Okay, here's the deal. House bill is complete. A separate vote in the house on HR 676, Single Payer is also supposed to happen. Senate does not have a bill. When the Senate has a bill, the two bills get voted on, then they go to reconciliation committee. Then I think that bill gets voted on, then the President signs.
House Bill (2260?)
-Insurance Reform
1. No more lifetime limits
2. Cannot non renew a policy unless there's fraud
3. Annual caps on out of pocket expenses
4. Cannot discriminate based on gender or preexisting conditions (but can discriminate on age in terms of premium)
5. Individual mandate - meaning if you don't have insurance you pay a tax penalty
6. No employer mandate - meaning employers who don't offer insurance don't pay a tax penalty
7. Funding is unclear at this point, but some would come from Medicare "savings" which is a point of contention, and the rest might be funded by taxes on those making $250,000+.
8. Government panels that recommend treatments and end-of-life counseling. The panel's recommendations would be unbinding. This piece of the bill has a lot of misinformation around it, critics compare it to something Hitler did, although it's really not like that at all. Seriously, I just want to go to the doctor when I'm sick, and these schmucks at the Town Halls are carrying around pics of Obama with a Hitler mustache. Arrrggh! So anyway, the panels might get wiped out.
-Public Option
1. An "exchange" (read Web site) would be created where consumers could choose from government-negotiated private plans, or they could choose a government-run public plan, presumably cheaper because it doesn't include profits, marketing, or underwriting costs.
2. Government plan will have to negotiate reimbursement rates with doctors, won't use Medicare rates
3. Subsidies for low-income
4. Financed by premiums only, no new taxes
5. Not in place until 2013
Senate (what we will probably see)
I expect the Senate to widdle down the already watered down bill to include non-profit "co-ops" instead of the government run public plan. "Co-ops" could be seen as more politically popular, as they would be managed by non-government organizations (who would actually manage these things is unclear). Presumably, there would be several co-ops in the exchange, vs. the one public option in the House Bill.
Now, co-ops in my opinion are not a good solution for a very simple reason. The Law of Large Numbers. Insurance is about spreading risk. The more risks in your pool, the fewer relative losses, the cheaper the premium. Hence, big groups can negotiate better plans than small groups. One federally administrated government plan would probably attract a lot of consumers, hence allowing lower premium. Not to mention, Uncle Sam is much sturdier negotiater than any Tom, Dick or Harry that would be managing these co-ops. The Feds can basically dictate the terms of most contracts, incl. reimbursement rates for doctors and pharmaceuticals. Unfortunately, they are loathe to flex that muscle currently, preferring large campaign contributions to consumer-friendly policy.
Frankly, I am very upset about the way this is going. I am not convinced the consumer will see savings from this, in the short term or in the long term, esp. if we lose the public option.
Not to mention, it is so fucking clear that the Republican mantra of tax cuts, unregulated markets, and small government DOESN'T FUCKING WORK!!! Bush tax cuts created 0 jobs. ZERO!!!! We've lost jobs even as population has grown. It's like we just keep letting the chimpanzee drive the car. Chimpanzees can't drive! They don't even believe in driving. They just get distracted by shiny objects until the inevitable crash.
It's time for Democrats to do the job we elected them to do, but instead they seem prepared to sell us out to corporate interests again.
The fight will never end. Keep the pressure on. See below to contact your Senators. Tell them you want a public option that will keep costs low, NOT CO-OPS!
About Me
Friday, August 14, 2009
Wednesday, August 12, 2009
Saturday, August 1, 2009
Heathcare!!!!
http://www.pbs.org/moyers/journal/07312009/watch.html
First off, I love Bill Moyers. Yes, I am a nerd who would rather watch PBS on a Friday night than go to a bar.
One thing I've noticed is how every argument against a public healthcare option can be countered with, "That's what's happening now!"
The rich will subsidize the poor
That's what's happening now!
There will be a bureaucrat between you and your doctor
That's what's happening now!
Competition will be stifled
That's what's happening now!
It will be inefficient
That's what's happeing now!
It will be too expensive
That's what's happening now!
It will kill old people.
That's what's happ - oh wait, old people have access to Medicare, a publicly run healthcare provider which is very efficient and has higher rates of satisfaction. Old people would not see much of a change if a new public Medicare-like option was available to all. Admittedly, they will continue to die from time to time.
So I guess not every argument...
It breaks my heart that a few "blue dogs" can almost kill a public option and employer mandates. When the Republicans were in charge, moderates like Chuck Hagel didn't have this kind of power. Many very conservative policies were enacted, killing regulation and civil liberties. We all know how that ended up...
(Update: just learned that Nancy Pelosi has promised to have a vote on Single Payer Healthcare on the house floor. Yea! The House's final bill maintains a public option, but requires them to negotiate rates rather than tie rates to Medicare. The Senate will be trickier, and they don't really have a bill nailed down. The Senate Finance Committee chaired by Max Baucus is the real bear. Write to him and tell him what's what: http://baucus.senate.gov/contact/index.cfm)
Fact is, Republicans do not support responsible policy, they support corporate lobbyists. They've proven it. America voted for CHANGE, we want Democrats to exercise as much disregard for conservative interests as they did for our interests when they were in power. I don't want to build a bridge to a rich thief that wants to continue to give my money to other rich thieves. What I want is to go to the doctor when I'm sick, and not get a damn bill in the mail that I have to dispute every single time. I want drug addicts to be able to get counseling so that they have a chance of getting clean, rather than committing crimes. I want to know that even if I lose my job, I can still get treated for unexpected illness. I want to know that our kids are going to school with healthy kids.
