Health Care & Teabaggers: the War Against an Abstraction
by Bruce Webb
Whence Teabaggery?
Opponents of Health Care Reform vow to keep up their efforts and sweep Republicans to victory in November. But where do they take their stand? Up to now they have been opposing potential legislation that existed mostly in their own imagination: Socialized Medicine, Obamacare, Government Bureaucrats between You and Your Doctor. But now that the die is cast, because in the bigger picture the reconciliation bill is just tinkering around the edges, what will actually change for the average Teabagger?
Will they have to get government approval to see a doctor? Well no. Will there be dramatic changes in their out of pocket expenses? Well no, if anything the change will be in the other direction. Will insurance or the hospital start denying them categories of care? Well no, same thing. The fact is that if you already have insurance, and from the looks of most of the Teabag crowd they already do, you will see zero change between now and November. At least negative change.
Will the passage of Obamacare put us on the path to Socialized Medicine? Well maybe, personally I believe that the changes in this bill will over the long-term drive change in that direction. But will anyone notice any big changes in the interim? Well no. And what changes they do notice will be positive, at least in the short run, because the sweeteners in the bill are front-loaded. More under the fold.
I know a young bartender in a Chinese restaurant that has a congenital condition in her leg. Nothing particularly disabling but enough to prevent her from buying insurance in the private market, like almost everyone in the hospitality industry except workers in big hotels she is on her own, if she gets sick enough to need to see a doctor it means cash payment at the Walk-In Clinic or a trip 20 miles North to the only Free Clinic in our area. Now if she gets really sick she is lucky enough to live in a city where the two main hospitals are operated by the Sisters of Providence who have an excellent record of writing off the costs of hospital stays for those who can’t afford to pay, God Bless the Nuns, but unless that case of flu has progressed to pneumonia my bartender is relying on tips to pay off the doctor.
Well under this bill she has some near immediate options. It establishes a High Risk Pool plan which would allow her to buy insurance that would cover her congenital condition and any illness that would require hospitalization. Given her income level she might not be able to afford the unsubsidized premiums, but then she has family that would probably help if the interim, her Dad has a new job as a government lawyer in DC and could probably throw some dollars her way until the Exchange and its subsidies kick in, whereas right now she couldn’t get insurance coverage at any price. And she is not alone here, I am in that same category, insurance companies would simply laugh if I applied. Under this new bill and right away, if you apply for insurance through a private company and are denied, or are offered insurance at an unaffordable rate you will be eligible for the new High Risk Pool. Yes it will be expensive and no maybe you won’t be able to afford it normally but if it comes right down to it that insurance will be available.
I suppose there may be a teabagger or two who doesn’t know anyone in the position of my bartender friend or me, who doesn’t know someone working in a service job or at a store making too much to qualify for Medicaid but not enough to pay for insurance. Maybe some of these people have never walked past a collection jar on the counter raising funds for an otherwise unaffordable operation for some local kid, never heard an appeal for donations for a fellow church-goer, but somehow I doubt it, when you lower this to the concrete level it is not all about giving health care to brown people in the inner city, in fact many of those people have access to health care, it is about people they rub shoulders against every day.
The Republican Party is betting that its supporters will remain white-hot over an abstraction that will have little to zero impact on their own lives but will have huge positive impacts on people in their own communities. If you are middle class and insured you will probably see no changes at all in the next six months, on the other hand the waitress down at the cafe might be able to finally enroll in a health plan. Or you might finally be able to consider the possibility of an early retirement rather than holding onto your job waiting for Medicare to kick in. How long will Boehner and Beck, themselves wealthy white men with health care paid for, be able to whip people up over abstractions like ‘Obamacare’ in the face of day to day reality?
Bruce,
Your entire post highlights the lie of the democrat healthcare bill. They sold it on cutting costs and all you’re talking about is spending more. A bill sold on a lie is subject to revision.
Another point is that as the bill was being crafted it seems it set out to try to bankrupt insurance companies. However, a needed element to achieve this was the public option. As the plan drove up the cost of private insurance people would have switched to the lower cost public opinion with the low cost achieved cherry picking the young and tax subsidies. The public option was the road to socialism. However, republicans blocked it with the help of a few democrats. Without the public options I think the healthcare plan changes from the road to socialism to the road to nowhere. Nowhere is also subject to revision.
As Bruce’s post implies, but does not clearly state, the reform is only about the payment for health services. The bill has virtually nothiing to do with the practice of, or the provision of, health care itself. Nothiing changes in the health care provider industry except that more people will now have access to those services. For most people we will choose our doctors and service providers as we have always done. For some others they will now be able to see a doctor or go to a hospital.
People like Beck and Boehner have been peddling out right lies and misinformation to the public. Beck is often ridiculed for doing so. Boehner should be censured for doing so in his role as a member of the Congress. Free speech doesn’t allow for dishonest representation.
Bruce
thank god for Cantab and insight into the Republican mind. They will find something to be outraged about.
