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Ear to the Ground

Senate Reworks Health Care Proposal

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Posted on Jul 2, 2009
EKG
ekgpulse.com

Let’s see if this one takes. After critics blasted an earlier, more expensive version, the Senate Health, Education, Labor and Pensions Committee took another crack at a plan to provide coverage for tens of millions of Americans without health insurance. The latest plan, released Thursday, comes at the lower cost of $611.4 billion, as opposed to the $1 trillion proposal that didn’t go over so well last month.

WSJ.com:

The vast difference in dollar figures results in large part from a section in the proposal that would slap penalties on employers who don’t offer employee health benefits. Under the proposal, firms with 25 or more employees that don’t offer coverage would face fees of $750-per-year for full-time workers and $375-per-year for part-time workers.

The employer mandate would keep more people in their employer-based coverage, instead of forcing a migration of workers to the individual health insurance market. That migration is costly, because the legislation would provide subsidies for low and middle-income workers to purchase insurance on the individual market.

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By ardee, July 3, 2009 at 6:33 pm Link to this comment

hsr0601, July 3 at 9:43 am #
...................

Can you provide a link or links to these comments? It would be very helpful to those who seek ammunition in this fight.

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By coloradokarl, July 3, 2009 at 8:18 am Link to this comment

A pharmacist told me the Congress should write a Health Care plan that would acceptable to themselves and THEIR families. Good Idea, I think…...

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By hsr0601, July 3, 2009 at 6:43 am Link to this comment
(Unregistered commenter)

The independently-funded healthcare policy research organization, The Commonwealth Fund, compared possible savings ‘a health insurance exchange’ could bring under three different scenarios. One would include a Medicare-like plan along with private insurance. Another would instead offer only a government-run plan with rates somewhat higher than Medicare. The final one would be private insurance with no government plan at all.
Commonwealth’s study found cumulative health system savings between 2010 and 2020, compared with projected trends for that period, would range from $3.0 trillion under a Medicare-like plan along with private insurance paying providers at Medicare rates in competition with private plans, to $2.0 trillion for a public plan paying providers at rates between Medicare and private plan rates, to $1.2 trillion in the private plan-only scenario. All three options would help insure nearly all Americans, it said, with the number of uninsured dropping to about 4 million people by 2012.  ‘Such an exchange’ would offer a central point for consumers to shop for and compare health plans.

Under the Medicare-like plan along with private insurance, all U.S. residents would be required to obtain health coverage. The plan would establish a new government-sponsored health program for people younger than age 65 who are not eligible for Medicare. More than 40 million people would be expected to enroll in the program, according to Cathy Schoen of the Commonwealth Fund.

The government-operated insurance exchange would be similar to an existing program in Massachusetts and would allow people to compare coverage offered by private insurers and the new public program. In addition, the plan supports wide adoption of health information technology, better disease prevention efforts and ‘changes to the insurance payment system’ that promote efficiency. Health spending would continue to increase under the plan, but at a slower rate than current projections over the next 10 years. The Commonwealth Fund said the plan would reduce annual health care spending growth from a projected 6.7% to 5.5% and save a cumulative total of about ‘$3 trillion’ by 2020, adding a national health insurance exchange program that includes a federally managed health insurance option could potentially save $1.8 trillion more than a plan consisting only of private plans.
The group’s analysis assumed other changes would also be made to the U.S. healthcare market. These include an expansion of existing government coverage and new regulations that would require insurers to cover a wider range of consumers. Hospitals and doctors would also see their revenues grow with any of the three exchanges but at a slower rate, the report said.

The proposal’s advocates have argued that a government-sponsored insurance plan would offer the 46 million uninsured Americans an affordable alternative to costly private insurance,  adding that It would provide a strong incentive for private plans to strealine, innovate and compete.

Thank You !

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By erichwwk, July 3, 2009 at 5:54 am Link to this comment
(Unregistered commenter)

“So making American companies pony up for health is the answer? What kind of crap is this?
Let’s chase more US companies out of the country and lose more jobs.”

I too would like to see the link between companies and health care providers broken. The original reason for this relationship is based on history and bad logic - to allow firms to circumvent the WWII price control on wages by offering this perk. Worse, this perk is tax free, whereas similar privately bought insurance is not, causing a huge inequity.

