurance- and therefor deny them the ability to drive. There are alternative forms of transportation and it’s not a life threatening or society-threatening situation. If we deny people health insurance it has a disastrous effect on them and on society.

        • While I guess reasonable people could argue about whether one “chooses” to be a bad driver or not, for the most part good drivers are good because they have good habits and bad drivers are bad otherwise.

          I 100% agree that we should have surcharges on certain risks – smoking cigarettes is a good example of one. If you smoke, your healthcare is eventually going to be more expensive and you should pay more. It’s your choice.

          However, no one chooses to be born with a gene that makes them more likely to have breast cancer for just one example. I just don’t think it’s fair to aggregate risk pools based on stuff like this. It’s a tough place on where do you draw the line – if someone has a diet and lifestyle that is likely to lead them to diabetes, can you start charging them more? I’d say sure, but I bet a lot of tea partiers (and to be clear, Americans in general) might rebel over this point since most of us fall into this category of bad diets and lifestyle choices that will eventually lead to high health care costs.

          A lot of conservative proposals that I’ve seen essentially want to create risk pools for people with cancer, and then give them subsidies if they can’t afford it. If you ask me, that sounds like welfare and I’d rather spread the risk (and benefits) across everyone. Something like 1 in 3 people are going to get cancer (or a heart attack or whatever) eventually, might as well spread it across.

          The other problem I have with allowing people to buy insurance across state lines is the only way that would work is to have a federally mandated minimum with limited state mandates tacked on top. So reasonable people might disagree on whether some mandates should be mandates, but here’s one example that we should all be able to agree on: If I live in Georgia, I have about a 0% chance of getting lime disease, and lime disease treatment and coverage is not mandated by Georgia for its insurance plans. If I live in Connecticut, my chance of getting lime disease is about 1,000 times higher and is mandated (and adds less than 1% to the cost of plans in Connecticut).

          So I’d be all in favor of having a national standard plan (that doesn’t include lime disease coverage) that an insurer would be able to say costs $200/month (just an example here) except when they sell it in Connecticut, there is a $3 lime disease coverage surcharge that you have to pay if you live there.

          That sounds like a great plan to me, I just don’t believe the Republicans in Congress would ever create a system to enforce a national minimum mandate or an exchange like this. So what would happen in a place like Connecticut without this, is everyone who doesn’t have lime disease would buy the cheaper “Georgia” plan to save $3, and those with lime disease would all of a sudden see a tremendous spike in their premiums because only the sick would remain with a Connecticut plan.

          From what I understand, even Perdue’s proposals would still require the state to certify a plan from across state lines. And I also believe that the Senate bill includes state based exchanges, and encourages states to smooth out the regulatory wrinkles so exactly something like this can happen.

          So let’s say you are a Republican and you want to reduce state based mandates to make a national minimum level of coverage and sell it across state lines. I think that’s WAY more likely to happen in a future Congress that tweaks the already in place framework to make it more conservative than it is to start from scratch if the current effort fails.

      • Doug Deal says:

        I want to complement you both on raising good points. That’s the discussion that I want to see, and it needs to be done in the open and in manageable chunks.

      • Doug Deal says:

        I finally have a chance to reply to your comment on “death panels”.

        I do not mean someone deciding what care you will receive based on a cost/benefit analysis to the state. I mean the patient gets informed that procedure 1 will cost x, office visit 2 will cost y, etc. Restaurants, at least the ones that I can afford, have the decency to put their prices on the menu before you order. Doctors, on the other hand, examine you, send you to a specialist who you also have to pay, prescribe medication, order tests and want you to come back all before you even know how much any one item is going to cost.

        This is completely unreasonable. They should be required to operate under published costs, so that if I come in with cash, I pay a set price and don’t have them just charge me some ridiculous amount in hopes I pay at least a third of it.

        Also, a patient should be encouraged to turn down a procedure or test if it is not 100% necessary. I once paid over $2,000 out of pocket for a battery of tests for a fishing expedition. If I had known the costs, I would have turned down the tests because I knew they were long shots. This is one reason costs are so high.

        Further, if I knew clinic 1 charged $400 for as chest X-Ray and clinic 2 charged $1,500, I should be incentivized to go to the less expensive place, which would then also require them to be competitive.

        • Obama is including HSA’s on the future exchanges. And the plan would have Medicare be the engine to change how costs are paid from being line item by procedure to one charge for the treatment.

          A few years from now, if I were a small businessman or self employed, I’d love to be able to buy a high deductible HSA with negotiated rates so that I could do that, and honestly I believe something like this will happen. In fact, I believe that once the bill passes, “repeal” will be impossible because no one is going to want to repeal pre-existing conditions (and the CBO will be able to run a report that says if we repeal the mandate but not pre-existing conditions, costs will skyrocket etc).

