House Health Care Plan
The key committee chairmen put out an outline today of their approach to health care reform (more in-depth info here), and there's one thing they want you to know about it: "Uniquely American," said House Education and Labor Committee Chairman George Miller. Added Energy and Commerce's Henry Waxman: "Uniquely American." And what does former Energy and Commerce Chairman John Dingell like so much about it? "An American solution," he said.
But the insurance industry has a few reservations. Like this one: “We need a uniquely American approach to health care reform," warns Robert Zirkelbach, a spokesman for the trade lobby America's Health Insurance Plans.
Anyone who has followed this debate for more than 20 seconds will immediately recognize all this talk of unique Americanism as another way of saying not single payer, which is the government-financed system that just about every other industrialized country uses in one form or another. And all this skittishness about single payer explains the delicacy with which the House drafters have tried to finesse the question of whether their system will have a public plan, something like Medicare, but for people under 65.
The answer is, it will have a public plan, and a strong one--at first.
In the early stage, the public plan would reimburse health care providers at rates that are "similar to those used in Medicare"--that is, significantly lower than most private insurers pay them. This is something that the insurance industry, doctors and hospitals will all hate. “A government-run plan that pays based on Medicare rates – for any period of time – is a recipe for disaster," Scott P. Serota, president and Chief Executive Officer of the Blue Cross and Blue Shield Association, said in a statement issued by the association. "Already in some parts of the country nearly 30 percent of Medicare enrollees report that they cannot find doctors willing to accept new patients, due to below market rates. Rural hospitals, in particular, are struggling to keep their doors open. These low payment rates would threaten the quality of healthcare and undermine the improvements that we believe reform can bring to communities across the country."
Advocates would argue, on the other hand, that those lower rates could be a powerful engine to bring down health costs. Which is why they won't be happy with what happens next. According to the summary, this tie to Medicare rates would be "severed over time as more flexible payment systems are developed." In other words, this public plan would eventually evolve into something that looks--and competes--more like a private insurance company, albeit one that happens to be run by the government. At the news conference, I asked the committee chairmen precisely what that means--When would that happen? And under what circumstances? They couldn't tell me, and demurred that this is the kind of thing that still needs to be worked out. Waxman said it would take "a period of time" for the public plan to get started, but that "they will at some point compete."
The House committee chairmen are trying to have it both ways on the public plan. That might work--or might just end up satisfying no one.
Of course, the biggest thing that needs to be worked out is how they are going to pay for this bill, which they said would ultimately assure that 95% of Americans have health coverage. What they are looking at is a combination of reductions in Medicare and Medicaid spending and taxes. The Associated Press reports: "To pay for it all, House Democrats are considering everything from taxing soda to raising income taxes on people earning more than $200,000 to imposing a federal sales tax."
Until they figure that part out, all of this other stuff is written in smoke.
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KT:
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"Uniquely American"
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...as in "unique amongst the developed nations of the world, Americans pay the most, and yet get the least from their health care system"?
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Or "uniquely American" as in "unrecognizable to outside observers as a solution of any kind"?
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I just love it when Democrats speak the language of the rightists reflexively. I can't wait to give them more of my money! -
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KT:
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This is something that the insurance industry, doctors and hospitals will all hate.
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Awwwwww....I'm so upset for these people...
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Hey, can you remind me of something, KT:
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When the interests of ordinary people implacably collide with those of the professions, on who's side are the Representatives in the House supposed to be, again? -
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Kennedy kids have penchant for timing luxury oceanfront rehab stays with summer vacation season, taxpayers demand refund for time drunk.
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Obama declares 20 percent medical cost savings possible in first quarter of 2010 if most new cars equipped with No Kennedy Allowed device.
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Not that they are the most sympathetic bunch in the world, but I'm not understanding why everyones so surprised that doctors and insurerers are protesting a massive pay cut. If more people are to receive coverage the money has to come from somewhere. Apparently there are a bunch of people perfectly willing to stick it the Doctors. Perhaps they're overpaid, but you don't expect them to roll over and play dead while their meal ticket's being snatched away from them, do you?
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KT has been liveblogging on twitter today. Do follow her to stay up to date on health legislation.
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Also, I am starting to compile public option video--insurance horror stories, lying congresscritters, explanations. http://kroydblog.blogspot.com/
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Send along anything good you find to me at twitter jayackroyd or by email jay@ackroyd.org -
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PBS cancels plans for Bill Moyers Cocaine Kid Journal, will instead offer re-runs of coverage of latest Kennedy clanster hitting rehab tree.
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I like this idea, get a public plan in there, somehow, foot in the door, even if there is plans to phase it out. Every year, Congress makes a ritual of putting off a planned drop in Medicare reimbursement rates because they know that the public will freak out. I could see the same mentality for this public plan...get Republicans on the record every single year on how much they love government-run health care.
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[...] But, for the moment, this seems like good news. Update: More analysis from Ezra Klein and Karen Tumulty, who actually asked a question (a good one) at the press conference.--Jonathan [...]
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Mexico estimates up to 40 percent of drug war deaths directly linked to coke habit of Ashley Biden, CBS disturbed by lack of rape jokes.
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Karen
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a couple of days ago, I asked you why Baucus was setting the health reform agenda -- you said because the House leadership decided to let the Senate take the lead.
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So why, now that the Baucus has already poisoned the well, are House Democrats coming out with their own proposal? What changed -- are House members actually disgusted with what Baucus is doing, or is public pressure forcing the hand of House members? -
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President Newports offers compromise on universal slacker care, will ask Republicans to honor his mandatory insurance mandate on men and men-owned businesses down to 1 employee, in exchange for his vow to switch to Virginia Slims.
