Healthcare Update

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!