          So, I believe after a cooling off period, Republicans will decide that they want to introduce some conservative and market reforms such as ones that you and I would clearly agree with into the framework and stuff like this will be possible.

          As an aside, Wisconsin I believe had a really cool plan for younger people. It was very inexpensive and was essentially catastrophic care only. So it was something like $30/month. Coverage only kicked in when costs went above a certain number $50,000 I believe. IF a catastrophic event happened to you, you switched to regular insurance but you then have to pay $10,000 over the next 3 years to make up for risk happening.

          Most younger people I know who buy insurance on the individual market pay something like $100 (if they are male) or $150 (if they are female) for insurance they never use, or maybe use once a year for a cold prescription.

          The biggest problem with insurance right now, in my opinion, is that the insurance companies compete with each other over who can deny coverage the best. That is the competition and if you are a shareholder, that’s the best way to get value for your money. If we mandate that everyone has to buy (and everyone has to sell) I look forward to insurance companies actually competing FOR our business, and think some amazing free market reforms could be unleashed.

          As much as I hate getting 10 car insurance solicitations every week begging me to switch for the same coverage at a lower price, I’d love for the same thing to happen with healthcare.

  7. Andre says:

    Can we talk about transparency or the lack thereof in this thread?

    After hearing all this talk about having the most open, most honest, most ethical and most open government ever, I expected the Democratic Party to open up the doors of government and let the sunshine in.

    Ironically, during Sunshine Week –a week dedicated to opening a dialogue about the importance of open government and freedom of information– the front page of C-SPAN.org says it all:

    “House Democratic leaders are continuing to work behind closed doors to craft a health care bill that will secure the necessary votes to pass in the House. ”

    Where’s all this openness and transparency that the American people were promised?

    These backroom negotiations and sweetheart deals, like the Cornhusker Kickback and the Gator Aid, make congressional Democrats no better than the Republican state legislator who used his office to give Gov. Perdue a middle-of-the-night, $100,000 tax break.

    • polisavvy says:

      I think your transparency question is pretty valid particularly in this case. I ask you guys this: would you buy a house without going to actually see and asking about its price OR would you buy a car without driving it and knowing the cost? If you answered yes to either of these questions, then I ask you this: If you were elected to represent the people of your State, how could you, in good conscience, vote for something that you had not even read or had no exact number as to what the cost would be? Does that not seem a tad derelict and irresponsible?

      • Republican Lady says:

        Yes it does but I feel that the pres and Pelosi are strong arming everyone in sight that some of our senators and reps may be going along to get along and that attitude is so dangerous. We will all pay for this bill in money, lives, or negligent healthcare.

        • B Balz says:

          No disrespect, but we are already ” … pay[ing] for this in money, lives, or negligent healthcare. …”

          Yes, the President and the Speaker are strong arming everyone they can.

          Everyone reading this, who has not already made some effort to contact their rep, needs to do so, ASAP.

          Let ’em know what you think, this will change the face of healthcare for everyone.

          • Republican Lady says:

            You are right, but I just feel the costs as stated above will increase exponentially as this goes on. It’s like an out-of-control freight train heading toward a heavily populated city with no time to warn anyone in its path.

            Some of the hardest hit are people who have worked 20-30-40 years who have been laid off through downsizing, or companies bankrupting, or for whatever reason. If they lose insurance benefits, they will have a hard time getting more with preexisting conditions.

            Older workers have lost huge amounts of money on stocks, bonds, real estate, 401k’s, and other methods of planning for the future and cannot afford to lose income. It isn’t poor planning on their part, it is the many factors going into this chaotic economy. Sure it will straighten out in time, but how do people survive until then with nothing coming in?

            Older workers have a harder time getting re-employed and some are losing homes because there is no money coming in for them. Then there is the added health costs of living longer, having more illnesses, diseases, prescription costs, etc.

            Many don’t want to retire and draw social security but that may be the only option they feel they have if we don’t get some job stability soon. You know it is fine to say let’s streamline budgets by cutting jobs, but what happens to those people?

            • B Balz says:

              That is a valid argument, I don’t know of any Gov’t program that has ever shrunk in size due to vast efficiency. So, I philosophically agree.

              The issue is cost of a ‘decision in progress’ and this one will bankrupt business and the US.

              Earlier GOP plans involved making the consumer aware of costs so we could shop for services, pharma, etc.

              I say we explore that option on a truly non partisan basis.

              • John Konop says:

                The irony, we can buy substandard products from China that may kill you, but we cannot buy medicine from Canada for less that could save your life.

              • LoyaltyIsMyHonor says:

                BBalz, how about the Bureau of Indian Affairs? The more efficient the US military became at eradicating them Injuns, the less use was needed for the Bureau.

        • benevolus says:

          Strong-arming is part of the process. Republicans are much better at it than Dems. And the media is pretty good at it too. So many things I have heard from opponents of a plan are just flat out wrong. They are made up excuses. Opponents have extensive media access and have been beating the drum with false claims. That is strong arming too.

