Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by Redux

The latest CBO letter you posted was in regard to ONE component, ONE specific level of coverage (bronze) to be offered through the Exchange (which you think is a fantasy) in response to a request from ONE senator.

That is why it is a factual bit of information that needs to be added to the debate as the American Public is then able to see what the real costs to them will be. The "Bronze" level is the lowest level of coverage, the coverage that most Americans will be exposed to. And by their own admission the costs are going to go through the roof. If you don't think that nearly $20,000 for family insurance is not a significant increase...

It supplements.....not replaces or updates. It doesnt change the overall "score" that CBO provided on the overall Senate bill that was adopted. If you know anything about the CBO scoring process, you would know that. But that requires someone interested in the full analysis and not just those pieces cherry picked to support a pre-disposed opinion.

I am quite familiar with the process. They are nothing more than a math clearing house for what ever information they are fed. They don't and cannot, by their own admission, predict what the actual costs will be in the end.

And deficit neutral has nothing to with what any individual will pay...it refers to the impact on the federal budget.

You are right, which is why for those who are actually going to see a significant increase in their costs could really care less about the fantasy of "deficit neutral". If you are paying significantly more for less care the average citizen is really not concerned with something the Federal Government has so far been unable to achieve in it's history.

Have you forgotten the "death panels" and the Medicare scare tactics, the "government rationing", the industry "studies" that fudged the costs to their benefit and all those endless partisan opinion columns with an agenda that misrepresented the facts and that you flooded the discussion with.... not to mention the sudden tsunami of inane pictures you "contributed" to the discussion recently

Your opinion. The opinion peices I contributed were merely against your parties line. That does not make them "partisan", other than they disagreed with your White House talking points. If you look at the majority of opinion pieces they are from subject matter experts, not a partisan mouth piece of the Demoncratic party.

[SamIam]

Here is the real problem with our health care system.

It's hard to constantly come up with new ways to say "America spends way, way, way, way, way more than any other country on health care." But we do! Just look at the National Geographic graph above, which puts per-person spending on one side of the chart and average life expectancy on the other. Or consider this: If we spent what Canada spends per person, our deficit problem would go away entirely. And Canada's per-person average is in a country where everybody is fully covered and so has full access to care. America's is in a country with 47 million uninsured, and so many people skimp on needed care. So the comparison is actually unfair to Canada.

David Leonhardt has another way of making the point. We don't have a government-run system. But our system is so expensive that our government's partial role is pricier than the whole of government-run systems.

http://voices.washingtonpost.com/ezr...y_way_mor.html

Originally Posted by TheMercenary

That is why it is a factual bit of information that needs to be added to the debate as the American Public is then able to see what the real costs to them will be. The "Bronze" level is the lowest level of coverage, the coverage that most Americans will be exposed to. And by their own admission the costs are going to go through the roof. If you don't think that nearly $20,000 for family insurance is not a significant increase...

I am quite familiar with the process. They are nothing more than a math clearing house for what ever information they are fed. They don't and cannot, by their own admission, predict what the actual costs will be in the end.

You are right, which is why for those who are actually going to see a significant increase in their costs could really care less about the fantasy of "deficit neutral". If you are paying significantly more for less care the average citizen is really not concerned with something the Federal Government has so far been unable to achieve in it's history.

Your opinion. The opinion peices I contributed were merely against your parties line. That does not make them "partisan", other than they disagreed with your White House talking points. If you look at the majority of opinion pieces they are from subject matter experts, not a partisan mouth piece of the Demoncratic party.

Sure, dude. Everyone is partisan but you and your links and your cherry picking!



It was Voltaire who said: "The perfect is the enemy of the good"

It is not a perfect bill but I believe it is a good bill, wtih signficant benefits to those both with insurance and without. I also understand that no major legislation is implemented w/o bumps along the road and I expect there will be some with this bill.

But the fact remains that no one knows the level at which it will succeed or not...and, IMO, should not be described as a failure before it is impemented.

You believe that you and those opposed to the bill somehow have greater insight into the future.

Sorry, dude. IMO, the lies and propaganda that you have perpetrated is partisanship at its worst and I, and many others here, see right through it.

[Shawnee123]

Volt-air? Was that there feller the guy who invented elektricity? Cause man, your being to smart for me.

