House Democrat Health Plan

[Autodidact]

What if they can't afford it?

Up to 400% of poverty, it is subsidized. There is a hardship exemption. If you're above 400% of poverty, don't have an exemption and don't get it, you're liable to a penatly of 2.5 % of your income.

Any particular amount they have to provide? You gotta tell them to make it at at least a certain level, or else they'll be able to do something ridiculous, like pay only ten dollars out of the total cost of a several-thousand dollar operation.

There are minimum plan requirements.

Is the tax credit relevant to the amount of insurance they provide?

It's tied to the size of their payroll.

How?

-reduces paperwork by standardizing procedures
-limits annual premium increases
-restructures Medicare and medicaid payments, especially to favor preventative care.
-requires Secretary to negotiate directly with drug manufacturers for lower costs.
-and some other misc. measures to reduce waste and fraud in gov't. programs.

If you're paying the scientist, won't his results be based off the money rather than genuine science? In other words, is there a system that stops scientists from getting paid to keep inventing the wheel over and over again?

I think you're misinformed here.

Also, where did the rumors about death pannels and eugenics come from?

There is a provision that if you choose to meet with your doctor to discuss advance planning, including end-of-life planning, the doctor can bill and be paid for that time. That's all it is; I swear. The rest of it is a lie, plain and simple.

Here and here are summaries that should answer your questions in more detail.

 

[Copernicus]

What if they can't afford it?

The bill addresses that. The implementation may not be perfect, but everything is subject to tweaking by Congress or the executive branch in the future. For example, nobody likes the "donut hole" in prescription payments, so there is an effort to fix it by legislators working on this bill. What almost everyone agrees on is that the government program of prescription subsidies should stay in place.

One criticism of Obama that I happen to agree with comes from George Lakoff (The Policy-Speak Disaster for Health Care). Obama comes out of the legislative world, so he has framed the health care issue in terms of a list of policy solutions that go into the legislation. As President, he needs to frame the issue differently. That is, he needs to emphasize the generality of what the fight is about--the overarching goal of his plan. He also needs to take ownership of the plan rather than to give the impression that Congress is in control of its final form. Anyone can attack his position by simply sniping away at the policy details in the bills in Congress that are under consideration. Given the turgid legal language in the bill, it is very easy to distort what the bill actually says. It is also very difficult for the average citizen to read it. So we get all kinds of conflicting interpretations in the public forum.

Everyone is now asking for details, but the actual details of the finished bill are almost certain to be different from the ones now under discussion. Thanks to the hysteria generated over the "death panel" lie, the current bill no longer supports a provision to fund end-of-life discussions with doctors. Individuals get hung up over tangential single-issue flashpoints such as whether abortions will be funded and employee insurance premiums be taxed. Whenever we see the President speaking about the bill, we hear him tell us about all the things that are NOT in the bill. He is constantly on the defensive, as he tries to put down all of the lies and misinformation about details. That is, he has lost control of the public debate.

I am presently pessimistic that we will get any kind of meaningful reform out of this effort. It may be another decade before the country addresses it again if we fail on this round. I still think that Obama is the most brilliant politician to come around in a generation, but he still needs to grow into the presidency. First off, he needs to learn that he is no longer a member of a legislature, and this experience may well teach him that lesson.

 

[Autodidact]

The bill addresses that. The implementation may not be perfect, but everything is subject to tweaking by Congress or the executive branch in the future. For example, nobody likes the "donut hole" in prescription payments, so there is an effort to fix it by legislators working on this bill. What almost everyone agrees on is that the government program of prescription subsidies should stay in place.

One criticism of Obama that I happen to agree with comes from George Lakoff (The Policy-Speak Disaster for Health Care). Obama comes out of the legislative world, so he has framed the health care issue in terms of a list of policy solutions that go into the legislation. As President, he needs to frame the issue differently. That is, he needs to emphasize the generality of what the fight is about--the overarching goal of his plan. He also needs to take ownership of the plan rather than to give the impression that Congress is in control of its final form. Anyone can attack his position by simply sniping away at the policy details in the bills in Congress that are under consideration. Given the turgid legal language in the bill, it is very easy to distort what the bill actually says. It is also very difficult for the average citizen to read it. So we get all kinds of conflicting interpretations in the public forum.

