Obamacare, Brave New World revisited

[Bob Gutermuth]

If socialized medicine is so far ahead of what we have now, why didn't Teddy Kennedy go to Canada for treatment?

[Uncle Bill]

I now have the true definition of 'oxymoron'.... "a well educated Jeff Yardley". You have the audacity to print this?

"The reality is that few things threaten the future of our economy more than our existing runaway health care system. Currently, health care spending totals about 17% of GDP. Individual spending on health care is a small fraction of that total. Health care expenditures are growing at about 2 1/2 times inflation. Health care already consumes a greater share of GDP than all Federal government spending for non-health care purposes. The system is broken, and it will not fix itself."


And your answer is what's being proposed by the insane Democrats and their CF leadership?

Has the old adage of "jumping from the frying pan into the fire" have no relevance to your form of thought?

And you, like your 'other' so called independant "frogs-in-the-pot" believe that since the broken system won't fix itself, we'll go with something so incredulous it will turn our nation into the inevitable "Humpty Dumpty".

The sickening thing about your stance is it's a 'must for everyone'. From one boondoggle to another, but it only makes you happy, like is the socialistic way, if EVERYONE is made equally, universally, miserable.

I am a firm believer that people will pay for what they feel is important to them. Having been self-employed since 1980, I've paid for my own health insurance, as well as both sides of my FICA taxes. After my kids aged out, we cut back considerably on our insurance costs, by getting a high deductable policy.

Furthermore, if you had any onions at all, you'd be furious with what your politicians have for THEIR healthcare insurance...AND DEMAND WHATEVER THEY ARE FOISTING ON THE SHEEPLE, THEY PLACE THEMSELVES ON THIS "WE-CAN'T-DO-WITHOUT-THIS-IMMEDIATELY" PROGRAM.

You can't really be so dense you are willing to endorse what is being proposed, regardless of how badly you view the present system. If indeed you are that 'wounded-by-the-sword-you've-fallen-on", you have my sympathy. Just please stop promoting what this administration is pushing as the messianic answer for all of us.

UB

[dnf777]

By being something I choose from the many companies that offer it. If you can't recognize the difference, I can see how you have become part of the problem.



Since you can't bring yourself to say it, the unions caused business to get into the insurance payment perks that have skewed the healthcare costs so radically.



While I concur that todays system is far from ideal, what you and Jeff are allowing your messianic leader to ram down our throats is just asinine. If you can't recognize where this is leading, God help you all. You will have indeed been part of the annihilation of a truly great nation.

UB

So socialism is OK if if benefits you, and you CHOOSE it?? Ok, I got it. Like I said in other posts, it was gov't run medicare that provides my 90 yo grandmother her life-sustaining chemo, while MY policy would have dropped her at the first renewal cycle. (not to mention, 12,000/year still needs another 'rider' for cancer treatement....only available to those with no cancer, of course)

While unions adopted this eventually, it was not unions per se who ushered in employee provided healthcare. Notice I said healthcare, not health insurance. Big difference.

If God were helping us all, there wouldn't be any need for health insurance...

[YardleyLabs]

I now have the true definition of 'oxymoron'.... "a well educated Jeff Yardley". You have the audacity to print this?

"The reality is that few things threaten the future of our economy more than our existing runaway health care system. Currently, health care spending totals about 17% of GDP. Individual spending on health care is a small fraction of that total. Health care expenditures are growing at about 2 1/2 times inflation. Health care already consumes a greater share of GDP than all Federal government spending for non-health care purposes. The system is broken, and it will not fix itself."


And your answer is what's being proposed by the insane Democrats and their CF leadership?

Has the old adage of "jumping from the frying pan into the fire" have no relevance to your form of thought?

And you, like your 'other' so called independant "frogs-in-the-pot" believe that since the broken system won't fix itself, we'll go with something so incredulous it will turn our nation into the inevitable "Humpty Dumpty".

