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Thread: A little Transparency at last

  1. #21
    Senior Member Buzz's Avatar
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    Quote Originally Posted by dnf777 View Post
    There were more republican amendments put into the house and senate versions of the health reform bill than all concessions to democrats in the past 8 years combined. This is the first attempt at bipartisan governing I can recall. It is also the reason he has gotten nowhere with an obstructionist minority. They've as much as said so themselves.
    In retrospect, it's almost comical to think back to Republican portrayal of the Democratic Party as the party of no.
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  2. #22
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by Julie R. View Post
    Nor is the system of a priveleged group that can vote themselves raises and lavish taxpayer-funded health care packages determining what's best for the rest of us. ALL of the government should be bound to the health care decisions they're trying to cram down the rest of us.
    Interestingly, they are not eligible to receive raises that they have voted on unless they are first re-elected. With respect to the health care plan (e.g., HR 3200), members of congress were treated the same as everyone else in the country. Their plan remained intact and they continue to receive coverage.

  3. #23
    Senior Member Buzz's Avatar
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    Quote Originally Posted by YardleyLabs View Post
    Interestingly, they are not eligible to receive raises that they have voted on unless they are first re-elected. With respect to the health care plan (e.g., HR 3200), members of congress were treated the same as everyone else in the country. Their plan remained intact and they continue to receive coverage.
    There is also this:

    Okay, this is pretty fun. Senator Sherrod Brown is about to go to the floor of the Senate and use a procedural method to compel Republican Senators to add him as a co-sponsor of an amendment that would force Congress into a public health care plan.

    In case you missed the backstory, The Hill reported this morning that GOP Senators Tom Coburn and David Vitter are preparing an amendment to the health care bill that would force Senators and members of Congress to also use any public plan that is passed.

    The GOPersí idea is to put Senators who back the public option on the spot ó if the public gets a public option, Senators have to use a public plan, too.

    Turns out that Senator Brown thinks this is a good idea ó and has called their bluff by asking the GOP Senators to sign him on as a co-sponsor. But those Senators wonít let him!

    Now, however, Iím told that Brown is about to go to the Senate floor and demand that the Senate add him as as a co-sponsor by unanimous consent.

    That should force the issue and draw a lot more attention to it. Stay tuned.
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  4. #24
    Senior Member YardleyLabs's Avatar
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    However, what it misses is that the "public option" is designed to be identical to "private: options with the exception that it will probably only end up providing the minimum "basic" level of coverage, rather than the variety of additional benefits that might be available through normal employer-sponsored plans. If it also offers enhanced benefits, it would be competing directly with private sector companies in providing services in excess of mandatory minimum standards. It would be equivalent to Medicare offering wrap around benefit packages similar to those now offered by many major insurers (very profitably).

    In providing universal or near-universal coverage, the intention has never been to enroll everyone on a Cadillac plan. There is no reason to do so. Rather, we should define a base level of benefits and let anyone who wishes and can afford it (or whose employer can afford it) add benefits as they wish. HR 3200 set the minimum level for coverage at a level equivalent to about the 70th percentile of benefits received by those with coverage now. A legitimate way to reduce costs would be to decrease that minimum benefit level somewhat. However, there is no reason for the benefit levels of any plans -- including those available to Federal employees -- to be reduced to the minimum level.

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    Senior Member HuntsmanTollers's Avatar
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    Two points:

    1) Stop answering all posts with "8 years", that president is no longer in office and he didn't have party control of the house and senate for his entire term. Doesn't look like Obama probably will either.

    2) I understand that the adverstising for the public option states people can keep their plans if they want to. However, I still believe it is a poison pill. In my opinion, it will make it easier for employers to opt out and pay the fine at a lower rate than they would be paying for their share of insurance. So while on its face it isn't eliminating private insurance, in the long term it is setting the foundation for their failure.
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    Quote Originally Posted by HuntsmanTollers View Post
    Two points:

    1) Stop answering all posts with "8 years", that president is no longer in office and he didn't have party control of the house and senate for his entire term. Doesn't look like Obama probably will either.

    2) I understand that the adverstising for the public option states people can keep their plans if they want to. However, I still believe it is a poison pill. In my opinion, it will make it easier for employers to opt out and pay the fine at a lower rate than they would be paying for their share of insurance. So while on its face it isn't eliminating private insurance, in the long term it is setting the foundation for their failure.
    You are wrong, Bush had party control for a term and a half. (6 years)

  7. #27
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by HuntsmanTollers View Post
    Two points:
    ...

    2) I understand that the adverstising for the public option states people can keep their plans if they want to. However, I still believe it is a poison pill. In my opinion, it will make it easier for employers to opt out and pay the fine at a lower rate than they would be paying for their share of insurance. So while on its face it isn't eliminating private insurance, in the long term it is setting the foundation for their failure.
    Right now employers provide the benefits they provide despite the absence of any mandate or penalties at all. What makes you think that those same employers will suddenly reduce benefits once and mandate and penalties exist? That is illogical.