But, no it will not drive companies overseas. ALL perks are ultimately paid by the workers, including health insurance. While firms pay 1/2 of FICA, they do so out of the workers money, and the distinction is basically meaningless.

The impact from this recent nonsense to “hide” all this would be to distort the distinction between being employed or not (in the USA). At the margin who bears the cost is distorted between a working individual and a non-working one. In the latter case the burden comes from the general fund. The attempt to keep this linkage seems nothing more that to keep the public component “hidden”, to allow firms to maintain the control over workers, and to delude workers into continuing their belief of their getting something for free.  The bargaining power of a large firm needs to be replaced by one public bargaining entity.

We got into this mess by being dishonest and gimmicky with the health care market. We allow providers to monopolize activities, withhold pricing information from the public to enable price fixing (Did you know this was to facilitate charging the uninsured much higher prices?), allowing the providers rather than the individual to own their medical records, subsidizing providers rather than consumers, outlawing specialty hospitals, allowing meaningless private insurance companies that accept premiums, but hide under legalese to avoid payments, incentivising the provision of services rather than the well being of consumers, not developing an acceptance of dying or the limits of technical intervention, spending 25% of outlays in the last year of “life”.

Some of the discussion I find meaningful. Much is still unfortunately on how the elitists get to keep their politically enabled wealth ( the top 2 tenths of one percent now claim one half of all U.S. earnings.)The administrative expenses we incur to keep this incentive disadvantaged system cobbled together through a private insurance market is simply staggering, and incapable of the alchemy or vodoo of transforming what is a public good into a private one.

What is required is a transformation of the market, essentially segmenting health insurance into a “single payer” public one (that defines the minimum service that is public and independent of wealth and paid for out of general funds) and what is private (the high end, expensive and the elective procedures) and what is public (that which is a right, and the denial of which is not acceptable to our sense of society).

What value could a private insurance company add to a single actuarial pool?

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By Dr. Rick Lippin, July 3, 2009 at 5:51 am Link to this comment

ardee- I am a physician-forecaster. I forecasted the problems Big PhRMA is now having in July 2002 in a #9 point forecast

I watch TV news and specials on my topic, read and scan newspapers,magazines and blogs. But I also watch the faces and body language of the key players which is usually underestimated as a source of valuable information.

I do NOT apply a mathematical models to my forecasts.

My batting average is pretty good.

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By ardee, July 3, 2009 at 3:29 am Link to this comment

Dr. Rick Lippin, July 3 at 6:27 am #

Can you point to anything of substance to support this (overly)optimistic view?

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By Dr. Rick Lippin, July 3, 2009 at 3:27 am Link to this comment

We are about to make history on US health care reform

The corporate monied interests known this.

They are desperately manuevering to get a seat on this long stalled train which is now pulling out of the station.

We will see US health care reform in 2009 and it WILL include a public health insurance option

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By Cathy, July 2, 2009 at 2:25 pm Link to this comment

I would love to see what this crappy plan covers, too.  If it’s private insurance it won’t be much.  Most states have plans you can get like that.  They are worthless.

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By Rodger Lemonde, July 2, 2009 at 12:51 pm Link to this comment
(Unregistered commenter)

So if the insurance industry say it will cost you more that’s OK. If the government tries to get better health care for all it’s too expensive.
Sounds like mental health is sorely lacking on this issue.

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By ardee, July 2, 2009 at 11:58 am Link to this comment

It seems impossible for single payer advocates to break through the insular nature of our governmental processes. In the face of the many proofs that cradle to grave health care works in a score of nations, and at a much, much less expensive price tag, we plow on, enriching the insurance industry, impoverishing small business and killing our uninsured.

Those who believe salvation lies in the hands of either political party are simply kidding themselves.

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By GB, July 2, 2009 at 11:28 am Link to this comment
(Unregistered commenter)

So making American companies pony up for health is the answer? What kind of crap is this?
Let’s chase more US companies out of the country and lose more jobs. Would somebody in Congress who has any conscience tell the republicans they’ve already destroyed the economy and their ideas are moot.
This is not health care reform for the 21st century but an industry paid off cop out. Anything less than single-payer that let’s all Americans get care, takes the liability away from companies so they can compete in the world and hire AMERICANS on AMERICAN soil, and bring down the overall cost nationwide is a failure. If the dems don’t check with their constituents, they will be out in ‘10.

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