The sickening thing about your stance is it's a 'must for everyone'. From one boondoggle to another, but it only makes you happy, like is the socialistic way, if EVERYONE is made equally, universally, miserable.

I am a firm believer that people will pay for what they feel is important to them. Having been self-employed since 1980, I've paid for my own health insurance, as well as both sides of my FICA taxes. After my kids aged out, we cut back considerably on our insurance costs, by getting a high deductable policy.

Furthermore, if you had any onions at all, you'd be furious with what your politicians have for THEIR healthcare insurance...AND DEMAND WHATEVER THEY ARE FOISTING ON THE SHEEPLE, THEY PLACE THEMSELVES ON THIS "WE-CAN'T-DO-WITHOUT-THIS-IMMEDIATELY" PROGRAM.

You can't really be so dense you are willing to endorse what is being proposed, regardless of how badly you view the present system. If indeed you are that 'wounded-by-the-sword-you've-fallen-on", you have my sympathy. Just please stop promoting what this administration is pushing as the messianic answer for all of us.

UB

It's hard to figure out how to respond when your emotional reaction doesn't actually seem to be tied to any factual issues. With respect to participation in "the program" by members of Congress, no one is required to participate in any government operated program as part of HR 3200.

People are required to participate in "qualified" insurance programs -- which might or might not include the one you purchase now -- and employers over a specified size (It looks like they are now anticipating a payroll over $1 million) are required to provide an employer subsidized and qualified plan to their employees. Employers and individuals that do not meet this requirement are subject to penalties.

The Federal government health plans, including those provided to members of Congress, meet (or must meet) the definition of qualified plans. As a result, there would be no reason for anyone enrolled to change their plan of coverage. Similarly, if your plan meets the minimum standards for a qualified plan, you would have no reason to change. However, if you elected to change, you would be eligible to select from among any qualified plans included in a health exchange with no exclusions based on pre-existing conditions and no need to join special groups to meet conditions of participation. The only likely issue you would face would be if your current high deductible plan has an out of pocket cost limitation greater than $10,000 for you and your wife. If greater than that, the limit would need to be reduced to meet minimum standards. Even then there would be a few years before the change would need to be made.

As currently designed, the program does not remove choices, it increases them.

[Gerry Clinchy]

The only likely issue you would face would be if your current high deductible plan has an out of pocket cost limitation greater than $10,000 for you and your wife. If greater than that, the limit would need to be reduced to meet minimum standards. Even then there would be a few years before the change would need to be made.

No matter what we do, herein lies the rub.

If we add 20 million people to such a plan, (which limits a family deductible to $10,000/year).

The first people who will want to jump on this program, would surely be those with pre-existing conditions. The government undoubtedly can provide this far better than private industry because when the expenses go through the roof, the government simply asks for more taxes. While a private insuror would be crucified for raising premiums, will there be equal outrage when the government does the same?

Since expense for the entire program will be equally shared, if the cost for insurance is more than the 2.5% tax on the 30 yr old earning $50K , that young guy may just find it cheaper to pay the 2.5% "penalty". That would likely inspire an increase in that tax ... until the cost of the health care insurance is equal to the tax (to remove the incentive for remaining uninsured).

If health care consumes 17% of the GDP now, I'd be willing to predict that after the plan is in place for 10 years, the cost will increase dramatically ... especially if there are no controls on providing subsidy of this program to illegal immigrants.

Also, if the our legislators increased SS benefits without anticipating the cost, or if they stole from SS surplus to fund other programs (as you mentioined a while back), if that does not consitute poor planning, I don't know what does. Habitually, our legislators see $ & can't resist spending it ... forgetting that the surplus was specifically generated to take care of the anticipated future costs that the math showed would eventually present themselves. Even when they momentarily plan something properly, then they mess it up.

Without cost controls any plan is doomed. So far nobody seems to have a clue in how to do this on a significant scale, i.e. one that makes a real impact on the overall $ amounts.

It is purely arithmetic.

