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Healthcare Reform Failure
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jsteele
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Based on what we hear is coming out of the Senate, healthcare reform has been Liebermanized into a disaster. The public option has been stripped, yet the personal mandate remains (I'm not sure the business mandate ever existed in this bill). So, anyone who doesn't have company-provided insurance will be forced to purchase it from the same companies that are currently increasing premiums at many times the rate of inflation. Great. The Democrats' healthcare plan can be summarized as "bend over".
Obama was most popular with the young. It will be exactly that group that will be forced to turn its hard-earned cash over to the likes of Cigna and Aetna. Guess which group of people will be unlikely to support Obama again? I really can't believe that the Democrats are so blind to the politics of this (well, actually, yes I can). I am also really disappointed by Obama's seemingly endless patience with Lieberman. What does the guy have to do before Obama gets pissed? Lieberman is single-handily destroying the future of the Democratic Party and all he gets from Obama is praise. Unbelievable. |
Anonymous
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Maybe the individual mandate (stick) should be replaced with a carrot (allowing insurers to offer basic plans across state lines, without having to craft specific plans to get approval of specific state insurance commissions)? And I mean basic - everyone doesn't need to buy plans that cover chiropractic, vision, etc. They should be available sure, but not wrapped into each plan by fiat.
I think it is time to sit down with a blank sheet of paper and start over. |
Anonymous
| Lieberman is starting to remind me more and more of Doug Wilder (prima donna ex-Va Governor, current Richmond mayor) every day. |
Anonymous
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This will not work without an individual mandate.
As far as the public option is concerned, why would anyone want more medicare, or anything like it? |
jsteele
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Why not?
Because medicare is extremely popular (notice that Republicans have suddenly become its biggest defenders) and very efficient with much lower administrative overhead (meaning more money going to care and no money going to outrageous executive compensation). The desirability of medicare is probably best illustrated by the elderly woman at one of town meetings last August who got up and said "keep the government out of my medicare". It's so ironic that medicare is the closest thing we have to single-payer, it's very popular, and it's practically the only option that Obama and his minions refused to consider. |
Anonymous
The downside is most MDs, particularly in specialties (cardiac, ortho, etc.) consistently report that Medicare reimbursement for many procedures does not pay for their cost to provide them. So the idea of expanding the Medicare covered population for them is a non-starter. And while your heart may not bleed for the doctor, it is logical to expect that they will take steps to either limit the number of Medicare patients they accept in their practice, or not accept them at all. If the overhead for your medical practice (rent, utilities, staff, supplies, MD compensation) is $250 an hour and Medicare only reimburses at $200 an hour, you would be crazy to keep doing this (I pulled the numbers out of my a$$ for illustration only). In this sense, the doctors themselves would begin to ration care and who receives it. Guess what? Private insured patients would go to the head of the line! Fine for me, not so much for my grandmother. If it was my grandma at the town meeting, she too would say Keep the govt. out of my medicare! |
jsteele
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Doctors report the exact same problem with private insurance. A few years back, I almost couldn't find a dentist that took my insurance. I finally went to one who did and quickly decided it was better to go to someone else and pay out of my pocket. I have no problem with increasing payment rates where it is justified. In addition, there is considerable medicare and medicaid fraud. I'd like to see a greater emphasis on combatting that. If the amount of fraud were reduced, perhaps payments could be increased and there would be a wash as far as overall costs were concerned. |
Anonymous
| Sounds like a good idea - lets see if Washington can make those ideas work before they add 10 or 20 million more beneficiaries. |
Anonymous
Agreed. This whole thing is so disappointing. And on the economic front, there's Larry Summers saying the recession is over. Really? I hadn't noticed. |
jsteele
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Well, it looks like it's over for the insurance industry (and the financial industry for that matter). |
Anonymous
Then they are probably full of $hit. 
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Anonymous
So true.
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Anonymous
Yes. Bend over for their greatest supporters - fat union contributors. The main reason that the Dems pushed for the Medicare age to be lowered to 55 was for the unions. It goes like this: Retiree medical for many union members is most expensive for those age 55 to 65. This is because most retiree medical plans provide that once a retiree becomes eligible for medicare, medicare becomes "primary" and the employer plan fills in the gap between the actual cost of the care and the medicare reimbursement. Most union retiree medical coverage would be considered a "Cadillac" plan under the proposed healthcare bill and taxed accordingly because these plans cover many retirees in the 55-65 age bracket. Accordingly, all retirees covered by the plan would then have to pay the excise tax because they receive medical coverage from a Cadillac plan - even those retirees that are medicare-eligible and not as expensive as the pre-Medicare retirees. I agree with you that I am pretty amazed that Sen. Lieberman has not been punished for his "transgressions" against the party he caucuses with, but I think he got this one right. There is no sense adding more folks to a system that needs serious reform. |
Anonymous
| It won't work without the mandate because without the young and healthy workers paying into the system, there will be noone to subsidize the sick. And we are not in need of more medicare because it's a poorly run system that is insolvent and fails to adequately compensate providers. |
Anonymous
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Howard Dean's op-ed today in the WaPo calls for the health care reform plan currently in the Senate to fail. I mostly agree with his points, but need some help with one.
He complains that seniors pay 3x the insurance rates of younger, healthier individuals - why is that wrong? If I have a car accident and a DUI my car insurance will skyrocket - or be canceled while the driver in the car next to me with a spotless record pays a whole lot less. This makes sense, because it is a risk assessment. I can assure you that my mother uses far more than 3x the medical services in a year than I do - probably closer to 10x. I can see capping the spread - but capping it less than 3x seems foolish, and seriously penalizes the younger or healthier individuals whose rates go up to cover the "my mothers" of this world who, because of lifestyle choices and poor luck consume enormous amounts of health care resources. |