        • Andre says:

          That bill was accompanied with maps detailing what all that language meant.

          And I am more than willing to say that I would prefer our lawmakers read the bills that grace the tops of their desks. It is a far greater improvement than legislators voting the way the leadership tells them to vote.

          • benevolus says:

            It’s not realistic and the system is developed so that they don’t have to. They have professional staffs that do a lot of that bulky reading, just like judges have clerks. Do you think judges should do all their own research and writing too? They would never get to go to court!

    • ByteMe says:

      What exactly are you complaining about? That they are crafting the compromise bill in private but plan to post the plan (along with CBO score) 72 hours before the vote? They’ve had a YEAR to debate everything. You’re just annoyed because they didn’t ask you to be a part of the negotiations.

      • polisavvy says:

        You know, ByteMe, I am growing more and more concerned about the cost of this health care. I don’t necessarily mean just from a financial aspect, either. As far as the 72 hour things goes, do you know or have you heard how long this new compromise bill is going to be? I haven’t heard that anywhere. If you have, please let us know. Thanks in advance.

        • B Balz says:

          Slightly shorter than the combined total of 350+ Ray McBerry comments.

          That, btw, is a peachpundit record. The odd ones always get the most earned media.

        • ByteMe says:

          I have not heard anything on the length of it, but the intent is to take the Senate bill and strip some things out of it (the Cornhusker deal for one, since Ben Nelson wants it out now) and tweak some other things that will affect the revenue and cost sides of the equation. I’m withholding saying whether it will be better or worse until it comes out. What they have now is a pretty damn good start, especially since the regulations on rescissions and pre-existing conditions takes effect nearly immediately.

          I think all the anger should be directed at the NEXT step, which is to make it even better — especially on the cost side — and not repeal it.

          The politics of the situation at this point are this: it’s going to pass. Democrats aren’t going to cut Obama’s throat or their own. Some “no” votes from November will change to “yes” votes with all the changes. But the calculus looks like this: a failure means Obama’s domestic plans stop and Democrats lose big in November because Republicans will run on them as being ineffective AND out of touch. And it’ll be deserved. A success means the Republicans are going to try to run on “repeal it”, but people will see the rescissions and pre-existing conditions ending and will say “repeal hell!”

          The Catholic nuns are for it. 🙂

      • Andre says:

        Rule of Thumb, ByteMe, if C-SPAN subtly suggests that the process needs to be more open and more transparent, then the process isn’t open or transparent enough.

        Many members of Congress are pledging to support a bill that they haven’t even seen yet. As polisavvy said, that is just plain irresponsible.

        • ByteMe says:

          See above. The political calculus is clear. If Democrats want to hold their majority in November, they HAVE to pass the bill.

          And, really, C-SPAN is annoyed they have to put on more re-runs or show someone yelling in an empty chamber. It’s been a YEAR of debating and discussing the details.

          • Andre says:

            So you’re saying that you would prefer to score a political victory over allowing the America people

            Let me tell you something, ByteMe, every time I walk into the State Capitol, I feel empowered as a citizen knowing that I can go up to the third floor and get a copy of any bill or resolution that has been introduced into the House or the Senate. It feels good, personally, to know that I don’t have to depend on Jim Galloway or Dick Pettys or Matt Towery to tell me what my government is doing. I can either go downtown or log on to http://www.legis.ga.gov and get all the information I need.

            Compare that to what we see in Washington.

            Votes being promised on a bill that no one has even seen.

            Where is the bill that my Congressman, David Scott, says he’s leaning towards supporting? He hasn’t even read the bill because it does not exist. All we know about the health care legislation is what Barack Obama, Nancy Pelosi and Harry Reid tell us on television.

            While I’m sure that Obama, Pelosi and Reid are telling us the truth (or most of it), I would much rather read the bill myself and have the ability to turn on C-SPAN so that I can see how the bill is being perfected as it makes its way to the House floor.

            I don’t care how boring the process may be, I believe the process should be broadcast live and in color for the world to see.

            To paraphrase Ronald Reagan, I’m paying for those microphones and I’m paying for those cameras.

            • ByteMe says:

              Did I say I “prefer to score a political victory” or that the political calculus demanded that Democrats pass the bill?

              You also said “every time I walk into the State Capitol, I feel empowered as a citizen knowing that I can go up to the third floor and get a copy of any bill or resolution that has been introduced into the House or the Senate.” And yet you want this bill to somehow be published BEFORE it’s been introduced. It will be introduced by tomorrow is my understanding and it will be published, just like ALL House and Senate bills are published once they are introduced.

              And are you saying that bills in the Gold Dome aren’t first negotiated with different people BEFORE being introduced? Are you in those meetings as well?