[dnf777]

While a private insuror would be crucified for raising premiums, will there be equal outrage when the government does the same?

My insurance premiums have gone through the roof, I don't know about yours! There has been triple-digit increases in health premiums from private insurers.

I haven't seen any insurance CEOs nailed to crosses...rather they are doing quite nicely, with increased bonuses and compensations.

There has to be a happy medium.

[Gerry Clinchy]

I agree with you dnf777 ... we do crucify "the insurors" (generically) for this behavior, but we haven't focused on the executives who put their companies in these positions.

[YardleyLabs]

No matter what we do, herein lies the rub.

If we add 20 million people to such a plan, (which limits a family deductible to $10,000/year).

The first people who will want to jump on this program, would surely be those with pre-existing conditions. The government undoubtedly can provide this far better than private industry because when the expenses go through the roof, the government simply asks for more taxes. While a private insuror would be crucified for raising premiums, will there be equal outrage when the government does the same?

Since expense for the entire program will be equally shared, if the cost for insurance is more than the 2.5% tax on the 30 yr old earning $50K , that young guy may just find it cheaper to pay the 2.5% "penalty". That would likely inspire an increase in that tax ... until the cost of the health care insurance is equal to the tax (to remove the incentive for remaining uninsured).

If health care consumes 17% of the GDP now, I'd be willing to predict that after the plan is in place for 10 years, the cost will increase dramatically ... especially if there are no controls on providing subsidy of this program to illegal immigrants.

Also, if the our legislators increased SS benefits without anticipating the cost, or if they stole from SS surplus to fund other programs (as you mentioined a while back), if that does not consitute poor planning, I don't know what does. Habitually, our legislators see $ & can't resist spending it ... forgetting that the surplus was specifically generated to take care of the anticipated future costs that the math showed would eventually present themselves. Even when they momentarily plan something properly, then they mess it up.

Without cost controls any plan is doomed. So far nobody seems to have a clue in how to do this on a significant scale, i.e. one that makes a real impact on the overall $ amounts.

It is purely arithmetic.

I think you raise some valid concerns.

- From a technical perspective, the $10,000 ia not a deductible. It is the maximum amount that a family would be required to pay in deductibles, coinsurance and co-pays before insurance would cover the balance.

- No plan, private or public would be permitted to exclude people with pre-existing conditions. I don't know if it is likely that the uninsured have a disproportionate number of people with pre-existing conditions. I suspect that they do snce some of those people are likely limited by pre-existing illnesses that affect their employability and many others have deferred necessary medical care that they will seek out once they have coverage. The most severely ill are probably already receiving Medicaid. However, a short term boost in demand is likely. I do not know how the CBO addressed this in their cost estimates.

- It is obviously possible for people to elect not to purchase insurance and to pay the tax instead. Those are presumably people who do not purchase insurance now. The 2 1/2% will at least reduce the extent to which these people burden the rest of us with their medical bills.

- Illegal immigrants are excluded from receiving any government subsidized coverage under HR 3200. They will remain a burden on providers who are unable to collect for services rendered and on State Medicaid programs, but this burden will not be increased by the bills under consideration. Increased demand for health services is likely with essentially universal coverage. Over the long term, health professionals would tend to think that this would actually reduce costs since more problems would be caught when they can be treated relatively inexpensively rather than when treatment costs much more and is funded under Medicaid. However, it is estimated that more than 20,000 people per year die because they do not receive the care they need as a result of the lack of insurance. Having these people live will probably cost more than simply letting them die the way we do now.

- I agree with your comment on cost controls. One of the advantages of the proposed program is that it eliminates prohibitions on cost controls embedded in the current Medicare program and establishes some intiatives to improve future cost control. The CBO cost estimates do not assume that these will be effective. Despite that, the CBO estimates that the program will reduce the deficit over the first five years and increase the deficit over the first ten years. The latter estimate is actually the result of $245 billion in costs that the CBO has attributed to the program but that are actually the cost of not implementing a freeze in Medicare physician payments as was mandated in 1996. That freeze has been waived every year since it was enacted. The CBO counts the cost of continuing that waiver as a cost of the proposed national insurance program (I'm not sure why this is appropriate.). If you remove that cost, the CBO actually estimates that implementation of the program is deficit neutral over its first ten years. Whether thst is true or not remains to be seen.

