Why the Health Care Rush?

[shagdrum]

So, in an effort to stimulate the economy we are going to increase taxes on the job makes to pay for everyone's insurance? Yeah, that makes economic sense.

 

[04SCTLS]

These proposals are trial balloons at this point.

 

[shagdrum]

Yep, and any way you slice it, they are going to hurt the economy. Weather punishing job creators and thus hurting prosperity, taking away more money from everyone and hurting economic growth, forcing businesses to give every employee healthcare and giving the business incentive to lay-off employees (increasing unemployment and hurting economic growth). Yet this is all under the auspices of reviving the economy. It is double speak, nothing more. The reasoning behind it is disingenuous and the economics of it don't add up.

 

[shagdrum]

Understanding the Kennedy health care bill

Over the weekend a draft of Senator Kennedy’s (D-MA) health care bill leaked. After playing with Adobe Acrobat, here is the text of the draft Kennedy bill as a text file (173 K), and as a single Acrobat file (3.4 MB). Unlike the leaked version, both of these are searchable.

Calling it the “Kennedy” bill is something of an overstatement. Senator Kennedy chairs the Senate Health, Education, Labor, and Pensions committee, and his staff wrote the draft. By all reports, however, Chairman Kennedy’s health is preventing him from being heavily involved in the drafting. Senator Reid has designated Senator Chris Dodd (D-CT) to supervise the process, but as best I can tell, it’s really the Kennedy committee staff who are making most of the key decisions. For now I will call it the Kennedy-Dodd bill.

As the committee staff emphasized to the press after the leak, this is an interim draft. I assume things will move around over the next several weeks as discussions among Senators and their staffs continue. This is therefore far from a final product, but it provides a useful insight into current thinking among some key Senate Democrats.

Here are 15 things to know about the draft Kennedy-Dodd health bill.

1. The Kennedy-Dodd bill would create an individual mandate requiring you to buy a “qualified” health insurance plan, as defined by the government. If you don’t have “qualified” health insurance for a given month, you will pay a new Federal tax. Incredibly, the amount and structure of this new tax is left to the discretion of the Secretaries of Treasury and Health and Human Services (HHS), whose only guidance is “to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”
2. The bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.
3. In the Kennedy-Dodd bill, the government would define a qualified plan:
   • # All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.
   • A qualified plan would have to meet one of three levels of standardized cost-sharing defined by the government, “gold, silver, and bronze.” Details TBD.
   • Plans would be required to cover a list of preventive services approved by the Federal government.
   • A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.
   • The MAC would also define what “affordable and available coverage” is for different income levels, affecting who has to pay the tax if they don’t buy health insurance. The MAC’s rules would go into effect unless Congress passed a joint resolution (under a fast-track process) to turn them off.
4. Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.
5. Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.
6. # The bill would expand Medicaid to cover everyone up to 150% of poverty, with the Federal government paying all incremental costs (no State share). This means adding childless adults with income below 150% of the poverty line.
7. People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.
8. # People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area
9. There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.
10. Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.
11. States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.
12. Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.
13. # The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.
14. # The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”
15. The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

This would have severe effects on the more than 100 million Americans who have private health insurance today:

• The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”
• Health insurance premiums would rise as a result of the law, meaning lower wages.
• A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.
• You would find a tremendous new disincentive to switch jobs, because your new health insurance may be subject to the new rules and would therefore be significantly more expensive.
• Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.
• Far more than half of all Americans would be eligible for subsidies, but we have not yet been told who would pay the bill.
• The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.
• The Secretary of HHS could mandate that you provide him or her with “any such other information as [he/she] may prescribe.”

I strongly oppose this bill.

 

[foxpaws]

So, what do you do - you get in touch with your representatives and senators and tell them what you think. Do not email them - write them a letter, and if possible have multiple people sign it. A family unit works well for this.

"My family, including my Mom, Tracy, my Dad, David and my 3 brothers, Tom, Dick and Harry, all want you to know how we are worried about the consequences of the Kennedy/Dodd healthcare bill."