But my bet is that requiring people to buy insurance from organized crime is going to stick in the craw of more people than will bless the government for finally being able to get insurance at any price.
my guess is the 40 million uninsured include 39 million who don’t think they need it, and 900 thousand who are pretty sure someone else should have to pay for it.
a straightforward tax would go down easier. heck, i am almost thinking that FDR was wrong and that “insurance for workers paid for by workers” is not a political sure thing. today’s breed of “worker” still wants someone else to pay for it. a general tax would have the advantage of the only people noticing the tax would be the usual government haters. and everyone else would just be glad to have the insurance, thinking they were entitled.
The unknown here is how the currently insured will react. Most people have insurance and they have been in favor of some sort of reform. Your post appears to assume that their issue is people they know who don’t have insurance. I think it’s the insecurity of the insurance they have. With co-pays running 20% to 30% and arcane gotchas! about in-network and out-of-network and approvals and denial of claims for inexplicable reasons, people with pretty good insurance can end up with just horrendous medical bills. And those bills come in slowly over the months. You just don’t know what an interaction with the medical services industry is going to end up costing you. And I don’t see that this bill does anything about that — there appear to be few or no enforcement mechanisms to correct the insurance corporations’ illegal practices.
If people think this has changed and find out that it hasn’t, there’ll be some anger, especially if the usual “government is giving my money to those people” meme kicks in. In short, I’d be willing to give better than even odds that this will advance the “government is useless” idea for a lot of people.
While it’s sure there will be little change between now and November, none of the Republican rhetoric that I have heard bears any resemblance to what the fact based community would recognize. The key method for the teabaggers and conservative politicos in general has been to appeal to the subconscious fears and cultural anxieties of their constituents. Finding that fear and exploiting it is so easy for them, that the real work of running the country will always look a bit pathetic compared to the facility of the mind to create and exploit false connections. Practically we need another round of healthcare reform to assure that lower costs can be achieved. Nothing in the Republican agenda addresses that either by way of policy or criticism.
Traditions?
Like Health Insurance companies accepting payment for a promise to later pay for a service and when said service becomes necessary, denying or delaying payment for such service? Thats a tradition we can do without and thankfully (no thanks to a single republican) we will soon no longer have to bare the repercussions of such “traditions”.
This will save at least at least the 2500 per family when you realize that insurance companies will no longer be able to cap your lifetime payouts, will limit your out of pocket expenses and can no longer say bye bye when you have too expensive a bill. Requiring that they pay at least 80% of their premium collections to healthcare or refund the customers will be a savings as well. Will we spend less on health care? Not likely. Will we get more “health care” and less into bonus pools? Definitely.
So in one sense you are right. We unlikely will spend less on health care as individuals but there will be a lot fewer people (eventually none) who go bankrupt from medical bills and the people seeking only expensive health care when they are deathly ill will also diminish.
Fire insurance doesnt lower the cost of houses burning down but no one would argue that fire insurance is not a great thing and EVERY mortgage requires you to own it. Fire insurance and all the codes that are enforced to make houses burning down less likely probably cost all of us a lot, (they certainly dont save us any money) but they are certainly a cost worth paying. Health insurance is finally reaching that level.
The question is when Lincolns observation about fooling people will kick in further “you can fool all the people some of the time, and some of the people all the time, but you can’t fool all the people all the time” The teabaggers fear that the country is becoming one they did not grow up in partly because whites will no longer be a majority. The American (know nothing) party in the 1850 represented the fear that catholics and immagrants were going to take over. Recall that after blacks the KKK was after Catholics Jews and southern european immigrants. I contend that every generation reaches an age where the younger generation begins to influence the country in ways the older does not like. Lots of older folks did not like the changes of the 1960s and now the folks who brought the changes of the 1960s are having changes shoved on them.
Bowery Bum,
Practically we need another round of healthcare reform to assure that lower costs can be achieved.
This looks to me that those in the “fact based community” know that Obam’s promise to lower healthcare costs is one big pile of BS. If not you we not need another round to achieve the main stated objective of healthcare reform. Anyway, there won’t be another round. They told us their bill would work, not its show me the money time.
Cantab. YOU LIE.
The original bills were mostly sold with the twin A’s: Access and Affordability. Cost control only became the focus when Obama and Reid foolishly acceded to Republican demands for a hard cost limit under $1 trillion and turned control over to the Centrists and Conservatives that made up the Gang of Seven turned Six on the Senate Finance Committee. You tire me, I already alerted Dan and the other Bears that your comments on my posts are subject to deletion at my whim. And starting off with Ad Homs is not the way to stay around. And NO there is no symmetry involved, start your own blog and set whatever rules you like against whoever you like.
And you don’t bankrupt companies who made record profits last year or who like Aetna bragged in their conference call to shareholders about their plan to dump 600,000 policy holders in order to boost margins. And if you do, fuck ’em, if they can’t compete under MLRs that are lower than the ones they did in the past don’t come whining to us, we didn’t make these companies transform from being mutual insurers whose fiduciary responsibilities were to policy holders to for-profit companies responsible only to shareholders, if their existence doesn’t serve the overall public interest we have no reason to care.
Did Cantab say something?