    Currently fewer and fewer people are receiving health benefits through their employers. These benefits are disappearing because costs are growing faster than company revenues. Adding to this is the fact that employers in other countries do not provide health benefits to their employees and do not, therefore need to include those costs in their prices. I expect that trend to continue in the absence of reform. The only reason the number of uninsured has not grown is because a larger and larger percentage of the population is receiving benefits under government plans: Medicaid, Medicare, and Federal military and employee benefits. HR 3200, or an equivalent program, is only the beginning. The real need to get employers out of the business of providing health benefits altogether. That is essential if American businesses are to be competitive in a global economy.

  8. #28
    Senior Member Gerry Clinchy's Avatar
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    With respect to the health care plan (e.g., HR 3200), members of congress were treated the same as everyone else in the country. Their plan remained intact and they continue to receive coverage
    Since Congresspeople have a Cadillac plan, how would the bill provide for their "employer" paying a tax on that? Or would each individual Congressperson be taxed? Since I don't think the Fed govt can tax itself, I would think the tax would have to be assessed upon each individual receiving the benefit.

    It actually makes some sense for all individuals to get their group health insurance as a group that includes everyone, not just those with a certain employer. The employer could be allowed to contribute up to a certain %-age of wage to assist their employees in purchasing whatever coverage they choose to have. Making the "group" larger than even the largest employer would help spread the risk so that the cost for each insured should come down. An individual employer's rates might be set based upon the make-up of his own company's employees (older, w/child-bearing age members, younger, etc.) Older persons who have individual coverage could benefit; as could companies whose workforce is older.

    The key is that absolutely no exemptions would apply for certain basic coverages. "Options" would be available to those who wish to purchase them. Older individuals have no need for maternity & post-natal coverage. That could be balanced by the fact that older individuals might have higher risk of certain diseases not common to younger individuals.

    Wouldn't it be rather easy to establish that kind of a "program"? It would not necessarily been revamping the entire system to simply allow an insurance company to group all insureds by "industry" ... regardless of who the employer may be (or whether the individual is self-employed).

    Wouldn't it make sense to try that first before imposing taxes and penalties for not having insurance? This should bring rates down generally, which would encourage more people to get coverage if they don't now have it. But you can't exempt unions or anybody else if you want to get the best overall group within an "industry".

    If you wanted to go a step further, you would not even divide the group by industry. A pipe fitter has more chance of suffering back injury than a real estate agent. (The pipe fitter's union requires that most of its members be required to carry 80 # (or something like that) of pipe up a ladder. Other occupations do not require that kind of physical exertion. If there are more real estate agents than pipe fitters, the pipe fitters would benefit from a lower rate by being in a larger group that includes real estate agents.

    This would be a comprehensive perspective, but without having to establish whole new bureaucracies for implementation.

    Then there's tort reform ... again pretty much leaving the nuts and bolts of health care delivery untouched, but gaining savings in cost containment. We keep getting the reply on tort reform saying that it will ONLY save a few hundred million. We've gotten so used to talking about billions, that we don't blink at $200 million or so. $200 million could buy a lot of basic health care for Medicare.

    Only about a billion saved if we send the illegal immigrants home. A billion can buy a lot of basic health care for someone legally on Medicaid or for VA recipients.
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  9. #29
    Senior Member YardleyLabs's Avatar
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    Gerry,

    It used to be that the overwhelming bulk of all health insurance was provided through the "Blues" and that all premiums were community rated. That is, all groups paid the same amounts without regard to individual group risk profiles. In return for accepting a regulatory structure that supported this approach, the Blues were also permitted to enter into cost based reimbursement structures with hospitals and other institutional providers.

    As for-profit insurers began to enter the market, they did not have this same price advantage. Instead, they competed on two dimensions. They offered premiums that were rated based on the specific risks of the group. By going after employers with younger populations, they were able to undercut the rates charged by the Blues despite paying higher rates for hospital care. In addition, they were able to offer services across state lines whereas the Blues were restricted to covering employees within a single state (with minor exceptions for some employees living within a few miles of the state border). That meant the Blues were unable to meet the organizational needs of the largest employers. Finally, the commercial carriers were then successful in overtuning the preferred position held by the Blues in paying hospital costs. That broke the market open for commercial carriers, but at the cost of creating a highly segmented premium structure. For higher risk employers, including most small businesses, the resulting price increases resulted in a reversal of long term trend. Where previously, the percentage of employees covered through employer sponsored plans had increased every year, it began to slowly shrink. Those losing coverage tend to be at the lower income levels -- where premiums represent a much higher percentage of total compensation costs -- and with employees in higher risk categories.

    I believe you are right that a key toward making care more accessible for all is to return to community rated premium structures that base rates on the risks faced by the broader population. At the same time, it is important to prevent people from "gaming" the system by rejecting coverage until their risks increase either because of older age or known medical problems. The reality is that these groups normally have very low medical needs. However, when they do have medical emergencies, the costs end up being so great that taxpayers end up paying the bills through Medicaid or support to hospitals for unreimbursed care.

  10. #30
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by Roger Perry View Post
    You are wrong, Bush had party control for a term and a half. (6 years)
    And your point is? 6 out of 8 is not his entire term. I believe those last two years did a lot of damage.
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