              • reaganrev4 says:

                I may be a slower than usual reader but can anyone here honestly tell me that they can read, research, and fully understand a 2700 page bill on health insurance (which to me is a fairly confusing subject since i have to research 90% of the technical terms seeing as I am not learned in law) in 72 hours? This 72 hour rule I am sure has been sufficient with normal bills that arent trying to hide a provision or 1,000 but with this bill that seems hardly enough time. But then again, I may just be more dense than our trusty, dilligent elected officials

                • benevolus says:

                  They are very sophisticated at this sort of thing. If you’ve ever followed a bill through the Georgia legislature then you know how bills are revised. This bill isn’t coming completely out of the blue. There is existing language that will be modified, but 90-95% of it will stay the same and the changes will be clear to legislators.

              • Andre says:

                ByteMe, that’s the point. The bill has not been introduced.

                There is a process for a bill becoming law. It gets introduced. It is then referred to committee. The committee holds hearings, and then vote on the bill. If the committee approves the bill, then it goes to the Rules Committee where it awaits placement on the debate calendar. The bill then gets debated and there is an up-or-down vote. If the bill passes, then it goes to the other chamber and the process starts all over again.

                That’s what is on those Schoolhouse Rock tapes that we all grew up watching.

                Now, the House passed a health care bill. The Senate passed its own health care bill. The Senate bill won’t pass the House, and the House bill won’t pass the Senate. So what we’re seeing now is all kinds of crazy parliamentary machinations to pass a bill that contains a little bit of this, that and the other.

                This new piece of legislation, that has yet to be introduced, should go through the process the right way and in full view of the public. It gets introduced, goes to committee, etc., etc., etc.

                None of this “deem-it-passed” crap. None of this convoluted gobbledy-gook about parliamentary procedure. Pass the bill using the process we all learned from Schoolhouse Rock.

          • B Balz says:

            3 days, almost 3,000 pages. I love this Country! It will get analyzed, and I doubt that will change much.

            Byte may be correct about the calculus. The thinking I hear now is get it passed, and we’ll fix it on the back end.

            Somehow, I feel like Horsely’s Mule.

          • Doug Deal says:

            Chris, don’t you think bills should default to opposition and require a reason to vote for them?

            Every bill should report out of committee with zero votes, if you ask me.

      • Game Fan says:

        ByteMe
        So you approve of the 72 hour rule? Why? And who imposed this rule? From my end (down here in Podunkville, U.S.A.) the time ratio seems all out of skew. I mean a year to write the darned thing up and only 72 hours to read it? Wonder if anyone was paying attention the last few years but the ole “I didn’t know that’s what I was voting for” song and dance doesn’t play well with the voters. Perhaps this is what Nancy Pelosi realized when she declared that they should pass the bill even to the detriment of the Democrats.

        • benevolus says:

          It’s not like they are going to drop 3000 brand new never-seen-before pages on them. There is an existing bill that they will vote on, and then they will vote on changes to that bill. But the changes will only be small part of the package and will be indicated by strikethrough text or some similar mechanism.

          They’ve done this sort of thing before. It’s not mysterious or devious. It’s very pedestrian and mundane.

        • ByteMe says:

          It just has to seem nefarious for the paranoid, that’s all.

          The new bill is 153 pages. The original bill has been out there since December.

          The Democrats imposed the rule, by the way, that any bill coming to the floor had to be available online for review 72 hours before first vote.

          • B Balz says:

            Byte, I just want to say that you have consistently provided accurate and incisive information on this, and other threads.

            Commentary like this helps make PP worth reading.

  8. bsjy says:

    Rep. Barrow’s toll free number rings to a fax machine. I am sure he’s not hiding behind technology to avoid facing his constituents as they try to tell him how they “deem” the healthcare proposals being put forward by Speaker Madame Botox. Just a simple mixture of RJ-11 plugs, I am sure.

  9. John Konop says:

    If Romney would have been President I wonder what the debate would be like on healthcare.

    FROM WSJ

    The former Massachusetts governor enacted something very similar to the Obama health plan. It isn’t working well.

    WSJ… Mr. Romney claimed earlier this month on “Fox News Sunday” that the Massachusetts health reform plan he signed into law in 2006 is “the ultimate conservative plan.” But there are many similarities between it and the ObamaCare loathed by conservative voters.
    Both have an individual mandate requiring most residents to have health insurance or pay a penalty. Most businesses are required to participate or pay a fine. Both rely on government-designed purchasing exchanges that also provide a platform to control private health insurance. Many of the uninsured are covered through Medicaid expansion and others receive subsidies for highly-prescriptive policies. And the apparatus requires a plethora of new government boards and agencies…..

    http://online.wsj.com/article/SB10001424052748703625304575115691871093652.html

  10. btpull says:

    Hiding the true costs of Health Care Reform behind student loans.