Everyone is now asking for details, but the actual details of the finished bill are almost certain to be different from the ones now under discussion. Thanks to the hysteria generated over the "death panel" lie, the current bill no longer supports a provision to fund end-of-life discussions with doctors. Individuals get hung up over tangential single-issue flashpoints such as whether abortions will be funded and employee insurance premiums be taxed. Whenever we see the President speaking about the bill, we hear him tell us about all the things that are NOT in the bill. He is constantly on the defensive, as he tries to put down all of the lies and misinformation about details. That is, he has lost control of the public debate.

I am presently pessimistic that we will get any kind of meaningful reform out of this effort. It may be another decade before the country addresses it again if we fail on this round. I still think that Obama is the most brilliant politician to come around in a generation, but he still needs to grow into the presidency. First off, he needs to learn that he is no longer a member of a legislature, and this experience may well teach him that lesson.

I am cautiously optimistic that we will. Yes We Can!...and of course, you've contacted your representative and Senator to let them know how you want them to vote, right?

 

[linwood]

So far, all I hear is inflammatory rhetoric from BOTH sides of the political scene.

Untrue.
You`ve heard the benefits of a single payer system and they are not "hypothetical" considering we have almost all of Europe to look at as an example.

*The rest of the western world has health care...EVERYONE!!
*The rest of the western world has lower infant mortality rates than ours..evidence our system is substandard and a single payer system works.
*The rest of the western world has higher life expectancy than ours ...evidence our system is substandard and a single payer system works.
*Every single European I`ve spoken to about this is happy and satisfied with their UHC
(I work at a resort very popular with Europeans so I speak to many daily)

These are but a few of the empirical evidences in favor of UHC.
Can you falsify any of them ?

I have yet to hear a single actual bit of evidence opposing UHC.
I do however see and hear a lot of ignorant right wing sheep screaming absurdities at the tops of their lungs.It`s a tactic I`ve seen many many times in the past decade from the same ideologues it`s wearing thin.

Maybe if our politicians would give the American public REAL facts and REAL answers about the specifics of their healthcare plans, people would not be so upset. However, facts seem to be sorely lacking. All I'm hearing from the powers that be is what the plan does NOT involve, according to them (no death panels, no euthenasia, no rationing, no tax hikes, etc).

Read the bills, there are your facts.

I want answers, specifics, about the plan. I want to know how this huge change will affect my family's healthcare options. I want to know how I will be treated in ten years. I want to know if my children and grandchildren will be shackled with a huge debt, and if not - how are we going to avoid that? I want to know how this reform will be funded. I want to know whether or not my representatives can assure me that my taxes will not go up - or if they will go up, how much, and what will I receive in return? I may decide that it's a good return on my investment and support the plan. Or I may decide otherwise. But I need FACTS.

Read the bills, there are your facts.
The facts are there it`s nobodies fault but your own if you don`t know them.

 

[T-Dawg]