[Evan]

There has to be a happy medium.

Finally, a reasoned suggestion. I agree. I would strenuously assert that the current bill, which is still a work in progress, is not a sustainable, nor a choice -producing "happy medium".

I have a copy of the bill in its current form, and it's a monster of bureaucratic red tape. I'm working my way through it - a task many willing signatories appear unwilling to do. So far I have 10 pages of references to stipulations, all of which lead to the removal of personal choice in both short and long term health care.

Please take time out from this particular kernal of hope & change, and think clearly about its long term effects.

Evan

"'The nearest thing to eternal life we will ever see on this earth is a government program" ~ Ronald Reagan

Once they do this, getting rid of it will be harder than un-ringing a bell.

[Gerry Clinchy]

- From a technical perspective, the $10,000 ia not a deductible. It is the maximum amount that a family would be required to pay in deductibles, coinsurance and co-pays before insurance would cover the balance

I do understand that it is not a deductible, but one serious illness will make the $10K look like chump change ... as you mentioned with your own situation earlier.

- No plan, private or public would be permitted to exclude people with pre-existing conditions.

And they won't be able to charge any more for those people who have pre-existing conditions, as I understand it. Insurance is all about arithmetic. And, as mentioned, the fellers in DC make the law, but the bureaucrats implement it. How can you make a law like this without doing the arithmetic first ... and telling people what those premiums are going to be (at least at the outset)? I pay $328/mo. for a plan with a $1500 deductible. It's about double what I paid 15 years ago when I was younger. Arithmetic again. More likely I'm going to give them a zinger bill than someone younger. The increased premium I pay v. 15 years ago doesn't begin to reflect how much I could cost them in just one even brief hospital stay.

Suppose the monthly premium for one of the "universal" plan, using the laws of probability & doing all the arithmetic, comes out to $550/month. That might seriously influence how many people are in favor of this fix for the broken system. I am absolutely sure that there are many people who believe that installing this universal plan will be a decrease in their monthly premiums (if they have insurance). I'm willing to bet that won't turn out to be the case within a few years, if not right at the outset.

Of course it will create administrative jobs in the Federal sector

The 2 1/2% will at least reduce the extent to which these people burden the rest of us with their medical bills.

For the 30 yr old making $50K, that's a bit over $100/mo. If the insurance premiums are $200/mo. That dog won't hunt. I totally doubt that the monthly premium for this universal plan will be any less than $200/mo. when all is said and done. And that amount would undoubtedly go up frequently ... just as Medicare has required larger & larger contributions from the elderly.

Yes, there will be some savings from getting some diseases controlled sooner. Has anyone quantified that? v. the costs of providing the free insurance; v. the costs of subsidizing for those who have low enough income to qualify.

- Illegal immigrants are excluded from receiving any government subsidized coverage under HR 3200.

Well, that's interesting in and of itself. Since illegal immigrants seem privvy to other social services, I'm amazed that they will not find a way to get part of this pie.

Has anyone done anything about legislation to help us track these millions of people down and send them home?

While our legislators will not be compelled to give up their luxury health care plan, I think it would be appropriate that they receive only the "basic" plan at taxpayer expense, and pay for any "accessories" out of their own pockets. In that way, they could really get the feeling of how this universal plan operates. And it would be a great source of funds to put toward the universal plan. Has anyone mentioned how much is spent on this plan that our legislators enjoy?

If you remove that cost, the CBO actually estimates that implementation of the program is deficit neutral over its first ten years. Whether thst is true or not remains to be seen.

I'll believe it when I see it ... should I live so long