“my guess is the 40 million uninsured include 39 million who don’t think they need it,”
Dale your guess is dead wrong. I have never met anyone over the age of 30 who doesn’t think they need health insurance and certainly no parents. And it is 50 million uninsured.
As you travel around your town look around you and realize that every sixth man, woman and child is statistically likely to be without medical insurance. Do they all look like happy, carefree Invincibles who KNOW they will never get the flu, never crash a car, never have a kid get sick?
Well I see plenty of controls over how the insurance companies operate in this bill with the most important piece being the mandated minimum MLR.
But there are also significant rules about what care has to be covered and what if anything constitutes fraud. Plus there are strict limits on total out of pocket charges per family per year, effectively medical bankruptcy is an impossibility for almost anyone under this bill.
So I’d take that bet. For a start you have to realize that fully half of those projected to get coverage under the bill will do so under government plans that mostly don’t demand co-pays to start with.
Bruce, how wtong can you be??? Saying this: “The Republican Party is betting that its supporters will remain white-hot over an abstraction that will have little to zero impact on their own lives but will have huge positive impacts on people in their own communities. If you are middle class and insured you will probably see no changes at all in the next six months,…” is just the opposite of what the Dem pol have been hoping for. There will be little to no constituency for this bill for nearly four years. There are very few who actually support it due to gains in benefits, but, (a really big but) there will be many who find their taxes are higher. State Govt will find a far greater demand for their available medicaid funds.
So, the politrics of this bill are astoundingly silly. Dems have no constituency for this bill while they have energized a huge majority against it. November wil be a huge surprise to many safe Dem Pols.
Now, as to the fight against this bill. First, it will be in the courts. The first step will have a court ruled stay, to stop actual enactement. Secondly there are many, perhaps as high as 36 state, who are filing Fed law suits on several areas of constitutionality. This should take several years. All the while after winning at least the House in Nov., Repubs will be able to correct those consitutional ?weaknesses?. Thus turning the bill into one that most voters can accept.
Every bill that Dems want after Nov will have a rider attached to correct the HC bill. Eventually we will have a bill that Rep8bls will point to as theirs, and not the Dem, Weak unconstitutional, ineffective, and costly…(add any adjective you wish as it will be used).
Obama’s/Pelosi’s big mistake was to push thic horrible, bad bill forward when they had won the PR debate. A simple stop and restart would have gotten nearly everything they wanted and put the Repubs on the defensive. But, when you are narcissists, it is hard to admit that the chosen path is wrong.
Bruce, admitting this bill puts us on a path to socialism, a serially failed political approach, is the real issue that will motivate the anti-DC movement in Nov.
There’s so much more to discuss on this monstrosity, that it will take weeks for it to come to view. The unanticipated consequnces are just now being discovered. As they actually occur, I predict even you will be wondering why you were for it before you were against it.
I still maintain that Teabaggers need a starting point.
Right up to yesterday they could make claims as extreme as they wanted because nobody knew exactly what the final shape of the bill would be. For example there were up to the final days some dead-enders coming from the Left who were demanding some sort of vote on HR676, the so-called Medicare for All approach being pushed by Kucinich and Weiner. And if you read HR676 you realize that if enacted it would validate all the wild claims coming from the Right, it really was Socialized, Nationalized Medicine that would have extended free unlimited medical care to immigrants. That HR676 never had a chance to become the Democrats actual position and that Obama never once indicated any desire to take health care in that direction doesn’t erase the fact that their was a ‘Democratic’ plan for ‘Socialized Medicine’ out there.
Well that plan is dead as are pretty much all variation on what was passed on Sunday except those changes in the reconciliation bill still subject to tinkering and we are free to ask the Teabaggers specific questions: what about this bill adversely affects your current or future interests? As Jack pointed out very little about the actual provision of medical services changed although I would add that the addition of funding for Community Health Clinics is a pretty big deal that will keep many, many people from clogging up the emergency room with routine sniffles and cuts. So people who have insurance now will mostly have little to complain about, most people not having Cadillac Plans to start with. And as I said in my post from the looks of the Teabagging crowds few of them look to be likely candidates to be uninsured.
The flip side of Cui Bono? ‘To whose benefit’ (the question that should be asked at any economic proposal) is Cui Malo? ‘To whose hurt’. And it is hard to find an honest person outside the executive suite at the insurance companies and perhaps some durable equipment manufacturers that can say ‘Mine’. Obamacare is no longer some vague cloudy threat to turn American into a Medical Gulag with decisions made by a modern Dr. Mengele, it is or will be a defined piece of legislation that will be implemented on a defined schedule in a defined way. It will be possible to calculate for any given individual and family exactly what are their losses and gains. And on my reading the weight will be overwhelmingly on the gain side of the scale.
Cantab,
To save costs we need singlepayer insurance to reduce costs down to 1/10th of GDP as other nations do. Too bad, we will not see any insurance company go belly up. If that were to happen the road would be free to get single payer.
I would like to know why Republicans and teabaggers oppose affordable health insurance? What is wrong with that? Will they support the interests of the insurance company against their college aged children? The seniors I know who do have Medicare and claim they don’t like it will not drop it to buy private insurance. I know because they can’t get affordable private insurance.