Hey guys, I just heard the most recent anti-healthcare argument! It was from my mom. I'll try to reconstruct the conversation to the best of my memory (these are estimations of what was said, not exact words. Skip to the bold part for when she finally gets to healthcare):
(Mom started by talking about the cash for clunkers program, I don't remember her reasoning on why it only benefitted the car dealers, but I do remember that it made more sense than anything else she said.)
Mom: "The cash for clunkers program didn't benefit anyone. Except the car dealers."
Me: "Yeah, Obama's really a capitalist..."
Mom: "CAPITALISM ISN'T EVIL! Now, socialism is... not good. They take away money from hardworking people and give it to lazy people who sit on their butts all day!"
Me: "Just out of curiousity, do you happen to watch Fox News?"
Mom: "I watch it occassionally. I don't watch much of any news, all they do is argue and yell at eachother."
Me: "Anyways, capitalism is where you work hard and make lots of money and then I inherit it and sit on my butt the rest of my life."
Mom: "You aren't gettin' any of my money! What makes you think..."
Me: "I don't want your money. The point is that that's what most "rich" people do. Most people are "rich" because they inherited it, not because they worked for it."
Mom: "And I agree that that is wrong. Everyone should have to work for their money. You won't be inheriting any of my money, I'm spending it all on myself to have a good time while I'm alive."
Me: "So what about people like my brother who can't work?"
Mom: "They deserve help. Although, he's actually getting job training this school year. He'll probably never end up making a lot of money, but he'll be able to work. Now, then there's the lazy people who just sit around taking money from the government."
Me: "And what percentage of the welfare people do you think actually is the lazy type that won't look for a job?"
Mom: "A lot. The vast majority of people in welfare just sit there taking money from the government instead of looking for a job."
Me: "Uh, you DO realize that employees are laying off workers and finding a job is nigh-impossible, right?"
Mom: "There's always jobs out there. Now, if the people are still looking for jobs, then that's ok. But most people on welfare just take money and live off the government services. And when you expand these services, you get more of those people. That's what the whole healthcare thing is about. HEALTHCARE ISN'T A RIGHT."
Me: "It's not?"
Mom: "No, it's not. Unless Jesus comes down from heaven and heals you miraculously, then healthcare is a PRIVELEGE, NOT a God-given right. Life, liberty, and the pursuit of happiness!"
Me: "Life."
Mom: "Everyone's going to die anyway. Besides, people can buy INSURANCE."
(At this point, I just walked away, since if one can be convinced that the insurance system is fine, they can be brainwashed to believe anything. Also, as I walked away, I think she said something about "You have a right to life, but nowhere does it say you're going to be healthy. Everyone's going to die eventually, anyway.")

Emphasis on the "healthcare isn't a right" bit. Even though I knew my mom was what you guys would call a "right-wing nutjob," I was still shocked at this statement.
Well, at least she didn't bring up crap about death pannels and eugenics XD.

 

[Alceste]

Hiya, AmazingLoser, with that mom and your Reagan-loving dad, I must say you're doing remarkably well when it comes to making up your own mind about things. In contrast, both my parents are socialists (although I'm still MILES to the left of either of them).

 

[T-Dawg]

Mom probably loves Reagan too. :biglaugh:
How anyone could love Reagan is beyond me. I can vaguely understand how some people can connect his huge military spending with sucking the soviets dry (the soviets ended up destroying their economy to keep up with the US, theoretically, although if I remember correctly, they were already on the decline anyway before Reagan. And seriously, if the soviets were really going to invade, they would have done it BEFORE Reagan, back when the US military was in such sorry shape, or at least it was according to Reagan.), but I don't see that as justification for his destruction of the environment, cutting the funding for the educational system, and most importantly, supporting oppressive dictatorships in Latin America (in the name of fighting communism, of course).

 

[Copernicus]

I am cautiously optimistic that we will. Yes We Can!...and of course, you've contacted your representative and Senator to let them know how you want them to vote, right?

Absolutely, but it was that contact that turned me pessimistic. My congressman (Reichert) is a Republican who will vote against the bill no matter what is in it, although he disingenuously claims to want health care reform. Republicans tend to care more deeply than Democrats about what the more extreme elements of their base demand. Both of my senators (Murray and Cantwell) are Democrats, but neither will say publicly whether she favors the "public option". In other words, they are waiting to see which way the political winds are blowing. Unlike Republicans, they are much more inclined to vote against the wishes of their base in order to appeal to moderates. While they would vote for the public option, they will actually just vote for anything that the Senate considers so that they can say they voted for "health care reform". The insurance industry is running ads frequently extolling both senators and urging their constituents to write them thank-you notes for supporting "bipartisanship" (aka the health insurance lobby).