It's time for our party to get real about healthcare, and we need to demand it. I would rather pay taxes than these exorbitant premiums. The private market can continue to operate competitively along side a public, not for profit model. They have this thing in the Senate bill, "co-ops". It's like a community-run insurance option. Basically, they took a public model and cloaked it in complexity and inefficiency. So they could "get the votes." They also removed employer mandates, but maintain individual mandates. So if you don't have insurance, you pay an exorbitant tax penalty, like we do in Mass. But in Mass, employers w/ more than 8 employees also pay a fine if they don't offer insurance. So the burden is shared, and we're still operating at a deficit. Uninsured Americans cannot afford the whole burden of funding this system.
And while I'm on the matter of funding, can I just reiterate, I don't mind paying more in taxes if it means my overall, out-of-pocket healthcare expenditures go down. Next time you get anxious about higher taxes, imagine a life without premiums, deductibles, copays, scheduled benefits, lifetime limits, shared percentages, and out-of-network fees.
The reason Commonwealth Cares is operating at a deficit isn't because penalties aren't high enough. It is because MA is operating as an agent to insurance companies. The state goes out and negotiates plans with Blue Cross, etc. So we are still paying corporate profits, marketing, underwriting, advertising. All that would go away with a publicly administrated, not for profit alternative. Let the insurance companies live in a profit-driven vacuum, keep them out of any public option. The co-ops are trying to fill that void, but I'm skeptical...
These things always go longer than I intend them to...
First off, I love Bill Moyers. Yes, I am a nerd who would rather watch PBS on a Friday night than go to a bar.
One thing I've noticed is how every argument against a public healthcare option can be countered with, "That's what's happening now!"
The rich will subsidize the poor
That's what's happening now!
There will be a bureaucrat between you and your doctor
That's what's happening now!
Competition will be stifled
That's what's happening now!
It will be inefficient
That's what's happeing now!
It will be too expensive
That's what's happening now!
It will kill old people.
That's what's happ - oh wait, old people have access to Medicare, a publicly run healthcare provider which is very efficient and has higher rates of satisfaction. Old people would not see much of a change if a new public Medicare-like option was available to all. Admittedly, they will continue to die from time to time.
So I guess not every argument...
It breaks my heart that a few "blue dogs" can almost kill a public option and employer mandates. When the Republicans were in charge, moderates like Chuck Hagel didn't have this kind of power. Many very conservative policies were enacted, killing regulation and civil liberties. We all know how that ended up...
(Update: just learned that Nancy Pelosi has promised to have a vote on Single Payer Healthcare on the house floor. Yea! The House's final bill maintains a public option, but requires them to negotiate rates rather than tie rates to Medicare. The Senate will be trickier, and they don't really have a bill nailed down. The Senate Finance Committee chaired by Max Baucus is the real bear. Write to him and tell him what's what: http://baucus.senate.gov/contact/index.cfm)
Fact is, Republicans do not support responsible policy, they support corporate lobbyists. They've proven it. America voted for CHANGE, we want Democrats to exercise as much disregard for conservative interests as they did for our interests when they were in power. I don't want to build a bridge to a rich thief that wants to continue to give my money to other rich thieves. What I want is to go to the doctor when I'm sick, and not get a damn bill in the mail that I have to dispute every single time. I want drug addicts to be able to get counseling so that they have a chance of getting clean, rather than committing crimes. I want to know that even if I lose my job, I can still get treated for unexpected illness. I want to know that our kids are going to school with healthy kids.
It's time for our party to get real about healthcare, and we need to demand it. I would rather pay taxes than these exorbitant premiums. The private market can continue to operate competitively along side a public, not for profit model. They have this thing in the Senate bill, "co-ops". It's like a community-run insurance option. Basically, they took a public model and cloaked it in complexity and inefficiency. So they could "get the votes." They also removed employer mandates, but maintain individual mandates. So if you don't have insurance, you pay an exorbitant tax penalty, like we do in Mass. But in Mass, employers w/ more than 8 employees also pay a fine if they don't offer insurance. So the burden is shared, and we're still operating at a deficit. Uninsured Americans cannot afford the whole burden of funding this system.
And while I'm on the matter of funding, can I just reiterate, I don't mind paying more in taxes if it means my overall, out-of-pocket healthcare expenditures go down. Next time you get anxious about higher taxes, imagine a life without premiums, deductibles, copays, scheduled benefits, lifetime limits, shared percentages, and out-of-network fees.
The reason Commonwealth Cares is operating at a deficit isn't because penalties aren't high enough. It is because MA is operating as an agent to insurance companies. The state goes out and negotiates plans with Blue Cross, etc. So we are still paying corporate profits, marketing, underwriting, advertising. All that would go away with a publicly administrated, not for profit alternative. Let the insurance companies live in a profit-driven vacuum, keep them out of any public option. The co-ops are trying to fill that void, but I'm skeptical...
These things always go longer than I intend them to...
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