After this list your concerns, with personal information. Things like stating you are worried that your current health plan will become unaffordable, that you are worried about the additional debt that this country cannot afford, that you think that this (fill in the blank) type of solution should be looked at. That you feel this could bring hardship on your family - and why...

Make it personal, and make sure you do it quickly, and to each member of congress from your state, as well as the committee heads.

Many points in the Kennedy/Dodd bill are really terrible... and hopefully it won't get out of committee... but, with the Kennedy name attached it has a chance, that is why if you don't like the bill, you need to act right away.

 

[fossten]

The private healthcare system is too flawed to continue.

It's nothing compared to the disaster that will be Obamacare. Government healthcare is far, far worse.

 

[shagdrum]

It should also be pointed out that we haven't had a "private healthcare system" in this country for generations; at least not since medicare and medicaid (if not earlier) could the healthcare system in this county be considered "private". It is, at best, a hybrid between private and socialized.

 

[shagdrum]

So, what do you do - you get in touch with your representatives and senators and tell them what you think. Do not email them - write them a letter, and if possible have multiple people sign it. A family unit works well for this.

"My family, including my Mom, Tracy, my Dad, David and my 3 brothers, Tom, Dick and Harry, all want you to know how we are worried about the consequences of the Kennedy/Dodd healthcare bill."

After this list your concerns, with personal information. Things like stating you are worried that your current health plan will become unaffordable, that you are worried about the additional debt that this country cannot afford, that you think that this (fill in the blank) type of solution should be looked at. That you feel this could bring hardship on your family - and why...

Make it personal, and make sure you do it quickly, and to each member of congress from your state, as well as the committee heads.

Many points in the Kennedy/Dodd bill are really terrible... and hopefully it won't get out of committee... but, with the Kennedy name attached it has a chance, that is why if you don't like the bill, you need to act right away.

That is a real good suggestion. Are you a not a fan of this bill?

 

[foxpaws]

That is a real good suggestion. Are you a not a fan of this bill?

There are parts of it I have a lot of difficulty with... the system is in trouble now, this bill would only make what is bad worse... and not fix what needs fixing.

 

[shagdrum]

There are parts of it I have a lot of difficulty with... the system is in trouble now, this bill would only make what is bad worse... and not fix what needs fixing.

What, specifically don't you like about it?

 

[fossten]

What, specifically don't you like about it?

It doesn't take over the private sector quite enough. Remember, fox said a while back, Capitalism has had a good run, but now is time for a change.

 

[topher5150]

did you hear what the brilliant Ted Kennedy proposed: MANDATORY health car (you must have health care or be fined) government will be competing directly with private insurance companies, and the icing on the cake ONE TRILLION DOLLARS of non existent tax payer money
ted Kennedy go :q:q:q:q your self you fat :q:q:q:qing wino

 

[foxpaws]

It doesn't take over the private sector quite enough. Remember, fox said a while back, Capitalism has had a good run, but now is time for a change.

Wow - this is great - Shag asks me a question and Foss answers for me...

This will be easy!!

 

[shagdrum]

Government insurance will kill private insurance

Democrats have taken great care to make the new health-care plans hitting the House and Senate this week look like anything but single-payer, socialized medicine. They insist that they want to maintain the private insurers in the market and give Americans choices in coverage. However, by pushing for a government-run plan to “keep insurers honest,” they have created a Trojan horse for socialized medicine, as Ronald Baily explains at Reason:

In his weekly radio address on Saturday, President Barack Obama declared that “it’s time to deliver” on health care reform. In a letter to Sen. Edward Kennedy (D-Mass.) and Sen. Max Baucus (D-Mont.), President Obama wrote, “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.” This week Sen. Kennedy released a draft of his proposed “American Health Choices Act” which includes one such optional public health insurance plan. The administration’s goal is to report that bill out of the relevant Senate committees by the end of this month.