These right-wingers don’t like mandated and at the same they complain about people not having insurance until they get sick, which is it?
Why is the HCR bill the end of America? For once I would like to hear an honest reasonable convincing argument against health care reform. There just is none.
THE MIDDLE CLASS GAINS WITH THIS BILL. They can keep their college age children insured, they will not have their insurance rescinded, they can get insurance for children with pre-conditions, women to get pre-natal care and not pay higher premiums than men, they will have insurance when they lose their job, and take their insurance when they change jobs.
The idea that people who already have insurance will see no benefit out of this is absurd. The great majority get their insurance through their jobs. They know they could lose that job tomorrow, with only the right to pay an arm and a leg under COBRA to keep it for a little while. After that they are screwed: obviously if they (or someone in her family) have a pre-existing condition they may be denied insurance entirely; otherwise, the cost for crappy insurance with humongous deductibles and co-pays will be frightfully expensive.
The knowledge for a moderate income family that it will now be possible to get insurance at half or less the current cost even after loss of a job is a gigantic, current, immediate benefit. The biggest benefit of the entire bill is laying the foundation for consumer confidence that is the essential element of a thriving economy.
But it’s too much to expect some people to get that. They’re perfectly willing to leave their own lives at risk to prevent someone they imagine is an enemy to have a victory.
A critical aspect of cost reduction among providers that nobody is talking about is, the closer we get to absolute universality, the less need there is for the massive billing and collections infrastructure that doctors and hospitals currently are forced to employ. Don’t forget the Duke University hospital example: 800 beds, 800 billing administrators. Knowing from the outset who will be paying the bill and when will be an enormous administrative load off the backs of providers. It will be up to the user communities to demand that the providers pass these cost reductions through in lower fees and not pocket them as additional income.
At the insurance company level, there will be considerable savings when there is no longer the need for an infrastructure for finding and fighting over pre-existing conditions. We will all have to force that one through in reduced rates, too.
Bruce, can you show me some numbers about your claims on out-of-pocket expenses?
Lysistrata,
To save costs we need singlepayer insurance to reduce costs down to 1/10th of GDP as other nations do.
This is my metric for success too although I might consider up to 12 percent of GDP also a success. However, all I see with the Obama plan is a commitment to spend more so I don’t see how its going to achieve what I think is your common sense objective.
THE MIDDLE CLASS GAINS WITH THIS BILL.
Please explain to me what I gained. Its not clear to me.
Cantab,
Do you think the middle class is just you and you alone? And as long as you have a good job and you are young and healthy you don’t really know what you don’t have.
1 The ability to change jobs start your own company and not worry about health insurance.
2 an immediate gain in that children can stay on your policy until age 26.
3 No preexisting conditions for children immdiatley.
#1 implies more freedom to follow an economic dream.
I don’t know that “rules” are effective enforcement mechanisms. The bill makes it a rule that you have to buy insurance. It hands enforcement to the IRS. The bill has significant rules about “what care has to be covered and what if anything constitutes fraud.” How is that enforced? To take the example that Krugman gave of Fortis Insurance dropping sick customers as a reason we need this bill — well, what they were doing was already illegal. It was a policyholder lawsuit that enforced the law in the case of that policyholder. Is that the enforcement mechanism here? If so, I don’t see the improvement over the current “system”.
I’m not sure I was clear enough about the fact that I was talking about the currently insured rather than those projected to get coverage. I do think it’s great that half of the newly insured will have government plans without co-pays, but I still wonder how popular politically it will be with the “government is taking my hard-earned money to give to those people” crowd.
Lys said: “The seniors I know who do have Medicare and claim they don’t like it will not drop it to buy private insurance. I know because they can’t get affordable private insurance. ” Lys, seniors have no option on Medicare. If we take SS benedfits we automatically get part A. We can then opt for Parts B, C, D. Many if not most take part B at a cost of just under $100 per month. so all you have said in your comment is “I am ignorant of how medicare works.”
Now, medicare is already dying. Access to Drs in many areas is getting less and less. Wanna know why? Drs don’t make enough and fast enough to cover expenses. Medicaid is already dead in most areas. Few if any Drs take new medicaid patients.
Drs are now saying if this law is passed 1 in 4 to 2 in 4 will leave the field in the US. So is that argument enough to say this reform sucks. Healthcare reform was possible, but this bill is just a red flag for those voters who think rationally. That rational thinking percentage against this bill was ~3 out of 4.
Obama/Pelosi you know not what you have wrought. Nov. is going to be a nasty surprise for many.
UL said: “The knowledge for a moderate income family that it will now be possible to get insurance at half or less the current cost even after loss of a job is a gigantic, current, immediate benefit. ” What part of this bill provides this???? When does this benefit kick in??? None, but the marginal benefits kick in for years, so how does this happen????
UL, in what dream land do you live? Saying this: “…reduction among providers that nobody is talking about is, the closer we get to absolute universality, the less need there is for the massive billing and collections infrastructure that doctors and hospitals currently are forced to employ.” Where in this bill is that provided, and when? If its not there, then that might explain why there is no discussion of it.