    “The student-loan provisions would end federal subsidies to banks that make college loans and shift lending responsibilities to the government, while also raising federal support for Pell Grants, which benefit lower-income students. The changes, however, were estimated to save less money than expected—about $65 billion over 10 years, down about $20 billion from last year’s estimate.

    The lowered estimate reflected in part revised assumptions about the economy. Democrats had hoped the student-loan provisions would provide more savings in the health bill and were scrambling to hit the measure’s deficit-reduction targets, congressional aides said.”

    http://online.wsj.com/article/SB10001424052748703734504575125262604778060.html?mod=WSJ_WSJ_US_HealthCareReform26_4

    We are now at the point where Health Care reform will only pass by deception and lies.

  11. btpull says:

    No – this is different. Calling one thing something else (student loan savings as health care savings) to make the results look better is, quite frankly, fraud; people in the private sector go to jail for this type of deception.

    Predicting the outcome of an event (health care costs will be reduced verses the health care industry will be socialized) is a difference of opinion or perception.

      • kyleinatl says:

        ugh, computer posted too early…I was commenting on your last sentence.
        You see…healthcare reform wouldnt have needed lies and deception in order to pass if certain tea partiers hadn’t been so easily swayed by the Glenn Beck-Sarah Palin types who clearly had less understanding of the legislation than the Congressmen who they continued to tell to “read the bill”. It’s a shame really, a very nice and needed reform got perverted simply because it was Obama’s.
        Do I think it’s a great bill? No, as I think the general idea of universal coverage and the individual mandate is not fair, nor right, but now NO healthcare reform will pass because the dissenters have so poisoned the well.

    • benevolus says:

      “The overhaul of the student-loan program was separate from the health bill in policy terms, but Democratic leaders were planning to include it in the companion package as a way of speeding it through Congress. ”

      That’s not deceptive. They weren’t trying to hide anything.

      “Democrats had hoped the student-loan provisions would provide more savings in the health bill and were scrambling to hit the measure’s deficit-reduction targets, congressional aides said.”

      I think they mean “more savings FOR the health bill”. They’re just trying to calculate overall budget costs. Less savings in the loan program means they have to try to find more savings somewhere else to hit there budget numbers.

          • seenbetrdayz says:

            I don’t know where you got it from either, but there’s a huge difference between $940 Billion and $980 Billion, so try not to let it happen again, please. You see how easy rumors spread.

            • Republican Lady says:

              I guess it’s my hair. I woke up and just can’t do a thing with it so it affected my mind.

    • ByteMe says:

      And I think having it on Sunday is appropriate, since it’s definitely a “Come to Jesus” moment for the Democrats if they want to win in November.

      • kyleinatl says:

        Agreed, Congressmen like Barrow and Marshall need to stop worrying about the conservative vote (or right leaning moderates) and focus on their base…if you can’t get the base to support you, you’ve already lost the battle.

  12. Clone Of B. Plyler says:

    Everyone should check out the interviews that Brett Baier of Fox News was granted w/ the President this week. Personally, I commend Mr. Baier for his tenacity in trying to cut thru the campaign speech.

    Even Byte could learn something by watching it !! (by the way, POTUS wanted to come on Fox because the Cartoon Channel & USA channel have more viewers than any network news & Fox is the place he could get his message out to more people !!)

    Please watch the interview. However, here’s some of the spin (denoted by *) about this plan.

    * The CBO says that it will cost $980 BILLION over 10 years & it will cut the deficit by $138 Billion over the first 10 years. Nancy Pelosi then says that it will cut the deficit by 1.2 Trillion over the preceeding 10 years.

    So, we spend a TRILLION to save $138 BILLION over the first 10 years. (let me help you get your mind around a TRILLION: one trillion seconds = approx. 32,000 years ) Does this sound like sound monetary policy to you? Who knows what the Fed. deficit will be in these next 10 years at the rate of current spending? I bet that any number you can throw out will not be accurate.
    Then, who in the world can forcast the Fed. deficit thru 2030 ?!!! I guess that will be the same guy who can forcast the weather for 2030. (if you go w/ Gore, it will be hotter.)

    * People are dieing everyday this vote is delayed because they don’t have adequate health coverage. (Harry Reid says this one a lot.)

    If this thing passes, the taxes will start immediately (oh, joy!) w/ the provisions actually coming online in 2014. Wait…thousands of people will die by 2014 because they couldn’t get gov’t healthcare. The lie I mean logic is amusing.

    * This process is above board now that everyone can see the provisions until Sunday. I really like this one.

    If the leadership had the votes for this thing, it would have already been brought to a vote. That’s why POTUS is hanging around this weekend. Buy outs have been made & will be made to secure 216 votes in the House. If it does pass the House, it goes back to the Senate where this thing ain’t over with yet..not by a long shot.

    53% of the general public think the rules are being made up as we go..remember that perception rules.
    55% of the general public do not want this bill.