Earlier this week, Republican lawmakers sent a letter of their own, strongly warning the president that “Washington-run programs undermine market-based competition through their ability to impose price controls and shift costs to other purchasers. Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition.”​

When have we seen this before? Oh, yes … Medicare:

Defenders of the public option quickly point out that Kennedy’s American Health Choices Act promises to pay health care providers 10 percent more than Medicare. But as the Cato Institute’s Michael Tanner noted at Cato@Liberty, “When Medicare began, proponents promised it would reimburse at the same rate as insurance. That promise didn’t last long.” In fact, in his letter to Kennedy and Baucus, Obama explicitly endorsed the idea of setting mandatory physician and hospital reimbursement rates through the Medicare Payment Advisory Commission. In other words, the payments would no longer be merely advisory.​

Government doesn’t exist to turn a profit, nor does it face competition. That’s why, in part, government operates so inefficiently. We put up with that in certain areas, like the military, because we don’t want private groups arming themselves with tanks, bombers, and armies and navies. In most other areas, we prefer the private sector, as competition usually gets us the best products and services at the best prices.

Government exists to service its interests, at least in its present form. Mostly, it serves to further itself. Any government bureaucracy that sees danger in competition will work to eliminate it. The dynamic in health-care plans would not be government making private insurers “more honest”, but in squeezing them out of the marketplace to create a monopoly. Since government doesn’t have to show a profit to exist, it will simply low-ball the other insurers on price until they all drop out of the health-care field. In an ironic way, it’s similar to how Standard Oil built its monopoly, which the government had to bust in order to get real choice and competition in the gasoline market.

Any public option offered by the government will be nothing more than a virus at the heart of the plan, through which the statists can push through a single-payer national health care system, and it won’t take that long to get it. Once the insurers understand the dynamic, they will run away from their health-care plans at lightning speed, leaving the field to Medicare, or whatever new name the Left dreams up for it.

 

[shagdrum]

Health care a stalking horse for nanny-state restrictions

When government pays the bills for health care, it gains an important lever of power in dictating personal choices of living for all its citizens. Don’t think that has escaped the notice of Barack Obama and the Democrats. Politico notes that the autocrats have gotten a big boost in Washington and are preparing to dictate your food and leisure choices in the name of cutting health-care costs:

Don’t be fooled by the presidential burger runs. Obama and Congress are moving across several fronts to give government a central role in making America healthier — raising expectations among public health experts of a new era of activism unlike any before.

Any health care reform plan that Obama signs is almost certain to call for nutrition counseling, obesity screenings and wellness programs at workplaces and community centers. He wants more time in the school day for physical fitness, more nutritious school lunches and more bike paths, walking paths and grocery stores in underserved areas.

The president is filling top posts at Health and Human Services with officials who, in their previous jobs, outlawed trans fats, banned public smoking or required restaurants to provide a calorie count with that slice of banana cream pie.

Even Congress is getting into the act, giving serious consideration to taxing sugary drinks and alcohol to help pay for the overhaul.​

Supporters of Obama will say at this point, “What’s wrong with healthier eating and more exercise?” Nothing at all. Schools should put more emphasis on physical education, especially on cardiovascular exercise and health education. Americans would do better to consume fewer carbohydrates, especially from high-fructose corn syrup and sugar, and eat more vegetables and fruits, along with lean meat and other sources of protein.

But for adult Americans, that should be their own choice. We used to have an interesting concept in this country: none of your business. What did your neighbors eat for dinner? None of your business. When was the last time your neighbors took a walk? None of your business. How much did they spend on doctors’ bills last year? None of your business.

However, once we all start footing those doctors’ bills, it becomes our business — and that of the government. Surrendering to a single-payer system means surrendering a right to choice and privacy. Abdicating individual responsibility for their own costs creates an impetus for the growth of government to fill that vacuum, and it’s hard not to believe it isn’t by design. The HHS officials Obama appointed have long track records of autocratic diktats, the very kind of elitism that Obama claimed not to endorse during the presidential campaign.

How long before Obama appoints a Health Practices Czar to issue these kinds of mandates? Don’t be surprised if it becomes part of the current health-care reform bill Congress will produce this year.

 

[shagdrum]

YouTube - The Public Plan Deception - It's Not About Choice