Tag: Health Plans

Health Reform–Revisited

After a year of health reform back and forth….after a year of lies and misinformation…after a year of name calling and insults……after a year of political jockeying…….after a year of total Hell in Washington…..we have a health reform law…..that is NOT good enough states are trying to sue the government to stop the law….but all the while are preparing to implement the law….

The Dems have gone on the air and taunted the benefits of the law…..have talked about the victory for the people….but is it everything good that the Dems have echoed?  Is it all that and a bag of chips?

According to the Politico’s Jennifer Haberkorn:

Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama’s reforms.

Under the provision, insurance companies will no longer be able to apply broad annual caps on the amount of money they pay out on health policies. Employer groups say the ban could essentially wipe out a niche insurance market that many part-time workers and retail and restaurant employees have come to rely on.

This market’s limited-benefit plans, also called mini-med plans, are priced low because they can, among other things, restrict the number of covered doctor visits or impose a maximum on insurance payouts in a year. The plans are commonly offered by retail or restaurant companies to low-wage workers who cannot afford more expensive, comprehensive coverage.

Obama and his cronies have told us all about the millions that will now have health care…..they left out the part where some people could lose their plan altogether..

Where Is Health Reform Headed?

Now that the weather in Washington has cooled off, (is that because the hot air from politicians is missing?), and all the heated rhetoric of health reform has been silenced by some moronic words uttered by yet another dipstick politician……but what does it look like the final product, if they manage that, will look like?

The public option is pretty much dead, it has one foot in the grave and the other on a banana peel, and that the senate bill maybe the final curtain call for health reform…..

Senior House Democrats have largely abandoned hopes of including a government-run insurance option in the final compromise health care bill taking shape, according to several officials, and are pushing for other measures to rein in private insurers.

They also want the final measure to include a House-passed proposal for a nationwide insurance exchange, to be regulated by the federal government, where consumers could shop for private coverage. The Senate bill calls for a state-based system of exchanges.

Additionally, House Democrats want to require insurers to spend a minimum amount of premium income on benefits, thereby limiting what is available for salaries, bonuses, advertising and other items. The House bill sets the floor at 85 percent; the Senate-passed measure lowers it to 80 percent for policies sold to small groups and individuals.

So it looks more and more like the exchange idea will prevail….but what the hell is it?

This is how people would buy insurance if they don’t have an employer that provides it. The structure is complicated, but these exchanges would basically be run by each state in conjunction with the federal government, and states would be allowed to create additional mechanisms for offering insurance to their residents. Traditional insurance companies would be allowed to compete for customers through the exchanges, provided they met a set of requirements set by the federal government. The least expensive plans would offer catastrophic coverage only, and not be available to everyone. There would be several other levels of coverage, priced more for each bump-up in benefits. The exchanges would go into effect in 2014. The House bill includes similar reforms, although there would be an additional health-insurance exchange at the national level. And the public health-insurance plan (not included in the Senate bill) would compete with private plans on each of the exchanges.The Senate bill proposes to create state-based exchanges, while the House bill would create one national exchange. Consumers who don’t get health insurance through their employer or a government insurance program would be eligible to shop on the exchange for plans. Low- and middle-income people who shop on the exchange would be eligible for government subsidies to help them buy their insurance plan.

Both the House and Senate bills would provide $5 billion to create a temporary insurance pool until an insurance exchange is up and running. Under the House bill, this program would be available to people who have a preexisting condition or have been uninsured for at least six months. Under the Senate bill, individuals would have to meet both requirements to be eligible. The House pool would open immediately and the Senate pool would open within 90 days of the bill’s enactment. Both pools would set limits on the premiums and cost-sharing that individuals would have to pay.

And there you have the newest piece of…………sorry had to find a word that would offend others…….work from the people who brought you the Patriot Act. About the only people that will benefit largely from this piece of….work….is the insurance industry…they will have mandated 30 million  new customers that they can screw over endlessly….sorry people but with this you will get the best health care that the industry wants to give….not what you need….are you proud of this yet?

Are There Other Health Ideas?

We have heard all the clap trap about the Dems and we have have heard the plan from the Repubs…wait…my bad there is no plan coming from the Repubs……but there are others out there that have plans…..some pretty good some not so…..but at least they are trying to find a balance….

“A Better Way To Health Reform” written by Martin Feldstein in the WaPo….excerpts quoted below:

A good health insurance system should 1) guarantee that everyone can obtain appropriate care even when the price of that care is very high and 2) prevent the financial hardship or personal bankruptcy that can now result from large medical bills

A good system should not try to pay all health-care bills. That would lead to excessive demand, wasteful use of expensive technology and, inevitably, rationing in which health-care decisions are taken away from patients and their physicians. Countries that provide health care to all are forced to deny some treatments and diagnostic tests that most Americans have come to expect.

Here’s a better alternative. Let’s scrap the $220 billion annual health insurance tax subsidy, which is often used to buy the wrong kind of insurance, and use those budget dollars to provide insurance that protects American families from health costs that exceed 15 percent of their income.

Specifically, the government would give each individual or family a voucher that would permit taxpayers to buy a policy from a private insurer that would pay all allowable health costs in excess of 15 percent of the family’s income. A typical American family with income of $50,000 would be eligible for a voucher worth about $3,500, the actuarial cost of a policy that would pay all of that family’s health bills in excess of $7,500 a year.

The family could give this $3,500 voucher to any insurance company or health maintenance organization, including the provider of the individual’s current employer-based insurance plan. Some families would choose the simple option of paying out of pocket for the care up to that 15 percent threshold. Others would want to reduce the maximum potential out-of-pocket cost to less than 15 percent of income and would pay a premium to the insurance company to expand their coverage. Some families might want to use the voucher to pay for membership in a health maintenance organization. Each option would provide a discipline on demand that would help to limit the rise in health-care costs.