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"The insurance industry, doctors and hospitals will all" sleep easy, knowing the fix is in. The House will vote for something they can say next November they voted for, knowing full well the spineless weasels and self-interested whores across the rotunda will never let it become law. Even less chance in Hell the Cynate would pass increased taxes on their true constituents (the >$200K crowd) to pay for it.
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… and yippee skippee! A mere fifteen million Americans with no way to pay for health care even if this were to pass!
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Will this have at least the benefit of an honest face, i.e., the Epic Fail Imitation Health Care Reform Act of 2009? -
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Mothers Against Drunk Children to hold annual event at Kennedy cabana, this year's raffle prizes include used Oldsmobile and new SCUBA suit.
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well, pluk--setting aside for a moment the question of why you are even bothering to ask for any information from someone you called a "shill" earlier today--this is pretty much the time frame the House has been talking about all along. It is Baucus who has stumbled a bit on his. But it still looks like the House will be a step behind the Senate. Waxman says they will begin hearings on this bill next week, but he made no mention of a markup.
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Dirks
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One of the points ezra makes in the bloggerhead video I posted is that while doctors aren't happy with medicare reimbursement rates (about 20 percent less than private insurers, but with much less admin hassle) they don't have to accept those patients. In practice, they do. And, in practice, the huge increase in volume, especially for PCPs, associated with getting another 47 million people in the system offsets any loss related to price per visit. And a good plan would INCREASE PCP visit reimbursement. That is where the cost effective treatment happens.
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The only losers here are the people who are doing the damage, the insurers. Sure, they are gone fight to retain their government subsidized oligopolies. Sure, the plan they are going to advocate is one that increases the subsidy, by mandating participation, and using taxpayer dollars to subsidize the participation. But that destroys any possibility of cost containment, because it both retains the admin and profit to shareholders costs of the insurance industry and leaves doctor incentives aligned with overtreatment. That's why these "compromises" cost a fortune, because they don't bite the bullet. -
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Trial lawyers upset by lack of Hillary lawsuit against White House for latest trip and fall, may refer lack of case to UN and Hague and Jackson Browne.
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KT: Thanks for the thread and the info. If they're thinking we'll have a public plan "at first" then phase it out, I think they're in for a rude surprise. If the public gets a taste of a single payer system and likes it, there will be hell to pay at the polls if they think they can do away with it. The single payer system could very well become a new "third rail" in politics. That might be the plan all along. Say "single payer" is only temporary and then then tilt even more strongly toward it later when it has the backing of the public.
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I don't understand why they need a sales tax or a soda tax or any real kind of tax to pay for this. It's really simple: take the premiums I'm paying now, stop giving them to a private insurance company and instead give them to the government as a tax. Actually, take a slightly lower amount than the premiums I pay now since the government, without a profit motive, won't have to charge as much. Point is, you don't need any extra taxes, you just need to shift the money that's being extorted from us by insurance companies to the government.
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take the premiums I'm paying now, stop giving them to a private insurance company and instead give them to the government as a tax.
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That won't help cover the millions who are not currently paying any premiums or getting any care, which is sort of the point of the exercise. -
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Dirks:
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which is sort of the point of the exercise.
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With great respect as always, that is not the point of the exercise.
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The point isn't simply to help get the uninsured covered, the point is to help the tens of millions of people who pay into the current system finally get a good deal for their taxes, premium contributions and co-pays.
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It's not simply that we could lose our jobs and then be screwed without insurance, and therefore we must be "in solidarity" with our uninsured brethren.
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You know the drill: of the 65 percent of bankruptcies related to health crises, 80 percent of those bankrupted had insurance.
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The American health care consumer, i.e. everyone must see benefit in terms of their every day lives and futures made more secure (which of course includes the uninsured or soon to be uninsured), or this is a program that benefits the few at the top, i.e. industry, and the few at the bottom, i.e. those who qualify for assistance, and not the vast majority in between.
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Social Security isn't a program that only benefits people without pensions, and health care reform must have the same goals in terms of widely distributed advantages to health care consumers over their entire lives, otherwise it's (repeal-able) welfare.
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The point of the exercise is every consumer getting a better system for their hard-earned bucks, IMO. The problem to be solved is that Americans --that means everybody-- spend the most per capita in the world and get results for it that aren't nearly on par with those expenditures. -
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Paul Dirks: That won't help cover the millions who are not currently paying any premiums or getting any care...
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Well, it kinda does:The average U.S. family and their employers paid an extra $1,017 in health care premiums last year to compensate for the uninsured, according to a study to be released Thursday by an advocacy group for health care consumers.
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Families USA, which supports expanded health care coverage, found that about 37% of health care costs for people without insurance — or a total of $42.7 billion — went unpaid last year. That cost eventually was shifted to the insured through higher premiums, according to the group.However, there will be additional funding needed as well as some form of pricing control. Sin taxes and caps on the amounts charged for services.
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KT was called a "shrill." WTF people?
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Gunny, actually it was "shill" and see P-luk
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Stuart is right. The point is that the insurance companies are screwing the rest of us straight to the wall.
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I have private insurance. It costs me over $500 a month out of my take home pay. I know that if, God forbid, someone in my family became sick that they would cancel my coverage in a heart beat. They want my money. They don't want to provide coverage.
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Right now the insurance industry is screwing the individual consumers. Tomorrow they will be canceling the policies on bigger and bigger companies. They have already made it impossible for small businesses to offer health care for their employees.
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It is well past time for we - the citizens of the US - to band together in order to provide health care for ourselves. We already do that to provide police services, utilities, schools, and roads. Health care shouldn't be any different.
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Which is not to say that we should outlaw private insurance. Just as you can hire your own security forces or send your kids to private schools or build your own roads, you should be able to give away your hard earned dollars to scheming grifters like Blue Cross.
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