So I am resigned to the possibility that no bill will pass--because the Democratic base will splinter over a bill that supports co-ops--or that the bill that passes will be essentially toothless. Incapable of addressing the problems that are actually behind the drive for health care reform in the first place. I will be delighted if I am wrong, but I sense the political winds shifting in favor of the Republicans on this one. The Democrats are managing to snatch defeat from the jaws of victory.

 

[Alceste]

Absolutely, but it was that contact that turned me pessimistic. My congressman (Reichert) is a Republican who will vote against the bill no matter what is in it, although he disingenuously claims to want health care reform. Republicans tend to care more deeply than Democrats about what the more extreme elements of their base demand. Both of my senators (Murray and Cantwell) are Democrats, but neither will say publicly whether she favors the "public option". In other words, they are waiting to see which way the political winds are blowing. Unlike Republicans, they are much more inclined to vote against the wishes of their base in order to appeal to moderates. While they would vote for the public option, they will actually just vote for anything that the Senate considers so that they can say they voted for "health care reform". The insurance industry is running ads frequently extolling both senators and urging their constituents to write them thank-you notes for supporting "bipartisanship" (aka the health insurance lobby).

So I am resigned to the possibility that no bill will pass--because the Democratic base will splinter over a bill that supports co-ops--or that the bill that passes will be essentially toothless. Incapable of addressing the problems that are actually behind the drive for health care reform in the first place. I will be delighted if I am wrong, but I sense the political winds shifting in favor of the Republicans on this one. The Democrats are managing to snatch defeat from the jaws of victory.

Interesting insights. From my POV, it looks more like this:

The Republicans are exactly as stupid as the people who vote for them. They're not conforming to the view of the base, they're members of it. Both the Republican voters and the Republican legislators, despite the fact they are shockingly stupid, believe they are smarter than everybody else in the whole world.

The Democrats, on the other hand, think they are smarter than the people who vote for them (they think they're almost as smart as Europeans!) and they think they are not members of this group. Their entire political careers are spent apologetically explaining their policy objectives in a twitchy, limp-wristed fashion that springs from their sincere belief that if they let anybody see how clever they are, the whole of America will turn against them. (Which is kinda true, actually). However, they are only slightly less stupid than the Republicans, and the people who vote for them are generally WAY smarter than them.

Ralph Nader and Ron Paul, on the other hand, are actually smart. And they think both think Americans are just as smart. But nobody listens to them.

Nevertheless, this health bill is not useless. The very least it will do is prohibit insurers from denying or canceling coverage on the basis of pre-existing medical conditions. That appears to be an absolute requirement for both parties. In fact, with this provision in the bill, it hardly matters what else is in it. It could be 1000 pages of plans to conscript American toddlers to work as slave labour mining for Helium 3 on the moon with one sentence prohibiting denial of coverage for pre-existing conditions and it would be a safe political bet for either party, and a Godsend for Americans.

But that would be bad for the health insurance industry, hence the illusion of controversy.

 

[Copernicus]

Alceste, it is possible that the health care reform bill can be written in such a way that citizens are required to buy overpriced insurance, which would be a huge boon to the insurance industry. How could that happen? Look at Medicare Part D, which was crafted by the insurance industry. It ended up being a huge gift to the insurance industry, because it had no effective controls on expenses. Similarly, prescription subsidies in Medicare--again written up under Republican control--were a huge gift to the pharmaceutical industry.

The way this bill could work for the insurance industry is that those of us who can afford the insurance would be required to buy it at inflated rates. Those who could not afford it would be subsidized to buy it--at taxpayer expense. The public option would put in place a mechanism to block that kind of abuse by the private insurance industry, provided that the insurance industry did not gain control of the regulation mechanism (which it almost certainly would under Republican administrations).

I do not consider people who defend bad ideas to be stupid. What makes someone smart is the ability to defend ideas well whether or not they have intrinsic merit.