Two related problems remain. First, how would families find the cash to pay for large medical and hospital bills that fall under the 15 percent limit? While it would be reasonable for a family that earns $50,000 a year to save to be prepared to pay a health bill of, say, $5,000, what if a family without savings is suddenly hit with such a large hospital bill? Second, how would doctors and hospitals be confident that patients with the new high deductibles will pay their bills?The simplest solution would be for the government to issue a health-care credit card to every family along with the insurance voucher. The credit card would allow the family to charge any medical expenses below the deductible limit, or 15 percent of adjusted gross income. (With its information on card holders, the government is in a good position to be repaid or garnish wages if necessary.) No one would be required to use such a credit card. Individuals could pay cash at the time of care, could use a personal credit card or could arrange credit directly from the provider. But the government-issued credit card would be a back-up to reassure patients and providers that they would always be able to pay.

I am not endorsing what Mr. Feldstein is saying, but at least he has some ideas…which is more than we can say for a wealth of people on the Right.

What the final bill will look like is anyone’s guess….but I would almost bet that it will look nothing like a real “public option”…..most likely some pale imitation of the original concept…….but I think that ALL viable conceptions and solutions should get their day and then the best of ALL should be the final bill…..it is that simple….no need to turn it into rocket science….

More Republican Health Proposals

The following is from a group calling itself “Republican Main Street Partnership” has offered up what it calls “Principles Of Reform:

1) Preserve, protect and strengthen the private system of healthcare and the private system of health insurance. To do so, we must oppose any proposal that provides for a “government option.”

2) Shift our emphasis from the current “treatment paradigm” to one that focuses on the prevention of illness and disease.

3) Work to lower healthcare costs across the system. We should make lowering the cost of healthcare a priority.

4) Eliminate fraud and waste in both the public and private healthcare systems. Fraud in the Medicare and Medicaid systems alone costs taxpayers billions of dollars each year.

5) Enact meaningful tort reform that protects patients but at the same time ends the abuse of frivolous lawsuits brought by unscrupulous trial lawyers. The current system fails both patients and providers.

6) Harness 21st century technologies and innovation. Health information technology, for example, can save money and save lives.

7) Encourage cutting edge research and the development of new life-saving and life-extending treatments by updating the research and development tax credit and making it permanent.

8) Empower individuals to have more control over their healthcare decisions.

9) Encourage competition across the healthcare system to help lower costs and improve quality of care.

10) Prioritize federal healthcare dollars – eliminate wasteful, inefficient or unrelated spending in Healthcare Appropriations bills.

These principles sound a lot like the proposals that were given out by the GOP in recent news releases.  But who are the Repubs Main Street Partnership?

Republican Main Street Partnership (RMSP) is dedicated to promoting and building a pragmatic, thoughtful, fiscally conservative, and inclusive “Governing Majority,” where political debate is encouraged to promote solutions to improve the lives of all Americans. Embracing the full spectrum of center-right ideologies and values in order to build coalitions.

Impressive sounding bunch, huh?



The Baucus Health Plan

Or should we call it the “Gang of 6” health plan?

Talkingpointsmemo.com has published the summary of the health plan:

Key Features of the Plan

  • No Public insurance option. This was anticipated the Baucus plan relies on non-profit health insurance cooperatives to compete with private, for-profit, insurance companies.
  • Mandated Health Coverage.  Almost all Americans will be required to carry health insurance.
  • Tax credits to lower and middle income Americans. The plan is to use tax credits as  the method of subsidizing people who will now be required to purchase health insurance but unable to afford the full cost.
  • Increased federal support of Medicaid.  More people will be added to the Medicaid rolls by expanding the program to citizens and legal immigrants to those who earn less than 133% of the current federal poverty level.
  • Healthcare insurance exchanges. The exchanges would provide information allowing consumers to better make decisions on policies and compare prices between plans.
  • Prevents Insurance Companies from discriminating against individuals based on their health or demographic profile, and from capping coverage
  • Limits “out of pocket expenses” for health care to $6,000 per individual, and $12,000 per family.
  • No denial of coverage for pre-existing health conditions.  This is only possible if insurance is required for everyone.
  • Eliminates expense cap on healthcare coverage, often insurance companies have a lifetime “Cap” on the total amount they will spend on a patient, the Baucus Plan eliminates that cap.
  • No dropping insurance coverage once a policy holder becomes ill.
  • Coverage of wellness and prevention programs becomes the focus of health plans with greater coverage for those programs

Paying for the plan includes

  • New tax on insurance companies. Reform would be financed by a combination of a new tax on insurance companies who offer high end insurance plans and a fee based on market share.  This is estimated to generate $200 billion in the tax, and $100 billion in fees.
  • Cuts in Medicare — $400 billion will come from cuts and savings in the current Medicare program this includes payments to hospitals and physicians.

The bill was swiftly denounced by Senate Minority Leader Mitch McConnell, who complained it would cut Medicare, which provides insurance to the elderly, and impose new tax burdens on families and small businesses.

Should not that be championed?  The Repubs have been trying to kill Medicare for decades….but now it is a concern to them with the issuing of this plan.

Sorry Progressives…ain’t happening…there is NO public option mentioned in this plan, by the way a plan from a Dem that takes large sums of the health and insurance industries.

Now we will see just how gutless the Dems are…will they jump on this as a victory or will they fight for the option they have been championing all through the primaries and the subsequent election.

Now the slicing and dicing….the practice known as the “mark up” begins….the Senate bills will be played with until they have one bill and then it will go to the floor of the Senate for a vote……I can only imagine the games that will be played now.