[TheMercenary]

Originally Posted by Redux

Sorry, dude. IMO, the lies and propaganda that you have perpetrated is partisanship at its worst and I, and many others here, see right through it.

No lies. Little propaganda, well except what you post from the Demoncratic and White House talking points. Why is it that anyone who does not agree with the current plan is Demonized by the Demoncrats? I bet you the voters will let them know in a few short months.

Meanwhile, the secret talks at the White House continue. Even though I have posted a video of 8 time the President stood before the American public and stated categorically that the discussion would be open and transparent. There is a good like for you Redux, and your president gave it to you...

Senior Democratic lawmakers who spent hours at the White House on Wednesday rearranged their schedules to return at mid-afternoon, and Obama planned to address a closed-door meeting of the House Democratic rank and file in late afternoon.

http://www.msnbc.msn.com/id/34859430...h_care_reform/

Negotiations are being done in private behind closed doors, that despite the President's promise last year to keep the proceedings open to the public. President Obama repeatedly stated that negotiations would be televised on C-SPAN, but as of Thursday afternoon, that hasn't happened. C-SPAN CEO Brian Lamb accused President Obama of using his network as a "political football." Lamb, speaking on Bill Press' show, said Obama had "no right" to assume C-SPAN would cover the talks in the first place.

http://www.newson6.com/Global/story.asp?S=11786376

Originally Posted by TheMercenary

Why is it that anyone who does not agree with the current plan is Demonized by the Demoncrats?..

Why is it that anyone who does not agree with you or the insurance front groups or libertarian (stay our of our lives) groups are demonized as partisan?

Can you say hypocrite? Double standard?

You're still not fooling anyone.

[TheMercenary]

[quote=Redux;626522]

Originally Posted by TheMercenary

Why is it that anyone who does not agree with you is demonized as a partisan?

I only reserve that for people who spout the propaganda of the Demoncrats or White House. So that leaves everyone else in this country who disagrees with your party, regardless of party. So it is the Dems vs everyone else in the country who is not in support of your party.

But as I said, the voters are going to let you know in a few short months.

Originally Posted by TheMercenary

I only reserve that for people who spout the propaganda of the Demoncrats or White House. So that leaves everyone else in this country who disagrees with your party, regardless of party. So it is the Dems vs everyone else in the country who is not in support of your party.

I dont doubt for a second that you believe you are above partisanship. Deusions of grandeur?

I can only speak for myself.... and you are always good for a laugh (like your recent partisan pictiorial meltdown) with your double standards and blatant hypocrisy. And certainly never to be taken seriously..

[TheMercenary]

Originally Posted by Redux

I dont doubt for a second that you believe you are above partisanship. Deusions of grandeur?

I can only speak for myself.... and you are always good for a laugh (like your recent partisan pictiorial meltdown) with your double standards and blatant hypocrisy. And certainly never to be taken seriously..

Tell it to the guys getting left out of your parties lies about everyone being insured and the voters in Nov.

Originally Posted by TheMercenary

Tell it to the guys getting left out of your parties lies about everyone being insured and the voters in Nov.

We'll see what happens in November. I dont expect the Democrats will lose control of either house.

In the meantime, I'll just keep watching you trip over your own posts.

Most recently:

On one hand, you claim the Exchanges are a fantasy and on the other hand, you insist they are a pay-off to the insurance industry…..despite the fact that the industry has spent $20 million in the last few months on media campaigns opposing the bills.

Sure, they get access to potentially 30+ million new customers, but they don’t like the trade-offs which is why they are spending to oppose the bill: losing their anti-trust exemption, limits on premium in order to participate in the Exchanges and similar restrictions on increases in employer-based plans, ending exclusions for pre-existing conditions and dropping persons with coverage on a whim when faced with a new expensive condition/treatment, new limits on patient out-of-pocket expenses so no one will go bankrupt as a result of an illness, ending rate discrimination against women

Then you post a column from a Democratic Senator from 4 months ago and claim he agreed that the Exchanges would not work, when in fact, he was complaining at the time that the early draft of the committee bill did not include Exchanges anywhere near those in the final bill.

From there, you post a CBO letter on one small component of the bill related to one level of coverage to be offered in the Exchange and claim that updated it the overall CBO earlier findings on costs and saving and invalidated them.

Followed by the typical twists and dodges with each contradiction or misrepresentation.

As I said, always good for a laugh.