    * This bill is historic in that it will be a step to establish health care as a right to every American.

    That’s right, we’re entitled to it. Just as sure as life, liberty, & the pursuit of happiness. The legislative branch is using the same logic used by SCOTUS in Roe v Wade to legalize abortion on demand. It wasn’t in the Constitution or the Bill of Rights, but now after the death of at least 52 million babies…it’s a right.

    Ronald Reagin stated in 1982 that the destruction of our healthcare system would come with national healthcare. He was right.

    • ByteMe says:

      Sounds like you haven’t done enough reading, Bucky. Go to the original sources. Start with the CBO letter to Pelosi:

      http://www.cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf

      It’s the CBO that estimated the impact on the budget outside the initial 10-year window, not Pelosi. And, yes, we spend a trillion to save about a $135B in the first 10 years and half-percent of GDP in the next 10, which if you can’t get your mind around that, if we don’t pass the new law, we spend more than a trillion anyway and run the deficit up another $135 billion and even more in subsequent years.

      As for “people are dying every day”, perhaps you should look here: http://www.reuters.com/article/idUSTRE58G6W520090917

      The leadership has the votes for this thing on Sunday. That’s the only day that matters. Everything else is spin from the crazy opposition who can’t complain about some of the really great things in the bill, so they have to complain about “process”, which is insider baseball BS. Bunch-a whiners.

      As to the public’s perception, once the crazy opposition has to deal with facts about what’s actually in the bill, they will go off to find something else, like a fake birth certificate, to complain about. And then the public will start to hear from their employers and insurance agents what’s really in the bill that starts immediately… like the end of pre-existing conditions and rescissions.

      In fact, I posted this link earlier about what’s in the Senate bill and when it starts: http://www.benefitssellingmag.com/Issues/2010/March/Pages/Effective-dates-of-proposed-health-care-reforms.aspx, so maybe you should arm yourself with real information instead of crazy blogger information (it’s a magazine that goes to people in the Benefits/Compensation selling industry).

      Oh, and if it passes the House, from the AP article: In a strategy designed to skirt Republicans’ new ability to filibuster in the Senate, House Democrats on Sunday will move to pass both the Senate measure and the package of changes to it; the bill making changes could pass the Senate under rules allowing for a simple majority, not 60 votes.

      Republicans of course will be dicks about it and try to get certain provisions pulled from the reconciliation, but it’ll pass anyway. The political calculus demands that Democrats pass this.

      And, yes, if you think that a zygote is “entitled” to be born, then you should also think that a zygote is “entitled” to the necessary care to keep it alive after it’s born.

      Ronald Reagan also started us down the path of huge government debt. He wasn’t a god or even right all the time (Iran-Contra?). The myth is better, I suppose.

      • btpull says:

        The second decade’s Trillion dollars saving or deficit reduction is a VERY soft number per the CBO: “The imprecision of that calculation reflects the even greater degree of uncertainty that attends to it, compared with CBO’s 10-year budget estimates”.

        The CBO, also, shows 23 Million people will still be without insurance at the end of the decade. Before the measure’s coverage provisions kick-in employers will added 14 Million employees to their health care plan; afterwards employers will drop coverage for 13 Million employees.

        What is interesting it has been shown that allowing people to purchase insurance across state lines would add 12 Million people to the insured role. So if we allow the purchase of insurance across state lines and do not disrupt the trend of employers adding roughly 3 Million people per year (2011 – 2019) to their coverage, by not passing the current bill, the number of uninsured would decrease by 40M by 2019.

        The true cost of Health Care Reform and Coverage Expansion over the next decade is negative a -$287B not a positive $138B as being touted.

        The cost of coverage $940B
        Less taxes, fees, penalties related to the coverage: $146B
        Less actual health care reform measures: $507
        Nets to -$288B

        It also appears most of the health care reform savings are coming out of Medicare. Even if the current bill is not passed we still could pursue these Medicare savings; especially those that are related to waste-fraud and abuse.

        • ByteMe says:

          Three things:

          it has been shown that allowing people to purchase insurance across state lines would add 12 Million people to the insured role.

          Citation?

          And…

          The cost of coverage $940B
          Less taxes, fees, penalties related to the coverage: $146B
          Less actual health care reform measures: $507
          Nets to -$288B

          You are misreading the $135B number. That’s the savings relative to our current glide-path to bankruptcy. In other words, the costs are higher in the coming decade and beyond with where we are now relative to the HCR bill.

          Finally, of course, any projection 10 years out is going to be “soft” (actually, I refer to it as “made-up numbers”), but what’s more interesting than the number is where they assumed the savings would come from.

          • btpull says:

            The net -$288B is based on separating the costs and benefits that have to do with insurance coverage and health care reform from all the other non-health care related items, fees, and taxes. In my opinion the Democrat leaders are being very deceptive about the true cost of health care reform.