Lyle said: “1 The ability to change jobs start your own company and not worry about health insurance. ” Start your own Co. without including health insurance for the employees and you are fined. Do it long enough and you are jailed. So, why worry about starting a new business ? Health insurance is going to add another concern and costs to reduce our entrepreneurial efforts.
But, you keep on believing this bill provides those benefits.
Well, I see that we’ve got the usual uninformed comments from the usual suspects. Idiotic comments about costs from folks who couldn’t draw a supply and demand curve if their life depended on it and goofy comments about constitutionality from people who have never takend a ConLaw class in their life.
This afternoon I couldn’t resist listening to right-wint talk radio. I wasn’t disappointed. El Rushbo was a rambling as ever and Sean Insanity once again proved that a huckster with a high school diploma can make a lot of money if he targets an angry braindead audience.
Bruce, you clearly do not understand the “Tea Bag” movement. Saying this: “I still maintain that Teabaggers need a starting point. ” confirms my opinion. What makes you think the “movement” will stop due to this bill’s passage?
More pain than gain for the next four years will just expand efforts to change it into an acceptable form.
What are you going to do when you are allowd on medicaid and can not find a Dr to accept you? Or if you do , you will wait for months to get that scheduled appointment. Back to the emergency room process for care? Dunno, just asking.
Cantab,
This is the first crack in the monopolists’ wall.
Future assaults will be toward empowering the “insurers’ buyers” to negotiate prices of services they pay for………………
Let’s see how you all like a little market power switched to the demand side.
Maybe Say’s Law will work if both sides of the transaction are a bit more equal.
It is the inequality demanded by the teabaggers that destroys their logic and fuels anger and psywar.
Who wrote the bill so seniors must enroll in Medicare?
The logical reason for all seniors to enroll in medicare at 65 is to push down or spread the mean level of risk. Like hospitalization insurance for younger folks, some seniors, like me who are quite healthy, would take the risks on ourselves and later become medicaid recipients. Putting it as required is like making people pay taxes to mainatin a balance of public good from the process of paying for hospitalization.
Of course, caring is not in the republican or teabag vocabulary and jealously of the other “guy” usually poorer and of different ethnicity is a big factor.
The opponents of medicare have always wanted to put it in the same harsh climate as for profit insurers so the prophesy of big government failure will come true as under GW Bush.
You need to stop demanding self imolation of every program to help people.
The top few percent already enjoy the benefit 33% of federal outlays.
Why be threatened by seeing a few more percent over to the rest of them ( 95%)?
2Slugs,
On the way to work this AM I listened to a CD songs of Irish Rebellions. My St Patrick’s day tunes, still in the player.
“That poor nations might be free” goes to a lot of people in the US.
I stopped listening to the Limbaughs when the most useless and trough slurping GS’ I have ever seen went to them hook line and sinker.
The right wing deadenders in the radio waves coddle the hogs at the corporatists troughs.
And all the right wing deadenders will take all the advantages other people fought for too. But never would they acknowledge it.
Small companies are exempt. How many startups have more than 50 employees on day One?
Cantab,
If nothing else, you will have a consumer protection you never had before. Your insurance had the right to charge you as they please, they could rescind your policy any time, refuse your claims and limit the amount of claims. But you would not know.
What parts provide that? The parts in writing. Which you clearly haven’t read.
Well you could read the bills and the sections on “Cost Sharing” and “Individual Responsibility”. I am away from home and posting from my iPhone. But from memory there are both hard caps on premiums and cost-sharing that in a bad year would total no more than $20000. Big money but less by 50% than total bills for my uninsured hospital stay (with no surgery) in 2008.
Amen I would not call 50 employees a small business. Its a medium business. There has to be a full time manager in such a company and an accountant. I have in mind the plumber who goes out on his own possibly growing to 3-4 employees. The question further is is it total employees for a group or for an individual company in a group? By the time you get close to 50 you need a lawyer anyway and should be incorporated.
Lys yes he does. Cantab believes the argument “No one I knew growing up didn’t get presents at Christmas” was definitive against my argument that in practice Christmas reenforces class divisions. It really is all about him.
Would I like it to kick in faster than 2014? Sure, but that doesn’t mean it’s not in the bill. A family with a median $50,000 income will receive tax credits bringing the premiums cost to $300 per month for a reasonable plan (“Silver”). Know of any current family plans with other than huge deductibles and co-pays for less than $1000 per month, for anyone making any amount of annual income?
Bruce
I’ll have to give up my habit of speaking loosly to make a point if I am going to “debate” with you.
plenty of people over 30 dont’ think they need health insurance. they are wrong. but you are right about the ones with kids. at least the more alert ones with kids. you have to understand that a lot of people are not alert. as for the difference between 40 and 50 million, I don’t keep up, but can you seriously claim the actual number makes a difference? I’d settle for ‘a lot’.
By the way, I don’t disagree with you at all on the substance of this issue, or any other one I can think of. But I am afraid the politics of this way of doing health care are not going to come out good for the democrats. you can already see what Cantab thinks. Loosely speaking.