[classicman]

Originally Posted by Redux

We'll see what happens in November. I dont expect the Democrats will lose control of either house.

You think they'll lose seats? I was just trying to read up on the latest regarding this. There seem to be a lot more R's retiring/leaving than D's.

[classicman]

Hey Dux . . .

Whats the deal with this interpretation...

This is essentially health-insurance reform as little applies to the health-care delivery system and its costs. Here is the status of major provisions of the bills, mostly as they apply to employer plans provided to employees and retirees:

An issue that I think plays a major role in the end user/payor costs.

* The Senate’s Christmas bill dropped Medicare buy-in for pre-age-65 retirees; dropped the public-option plan and approved multistate “health exchange” private plans to ensure everyone has coverage available to them, to be overseen by the Office of Personnel Management.

* Due date for implementation: House bill 2013, Senate bill 2014.

* Overall cost for both bills is estimated at $900 billion over 10 years, but estimates are unreliable due to back loading of benefits in the early years while still collecting taxes.

* National (House bill) and state (Senate bill) “health exchanges” are created as insurance pools for individuals and small groups.

* Medicare Advantage plan phases out over three years (House).

* Medicare “doughnut hole” phases out by 2019 (House).

*

Hospitals are held accountable for preventable readmissions.

Does it say how? Won't they just pass this cost on somehow?
*

Employers will be required to “pay or play,” i.e., keep their current health plans or pay 8 percent of payroll (House) or $750 times every employee of 30 hours per week or more (Senate). Companies where $750 is a bargain will likely drop their private plans and take the state-managed “private” plan, setting the stage for a single-payer program later.

This seems really confusing. Isn't $750 a bargain for every company? They quote the average cost of a family plan to be something like $12,000. I must be missing something here, but what?

* A grandfather clause for five years under the House bill and unlimited by the Senate for employer health plans in effect on the day of enactment.

* Litigation against state health exchange plans would be subject to state laws (House bill) while historic Employee Retirement Income Security Act (ERISA) would continue national standards under the Senate bill.

* Work-place “wellness” is encouraged under the Senate plan which permits giving employee discounts up to 30 percent tax free for meeting plan goals.
* A long-term care program is included, but the details have not yet been thought through.

* Under the Senate plan, a 40 percent tax would apply to the excess of health-insurance premiums above $8,500 single and $23,000 married.

* High earners, under the House bill, would be subject to a 5.4 percent surtax above $500,000 single and $1 million married.

* Both bills have new taxes on medical devices, insurers, drugs, etc., all of which are likely to be passed to the public.

Well that sucks. . .

* Taxes under the House bill treat domestic partners as married. The Senate bill does not.

* Flexible spending accounts would be limited to $2,500 and indexed to the consumer price index rather than the medical cost index.

Again, all these points apply essentially to employer-sponsored plans for employees and do not address other issues such as access to and delivery of services. The Senate bill is almost certain to be the basis for a final bill as the Senate has already shown it cannot muster the votes for many of the House bill’s provisions.

Link

I don't know if this is spun or not, so I'm just throwing it out there for discussion.

Oh an after attempting to read some of this bill, I strongly suggest anyone with any problems relating to insomnia to try reading it.

Originally Posted by classicman

Hey Dux . . .

Whats the deal with this interpretation...

An interesting interpretation by the Chamber of Commerce, which is spending $millions, along with the insurance industry to oppose the bill.

But I would agree that more of the reforms are "insurance" reforms (particularly impacting small business, ie members of the Chamber of Commerce) but there are signficant provisions that focus on containing costs in the delivery system.

An issue that I think plays a major role in the end user/payor costs.

Does it say how? Won't they just pass this cost on somehow?

Yep it says how it will pay for the $900 billion cost...over 10 years.

In the House, its primarily from the 5.4 % surcharge on high income earners (over $500 K0 that will raise an estimated $500 billion over ten years...and the cuts in payments to Medicare Advantage providers who have been ripping off the system for years and getting an average of 15% over Medicare guidelines, but lettting addtional companies "bid" to offer the same services at a lower rate....expected savings about $150 billion.

That brings the revenue up to $650 bill out of the $900. The rest is less predicatable...including the taxes on medical devices, etc...but with tax credits to famlies up to 4 times the poverty level (about $88K...so many middle class families wont pay that tax)....and the least predictable of the remaining revenue is in the out years and from "savings" from greater efficiencies and technologies.....iffy.