 

[Alceste]

Alceste, it is possible that the health care reform bill can be written in such a way that citizens are required to buy overpriced insurance, which would be a huge boon to the insurance industry. How could that happen? Look at Medicare Part D, which was crafted by the insurance industry. It ended up being a huge gift to the insurance industry, because it had no effective controls on expenses. Similarly, prescription subsidies in Medicare--again written up under Republican control--were a huge gift to the pharmaceutical industry.

The way this bill could work for the insurance industry is that those of us who can afford the insurance would be required to buy it at inflated rates. Those who could not afford it would be subsidized to buy it--at taxpayer expense. The public option would put in place a mechanism to block that kind of abuse by the private insurance industry, provided that the insurance industry did not gain control of the regulation mechanism (which it almost certainly would under Republican administrations).

I do not consider people who defend bad ideas to be stupid. What makes someone smart is the ability to defend ideas well whether or not they have intrinsic merit.

Yep. I'll concede that those are all very reasonable fears. It's true that people who do not buy insurance will be penalized to the sum of 2 % of their income, which could be construed (loosely) as forcing people to buy private insurance if the public option is dropped.

There is a profit cap on the private insurance industry written into the bill as it currently stands, as well as measures that prohibit the private insurance industry from dropping sick clients or rejecting sick prospective clients in order to increase their profits. Both the "left" and the "right" - inasmuch as these fictions actually exist - agree on these points. With that in mind, if this bill passes in any form, it will put a gigantic dent in insurance industry profits. If so, they will almost certainly raise their rates in order to maintain their profits. Also, the cap will be ineffective because private insurers can easily increase their overhead to create the illusion of an "authorized" profit margin.

And you are right that the "public option" is not likely to benefit anyone: there are numerous clauses written into the law that require the administrators of this "option" to ensure it is pretty much exactly the same as the private plans on offer.

All of which is to say that universal, single-payer health insurance administered by civil servants on behalf of the public (the system that is in place in the entire western world except for the US) is the solution to your problems. American legislators are gaining nothing by trying to reinvent the wheel. They are hurting themselves by insisting that whatever form the "health care reform" takes, it has "made in America!" stamped on the collar. They are dooming themselves to failure by breaking their backs to ensure that no matter what happens, corporate profits are not interfered with.

What they ought to have done is just download the health care legislation from any other western nation in the world and do am MS Word "find and replace" to stick "USA" in where "Denmark" (for example) used to be.

 

[Copernicus]

What they ought to have done is just download the health care legislation from any other western nation in the world and do am MS Word "find and replace" to stick "USA" in where "Denmark" (for example) used to be.

I agree with you on this point. I am 100% for a national health care service and the treatment of health care as a guaranteed right. But it would not be as easy as it sounds. The health care industry has amassed a huge bureaucracy that is spread out in enough states to make it very difficult for representatives in Congress to simply devise a plan to replace it. Basically, the government would have to nationalize large segments of the insurance industry and then spend years on a massive overhaul of the system. Obama's strategy is to begin the move to national health care by passing insurance reform.

I just think that Obama made a lot of missteps by negotiating too much away from the very beginning. He underestimated how easily the insurance and pharmaceutical industries would be able to undercut him. For example, I believe that the pharmaceutical industry snookered him into a backroom deal--something he said he would not do during his campaign. Once he did that, they had him. At an opportune moment--several days ago--they released the bombshell news that he had cut a backroom deal with them. This was in the middle of an immensely successful propaganda campaign to erode public support for the plan with a snowstorm of disinformation and well-planned astroturf sandbaggings in town halls.

 

[Alceste]

I agree with you on this point. I am 100% for a national health care service and the treatment of health care as a guaranteed right. But it would not be as easy as it sounds. The health care industry has amassed a huge bureaucracy that is spread out in enough states to make it very difficult for representatives in Congress to simply devise a plan to replace it. Basically, the government would have to nationalize large segments of the insurance industry and then spend years on a massive overhaul of the system. Obama's strategy is to begin the move to national health care by passing insurance reform.