Bruce
the guy who did not have insurance because he gambled that his health was good is going to feel “hurt” by this law when the government tells him he has to buy insurance.
Lyle, the SBA sizing for small business is 500 employees, and presumably below. Bruce is correct the penalties for costs and penalties are for 50+ employees.
Lys
no good argument against health care reform. but this was not the only way to get it. even single payer is not necessary.. a bid system with the government taking the place of the “employer” in the current paradigm should have led to lower costs both through honest free market competition and government oversight.
what’s wrong here is a complete failure of imagination. i am hoping bruce is right, but i have never seen “logic” have any influence on politics whatsoever.
Tax credits? So the family pays full prices and the Govt gives back a fraction of the difference between $300 and their real price? Do I have that correct?
ilsm
i don’t think it’s “like making people pay taxes to maintain a balance of public good.” it’s making people act in their own rational self interest, given that they are incapable of rationality. not only does being forced to buy insurance protect you from your own folly, it also lowers the cost of insurance. my objection to obamaplan so far is that it doesn’t seem to have a hope in hell of lowering costs, and it forces people to buy from people they consider criminals.
i would add that if you are not paying your workers enough for them to pay for their own health insurance… or providing it for them… you have no business doing business in America.
Lys, Bruce, Lyle, 2lugs, ILSM, et. al. please understand. This bill has some good parts, and it has some horrible parts. It may even have some unconstitutional parts. All will be defined and those found wanting corrected.
But, the reality is that when it is actually enacted and fully operating the horrid bill passed yesterday will be dramtiaclly different. Those differences could have been enacted and all but a few would have been satisfied. This was so poorly played politically by ignoring the voters wishes, and it has tainted this bill so badly, that it will be hung as an dead albatros around any current and future Dem’s neck.
coberly,
I am philosophically a medicare for all type, having been covered by military health care and now by military insurance known as tricare.
I have no problem with Dr’s and nurses who are not Madison Ave types.
The voters wishes, the deadenders, thoughtless, blind followers of Limbaugh Gingrich etc. blither, “fallacious facts” from the right wing monkey teasers.
Their psywar only works on the monkeys and the blogsphere is limiting the number of monkeys the propagandists can cause to scream.
Mencken was wrong; the blogsphere will keep the screaming monkeys from running the circus by bringing the psywar out in the open and trashing it.
Politics and trust with the right wing class/psywar are vapid “fallacious fact” based debate.
There are no facts from the teabaggers’ source, just fright and malice.
“Fallacious facts” are a common thing selling trashing corporate welfare in the name of national security. I am well aware of them, can see them miles away.
The will of the voters based on skewed slanted polling……………..
Bruce,
If you didn’t get some kind of christmas present growing up and your not of a religion that does not recognize christmas then your parents were incompetent. It takes a real jack-ass to try to sell this troubled version of childhood to normal America.
Lysistrata,
If nothing else, you will have a consumer protection you never had before. Your insurance had the right to charge you as they please, they could rescind your policy any time, refuse your claims and limit the amount of claims. But you would not know.
Well this is the fear tactic that the obama and the democrats have been pushing to scare Americans into accepting their stupid bill. It failed with most. Honestly I can’t say that I know anyone personally that lost their private insurance or have heard of anyone that has. On the other hand I know of many people that have received treatment for disease such as cancer, back surgery, and other ailments where the insurance company paid all the medical expense.
How many people do you know who lost their healthcare because of a chronic disease? And if you know of anyone doesn’t it make sense to give them special government provided assistence rather then having government run the healthcare system for everyone else?
Slugs,
It seems all the bill is doing is to push out the demand curve. All things being equal how does this reduce cost? I don’t think it does anything to lower cost. The focus on insurance companies was just because they are the easiest to demonize but they pretty much have squat to do with the rising healthcare costs.
So this means that for small companies if the company does not buy the insurance then the cost will be pushed onto the healthy young employees. I hope most of these young idiots voted for Obama.
Coberly,
i would add that if you are not paying your workers enough for them to pay for their own health insurance… or providing it for them… you have no business doing business in America.
Great, now we will have a permanent 8+ percent unemployment rate.
ILSM, I’m not sure how and why, but Sunday I heard one Dr answer Yes, to a caller asking if it was true that Tricare was included in O-care. it might be worth while to look into it.
Bruce, know anything about this one?
Lysistrata,
And all the right wing deadenders will take all the advantages other people fought for too.
Do you seriously believe that If it were in my power I would not rescind it. Now it’s your turn. Did you mail back you’re Bush tax cut to the federal government? Did you figure out what you saved and send it to a charity? I didn’t think so.
I am away from home. Enjoy your moment in the sun because lime Mission Impossible this message and yours will disappear in five seconds. Or however long it takes me to get home. Bye Bye!!
Will we?
And a Guardian inquiry has found a lack of safeguards against access to the records once they are on the Spine, the computer designed to collect details automatically from doctors and hospitals. The NHS initiative is the world’s biggest civilian IT project. In the scheme, each person’s cradle-to-grave medical records no longer remain in the confidential custody of their GP practice. Instead, up to 50m medical summaries will be loaded on the Spine.