The Senate takes a different approach with the tax on high end insurance plans, but it appears that will be modified to raise the level at which plans are taxed t0 the benefit of many middle class workers and add a 1% FICA tax on income over $200K.

Some have a problem with the top 1-2% of taxpayers bearing a large portion of the costs in new taxes. I dont have a problem with that at all.

This seems really confusing. Isn't $750 a bargain for every company? They quote the average cost of a family plan to be something like $12,000. I must be missing something here, but what?

What is accomplishes is to enable companies that are marginal in size (to big for the small pool and to small for cheaper policies provided through big companies) to end their own employer-plan and enter a plan with a larger pool of other small businesses....a bunch of companies pooling together can offer cheaper insurance that a single small/medium company alone....simply by having a greater number of people included, spreading the risk.

Oh an after attempting to read some of this bill, I strongly suggest anyone with any problems relating to insomnia to try reading it.

You have to be a policy wonk to really want to read the bill, but there are good section-by-section summaries.

My Voltaire reference..."the perfect is the enemy of the good"

Who doesnt want a perfect bill that provides both comprehensive insurance reform and reform of the delivery system...all w/o costs to taxpayers?

I'll take what I think is a good bill and build on that...because the political reality is that the perfect bill aint gonna happen......or "a half of loaf is better than none."

Will it work as envisioned? Probably not completely. No legislation this comprehensive plays out completely as planned...never has and never will. But IMO, it is a reasonable approach, with most costs covered, and a good chance that it will accomplish many of the goals.

Others disagree and neither side should be claiming they can predict the future. I dont think i have ever suggested it is a great bill (I have always said IMO, it is as good as I think it can be given the politics) or that it will be 100% successful and everyone will be happy and healthy. And, I have tried to explain it as I understand it.

And, IMO, it is bullshit for others to be screaming "failed" even before it is given a chance to succeed....or claiming that the "propaganda" or talking points are all on one side of the discussion here. That is dishonest to the point of being blatantly and purposefully ignorant (not referring to you).

Only time will tell.

Or..we can punt and put it off again as we have for the last 80+ years since Teddy Roosevelt first called for comprehensive health care reform for all Americans.

Originally Posted by classicman

You think they'll lose seats? I was just trying to read up on the latest regarding this. There seem to be a lot more R's retiring/leaving than D's.

Absolutely, the Ds will lose seats....nearly always happens in the mid-term elections in the first term of a president.

There are more R retirments in both the House and Senate, but more D senators up for re-election than Rs.

The 60 seat super majority in the Senate is definitely gone. If I were to predict now, the Ds will hold 54 or 55.

The Ds have a 40 seat cushion in the House and many are in historical R districts....it would be shocking if they lose the majority, but it will shrink significantly...losing 20 or more seats.

But alot can happen between now and November and much also depends on the Rs....if they run extremists candidates like the hard core base wants or the Tea Baggers run independent candidates and split the vote on the right, the loss to the Ds wont be that bad.

[TheMercenary]

Some damm good questions:

The Honorable Barack Obama

President of the United States

The White House

1600 Pennsylvania Ave, NW

Washington, D.C. 20500



Dear Mr. President,

I read with great interest press reports indicating that Administration officials and Democrat congressional leaders have struck a deal related to the so-called “Cadillac” tax on high cost health plans. Numerous press reports indicate that health insurance plans covering state and local government employees and plans for employees in collective bargaining agreements would be exempt from the tax until 2018, while individuals employed in the private sector that are not covered by union contracts would pay the tax as early as 2013 -- even if they have the exact same insurance coverage.



While the reported deal is bad enough for working Americans, I am concerned that the deal that was negotiated behind closed doors may also have been designed to benefit federal government officials and employees at the expense of other Americans. Specifically, I request that the Administration provide answers to the following questions prior to announcing any final agreement on a health care bill:



1. Will the health care plans offered to Members of Congress and Administration officials, including Cabinet officers, White House staff, and political appointees, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

2. Will the health care plans offered to federal employees, including over 382,000 employees making in excess of $100,000 a year, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

I regret that I am forced to send this letter. I do not believe it would be necessary if you and your Administration had televised the health care negotiations on C-SPAN, as you committed to during the campaign.



Sincerely,



Eric Cantor

http://www.politico.com/livepulse/01...tes_Obama.html