Then that's what he should have done: stuck with a very simple proposal to prohibit the refusal of clients with "pre-existing medical conditions" to begin with. There's no point starting your gambit with "universal health insurance coverage" if you're willing to negotiate with the private health insurance industry. If you're going to go for it, you have to be willing to smack 'em down when they object, and exclude them from the debate. And you need to be sure you have the same amount of resources to spend on propaganda as they do before you start.

At an opportune moment--several days ago--they released the bombshell news that he had cut a backroom deal with them.

Are you sure this is true?

This was in the middle of an immensely successful propaganda campaign to erode public support for the plan with a snowstorm of disinformation and well-planned astroturf sandbaggings in town halls.

This is why I am skeptical that the "backroom deal" claim is true. (Not saying it ISN'T true - I don't know. Just pointing out that it's likely that you don't know either. )

 

[Jackytar]

I read this in Newsweek last night...

"One of this summer's iconic moments was when a man stood up at a town-hall meeting in South Carolina with Rep. Bob Inglis to demand that he "Keep your government hands off my Medicare".

Jackytar

 

[Copernicus]

Then that's what he should have done: stuck with a very simple proposal to prohibit the refusal of clients with "pre-existing medical conditions" to begin with. There's no point starting your gambit with "universal health insurance coverage" if you're willing to negotiate with the private health insurance industry. If you're going to go for it, you have to be willing to smack 'em down when they object, and exclude them from the debate. And you need to be sure you have the same amount of resources to spend on propaganda as they do before you start.

The public option is a good idea precisely because it gives the government a way to pressure the industry to bring prices down. The runaway inflation--caused mainly by insurance industry greed--is the first thing that needs to be brought under control. Nobody really believes that co-ops will have much effect on that, since they already exist.

Are you sure this is true?

I am sure that the backroom deal took place, because the Obama administration admitted it. I am not sure that the pharmaceutical industry intentionally plotted to use the information to discredit Obama, but the industry is doing all it can to discredit him. Since he has explicitly campaigned against backroom deals, it wouldn't take a genius to see how such a deal could be used against him. He was incredibly naive to go for it.

This is why I am skeptical that the "backroom deal" claim is true. (Not saying it ISN'T true - I don't know. Just pointing out that it's likely that you don't know either. )

Again, the Obama administration has officially acknowledged it. They are thinking that the pharmaceutical industry will give up 80 billion dollars in exchange for the government not regulating them further. I do not believe that they will even live up to that commitment. How will Obama deal with them if they simply reneg?

 

[Jackytar]

The runaway inflation--caused mainly by insurance industry greed--is the first thing that needs to be brought under control.

The escalating costs are mainly caused by provider fees, not insurance industry greed. The savings will have to come from identifying and reducing waste in the system.

Hard sell for Americans. Too much to swallow all at once. This will have to be incremental change. Social Security was watered down initially, only covering about 50% of Americans. It was subsequently strenghtened by the Voter Rights Act and the Civil Rights Act. Hope Obama gets a second term.

Jackytar

 

[Alceste]

I am sure that the backroom deal took place, because the Obama administration admitted it.

Well it looks like you're right. Yeah, this was incredibly stupid and naive of him, I agree.

 

[Valjean]

When Taiwan wanted to revamp its healthcare system, It did a survey of the various other systems already in use and pieced together a system that fit its needs from successful parts of other systems.

We could do something similar, if some of these republican blockheads who've never traveled more than 100 Km from home ( probably wouldn't know what a Km is) would realize we're not the only country in the world, that others have already tackled this problem, and that we're just re-inventing the wheel.

 

[twinmama]

About disbelief - those who read my post about family who are forced to live under in poverty in order to get help for their seriously sick child....

The Daily Dish | By Andrew Sullivan

 

[Alceste]

The Daily Dish | By Andrew Sullivan

How awful. Poor family! Quite a good example of how the private insurance system is bad for the economy overall when educated, qualified individuals with decent earning potential are intentionally staying at or below the poverty level to qualify for insurance for their kids.