The health department’s IT agency has made it clear that the public will not be able to object to information being loaded on to the database: “Patients will have data uploaded … Patients do not have the right to say the information cannot be held.”
Once the data is uploaded, the onus is on patients to speak out if they do not want their records seen by other people. If they do object, an on-screen “flag” will be added to their records. But any objection can be overridden “in the public interest”.
Harry Cayton, a key ministerial adviser, warned last month of “considerable pressure to obtain access to [the] data from … police and immigration services”, but he is confident that these demands can be resisted by his department.
http://www.guardian.co.uk/society/2006/nov/01/health.medicineandhealth1
Wait someone explain this to me, new to this websitie, but from what i gather, none of the big insurance companies are going to be made to compete, but will have nice new streams of revenue from people “forced” to buy healthcare, my opinion was that costs were increasing so much every years becase A. Government commanded so much of the market and B. none of the insurace companies were made to compete. Bruce, i do not know you but you scare me, mainly because you put all of your faith in government, a government that has decided to bail out the largest most corrupt institutions in America (Goldman, AIG, JP MORGAN, ect ect ect) to fairly enact healthcare…… I mean social security is such a wonderful shining example of how government is going to take care of us all!!!!! From my own observations, anything that the government has labeled as a right to people, or something that all people should have (College, Housing, Healthcare) the costs usually rise exponetially every year,
Looking at this health care legislation, I felt America have become such a polarized country. One of two very extreme views from both sides. This bill although signed and passed, it might not have a very long lifespan in it’s current form. I just don’t think a bill that really divides a country into two camps will survive for long. Couple of things I can already think of. This can become a “States” right issue, a Congression Bill proceeding issue (Senate bill versus Congressional bill version) etc.
Anyway, it’s highly likely will make it’s way to the Supreme Court and Our president will face a conservative court (and this court was the one he recently snubbed). I think the end result will be a toothless bill that only wastes a lot of taxpayers money the government and the various special interest getting “lawyered” over….
Tricare was specifically excluded by some of the last minute actions. This (HR 4887) might be part of the package going to the Senate; it’s not clear.
House votes to exempt TRICARE from health reform bill
http://www.govexec.com/story_page.cfm?articleid=44847
Ugh. I HATE tax credit/deduction methods. What that means is that TODAY I have to pay big, at costs I may not be able to afford TODAY and WAIT until NEXT YEAR to get any money back.
See, my bills are due now, not next year. Don’t give me that tax credit crap because that doesn’t do me any good NOW when I need it. The money from the tax credit is usually many months in the future and does me no good right this moment.
Tax credits are gimmicks that hurt.
I have heard some of our citizens say insurance is “betting against yourself.”
“Voter wishes” were tainted by outright false propaganda about “socialized medicine” or “communism” or “death panels”. With that nonsense out there too many people (teabaggers) simply closed their minds and do not even listen or read facts anymore. Hell, they IGNORE facts, objective stone-cold facts, when they are contrary to their preconceived notions.
I daresay that there was NO WAY to get a TRULY reforming bill through congress because magic words would have closed off too many minds (socialism! communism! death panels!).
Actual socialized medicine (as practiced by ALL other developed nations on planet earth) would have been better than the current bill. My hope is that, as some here have commented, that this current atrocious bill will actually get us there, perhaps even during my lifetime. What’s not to like? Lower costs, longer life expectancy, not a single medical bankruptcy for any reason EVER, access to ANY doctor at ANY location, no stack of forms to fill out (and process) in triplicate, etc.
It DOES leave a nasty taste in my own mouth, however, being forced by government to give my money to criminal organizations (insurance companies) while only requiring them to spend a mere 80% of there “take” on actual healthcare. How about 85% or 90%? 10% profit is good enough for anyone and if that means lower (or no) CEO bonuses or extra mansions or a cutback on golf junkets to St Croix and the like, TOUGH CRAP.
The court is so stacked with corporatists (who believe that corporations have more right to representation and control of government than actual breathing human beings) that are also “states rights” idiots that I cannot really predict how the SCrOTUS will rule. Their corporatists loving tendencies would no doubt LOVE government enforced profits for insurance companies while their states rights confederacy-loving side will want to side with the primative southern states and their riders that want to all but exit the union. Hopefully, 5 of the SCrOTUS justice’s heads will literally explode trying to balance their twisted, dark, selfish political desires.
Thanks, I’ll check that out.
Corev,
The real problem from the beginning was the absolute opposition of the Republicans. The distortions, the lies, made an honest discourse impossible. That is just as true now as it was 14 months agao. McCain has the audacity to come on TV and proclaim the refusal to work with Obama and the Democrats on anything. And he is the man who wanted to become president. The Republicans have become the party of idiots. How can anyone take them seriously being led by the likes of Boehner, Limbaugh, Bachman, Steel, Cantor, Beck and so many others like them. Can you name one, just one, man or woman in that party deserving respect? The best people have left a long time ago. What is left is party of shame.
CoRev better reading skills please.