            I’ve heard the 12 million figure a couple of times. Putting the interstate insurance issue aside if the CBO’s trend of employers adding 3 Million people per year to their insurance policies could continue through-out the decade an additional 28 million people would have insurance. The current health care proposal insures an additional 32 million. This seems like allot of effort for an incremental 4 million.

            What I find frightening is that employers will start dropping insurance coverage at a rate of 3 million per year once the bill is in full swing.

            • benevolus says:

              “This seems like allot of effort for an incremental 4 million.”
              So if I m reading this right, the scenario is that opponents can resist the bill for any or no reason at all, and then claim that the effort to preserve the bill is too great?

              • btpull says:

                I just think we can get to the same place or close to it with allot less effort and disruption. I really do not understand why we have Not gone after the Medicare reform and cost savings years or not decades ago, especially the waste – fraud – abuse. Fraud is illegal we do not need to reform the health care system to pursue fraud.

            • ByteMe says:

              Benev, I gave up on him. He can’t substantiate his “12 million” claim. He then makes up the idea that the CBO is “trending” employers adding 3 million people per year to their policies, when we’re not even adding that many employees per year at this point.

              And then he brings up this fear again without substantiation.

              I’m putting him in the “intractable no” column.

              • btpull says:

                ByteMe,

                Table 2 of CBO’s estimate, which you referred to a couple of days ago, clearly shows coverage trends.

                http://cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf

                Employer Coverage Addition/Subtraction

                2011 +3 M
                2012 +3M
                2013 +3M
                2014 +4M
                2015 +1M
                2016 -3M
                2017 -3M
                2018 – 3M
                2019 – 4M

                What is even more interesting it shows people move off Medicaid and CHIP between 2011 – 2013 and then in 2014 10M are added back.

                So the way I interpret the data:

                1) The CBO is assuming between 2011 – 2014 the economy is improving, employer start hiring, and employer based coverage expands.

                2) In 2014 employers deem that it is financial beneficial to drop coverage, especially for low wage workers , and pay the penalty.

                3) As more and more employers drop coverage it is no longer a competitive disadvantage, in terms of attracting the best employee, to not offer health care coverage so we see a long term trend of coverage switching from employers to Medicare and the exchanges.

                Maybe, I am a 100% wrong? It looks like the bill will pass so we shall see.

                • ByteMe says:

                  Much better response, thanks for continuing to play.

                  I think your interpretation is very close.

                  Looking at the number of insured covered by employers under current pre-HCR law, that number stops growing in those same years, and the only reason I can think of for that would be demographics of an aging population where the number of people moving to Medicare would be about the same as the number of people entering the workforce (about 150K per month or 1.8M). Only other explanation is that employers would be dropping coverage because of costs (again, under pre-HCR law).

                  However, notice the Exchanges line showing a huge pickup. If a small employer (say, under 50 people) says “I can pay you a little more each year so you can buy your healthcare on an exchange and get a good deal there”, that’s a trade-off a lot of younger employees will take and so will employers, because it immediately cuts costs and administrivia headaches. Right now, if you don’t get healthcare from your employer, it’s a royal pain in the tush to get coverage if you have any indications that you might have a past or future problem (and I have been there, done that). With HCR, starting in 2014+, you have a chance to get reasonably affordable healthcare from insurance exchanges and that is hopefully the first step to decoupling insurance from employment (which is part of our national problem with costs).

                  • polisavvy says:

                    Byte, any word on if people, like us, who pay so much for our health insurance as it is, will have our rates go down or are they going to increase? I am wading through the bill and haven’t been able to find that. Since you are so “in the know” would you mind answering that for me? Thanks in advance.

                    • ByteMe says:

                      Up. Always up. Only way to get to “down” is being called “socialism”. The question is whether it’s up by 2-5% or up by 10-15%.

                      I think that since the rules limiting the way insurance companies can spank us go into effect before the rules to mandate coverage and exchanges, I’m guessing we see slightly bigger increases in the early years — making us more apt to go postal at the insurance companies — and much smaller increases starting in 2014. My guess based on the way I’m reading it. The question is: will insurance commissioners at the state level step up and limit those increases?

                      Also, passing this bill is definitely NOT the last we’ll hear about HCR. Read an article last night that the Obama admin wanted to get more Republican ideas into the reconciliation (like expansion of HSAs, doing fraud checks on Medicare), but the reconciliation rules prohibit it and the Republicans aren’t going along even with their own proposals. Expect some additional tweaks on the cost side either right before the election (that Republicans will go along with in order to prove they can do more than say “no”) or early next year with the new Congress that will be tilted a little more toward balanced.

                  • btpull says:

                    “Much better response”

                    I thought I was saying the same thing along :).

                    “I can pay you a little more each year so you can buy your healthcare on an exchange and get a good deal there”

                    For the younger work or those without Health insurance this might be a good deal.

                    For those with health insurance coverage (80% of the non-elderly population), especially those making over $88K, the numbers do Not look so good. By the way it is not that difficult to earn over the $88K threshold for a dual income family.

                    So for example:

                    Employer currently is paying $10K per employee for insurance coverage. Assuming a marginal tax rate of 30% the after tax cost of the insurance is $7K.

                    If an employer drops the insurance in favor of letting the employees purchase on the exchange, the maximum amount the employee’s pay can increase is $6.5K (assuming the employer does try to lower their net costs).

                    Calculated as follows

                    Salary $6.5K
                    Employer’s Payroll taxes $.5K
                    Penalty $2K
                    Less Tax savings on Salary $2K
                    Nets out to the $7K after tax cost to the employer.

                    For the employee:

                    Addition income $6.5K
                    Less Payroll taxes $.5K
                    Less Income taxes $1.7
                    (Marginal tax rate 25%
                    State and Federal)
                    After Tax Dollars $4.3K

                    Now the employee has a financial hole of $5.7K to pay for the portion of the insurance coverage the employer was paying. Granted the tax credits will help for those under the threshold.

                    Maybe, the exchanges will drive down the cost of insurance? But it will have drive the cost down 30% to 60% (depending on how much the employee is also contributing to the policy before the employer drops coverage) to keep the employee whole.

  13. Clone Of B. Plyler says:

    Oh, and another thing, almost every state in the Union is either planning lawsuits against the Fed. gov’t if provisions are in the final bill that require citizens to purchase health care. Many of the same states are looking at constitutional amendments to trigger lawsuits if the provisions in left in there. WHY?

    Because it’s not in the Federal Constitution to require citizens to buy heathcare… that is unless you are Chuck Schumer who thinks that he can change anything.

    • seenbetrdayz says:

      That could be the biggest class action lawsuit in the history of the U.S. Lots of independents, democrats, and republicans are rather angry about the mandate. At the very least, the states should not allocate any resources toward prosecuting those who will not be supporting Big Insurance upon threat of force.

  14. benevolus says:

    The arguments opposing the bill are reduced to two things:
    – If you are a small government libertarian/conservative, you are going to have a philosophical problem with this bill.
    – Some anti-choice people seem to think that this bill will permit tax money for abortions. (Of course, your insurance premium money is being used to fund abortions now anyway. It’s not like insurance companies keep “your” money in a separate account and only pay out your money to you. Besides, abortions aren’t even expensive enough to meet most deductibles, so women don’t use insurance for that anyway unless there is a serious complication.)

    – There are no death panels.
    – Harry Reid has not inserted language preventing any changes to the bill for eternity.
    – It will reduce the deficit.
    – Our big corporations need this to be competitive.
    – People do want reform, they have just been deceived about what is in this bill.
    – Yes there are many ways to reform health care costs. This is one of them. Just because there are other ideas is not a reason to oppose this one.
    – This will be phased in over several years and very small businesses are exempt from some of the costs.
    – Every other industrialized country is already doing this.

    I don’t have any kids, but half of my property taxes go to schools. I don’t have a problem with that because I am confident that educated kids are better for me in the long run. I also believe that people having health insurance is better for me. Right now I am paying for health care for people who don’t have insurance. We need a better way to get them to start chipping in for themselves. This is it.

    • ByteMe says:

      As I wrote earlier, I think the angry crowd should start focusing on how to make this better and not just focus their anger on its existence. People are more attracted to a cause when it’s got a positive aspect to it instead of a relentlessly negative one.

      • B Balz says:

        Grown voters will realize how huge the elimination of ‘pre-exisiting’ conditions and lifetime caps will be. Many of today’s issues with this Bill will be forgotten as a result. Those benefits affect more voters, more profoundly than 20 year hence deficits or inflammatory RTL issues.

        Many will look at this Bill as the first time government helped them. Others will hate it as a continuation of Federal intervention. Those perceptions will not change easily, if ever.

        Is this HC Bill a perfect resolve? Oh HECK no!

        I think this is an indication of how our reps will be handling other huge issues facing the Nation. We’ll muddle though it, best practices be durned.

        Instead of sausage making, I would like laws to be made like Swiss timepieces. That is neither the nature or practicality of Democracy or our political divisions. Perhaps we can learn from this, public involvement in the ‘process’ certainly seems more vigorous, that will keep America strong.

        One aspect of any governmental HC resolve: “It will allow the Federal government unprecedented opportunity to examine every American.” GA is contemplating random drug use for State aid recipients, the Feds will have similar invasions or protections depending on your point of view.

        We all need to consider how we safeguard our privacy in the future.

  15. B Balz says:

    Stupak in is.

    Exec Order will insure no Fed Funding goes to Bill. Love it or hate it, that will be wrap.

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