On the particular issue of Health Care Reform Tea Baggers need a starting place. They know what they are against in principle, they don’t want Socialized Medicine. But that is not what this LAW (as of just now) delivers. It is no longer an amorphous bit of Obamacare, it is instead a set of provisions set out in black and white, and BTW linked to in a new front page post. When faced with the specifics which one are they going to hold their ground on? That’s the question. Pre-existing conditions? Being able to keep your kid on your policy while he is in Grad School? From what well will they actually draw their outrage.
And there is no data that would back up your appeal to months long waits for appointments. You are in the same position as the Baggers, appealing to outcomes that only exist in your imagination.
Even the luckiest and most healthy of us have accidents. And not everyone is as healthy as they might feel, only idiots wouldn’t take the opportunity of having their blood pressure, heart and blood sugar checked on a regular basis. Careful gamblers hedge their bets.
Assertions are like assholes. Except people often have more than one. Can you spell out the “many” who will have higher taxes under this bill? Because I see a tax on people earning more than $200,000 individual and $250,000 joint. You may know ‘many’ people in that category, personally I don’t know anyone. And I know an ex-VP at Boeing.
I am no more a lawyer than you are but I can’t see any Federal District Judge weighing in here, nor any compelling reason for the Supremes to issue a stay, the Constitutional argument seems to be that states and localities have the authority to order you to buy services from private companies, i.e. most places require households to have potable water and garbage services by law, many of which are delivered privately, but that the federal government doesn’t. Kind of a stretch of the reservations clause but I guess we will see.
Well I think the exemption Anna refers to was unnecessary which might explain the 403-0 vote approving HR4887.
The bills always defined “Acceptable Coverage” as including seven or so specific government programs, meaning that if you were covered under Tri-Care or VA you would be deemed to have met the ‘Individual Responsibility’ requirements. At that point any responsibility for ensuring conformity across programs would be up to Congress and the various administrators.
Trent,
Good points.
none of the big insurance companies are going to be made to compete.
However, they will be forced to take people with pre-existing conditions, which will drive up the premiums for everyone else. Many people/companies would choose to pay the fine as it is cheaper than the insurance, and only sign up for insurance when they are seriously ill.
Not only that, but insurance companies will be regulated by government price controls. If they need a premium increase due to the above, Uncle O can just say “No, you are just greedy.” Viola, you are out of the health insurance business, and our benevolent, efficient government will be there to step in to take care of you. Free, of course.
Cantab there is a phenomenon known as ‘extreme poverty’, probably not unknown in the Greater Boston Metropolitan Area. Some kids get this alleviated somewhat by the Salvation Army or the Marines Toys for Tots program but if you think this reaches every kid in every shack on the Mississippi Delta or some Indian Reservation then you are sorely mistaken. Have you ever seen a woman cry because she literally could not buy diapers for her twins because her supervisor was telling her that the boss just hadn’t gotten around to signing her paycheck? Well I have and I don’t think those babies got much for Christmas that year.
Well the rule is 85% Medical Loss Ratio for group plans and 80% for individual ones. And all insurance company costs come out of that 15% or 20%, it is not just profits and executive compensation, it also includes all employee payroll and such things as marketing, overall profit ratings run around 6-7%, which is plenty generous considering they will be getting a captive market. (Commenters here will claim 3.5% AVERAGE profits, which is what happens when around half of your sector is officially non-profit)
Schumer and Rockefeller did push for a 90% MLR but were essentially blackmailed out of it by CBO which said that it would score that as nationalization which under their rules would have boosted the cost number by trillions. Offset of course by scoring the premiums as revenues but no one wanted to try to sell a bill with a bottom line of 4 or so trillion dollars. So they backed down to 85%.
“Honestly I can’t say that I know anyone personally”
Cantab that seems to be your measure of just about everything. If it didn’t happen to you or anyone who grew up in your immediate surroundings it just never happened at all. I am thinking you haven’t got out much during the course of your life.
Bruce, you answered your own question: “…they don’t want Socialized Medicine. But that is not what this LAW (as of just now) delivers. ” They do realize the only way to stop it was to not get it passed. So the next fight will be in the courts,(as of now there are 13 state joining to file law suits) and then in the ballot box, until there is a law they can accept.
If the number of states grows to 33+, then we are in constitutional conbvention territory. I suspect that the wording of a constitutional amendment written by the state governments would be well enouogh phrased to get the rquired 3/4 of states to vote for it.
What this bill looks like in 4-5 years, I can not predict, but I am absolutley certain, that this bill will not stand anywhere near what it is today.
30% of Drs today do not take medicare patients in your state. Let’s see how many will be taking them in 2018, when the actual benefits take effect for the currently uninsured. And, that is only one of the many unanticipated consequeces.
Trent I think life is too short to unpack all the erroneous assumptions in your comment.
I am sorry that I scare you. That you evoke Social Security as some sort or self-obvious ironic “wonderful shining example” of apparent government failure shows that you really don’t know me at all. That link to “Webb’s Social Security” in the top bar is not a coincidence.
Bruce, the many will be in every state that will have to raise taxes to cover the newly mandated medicaid patients. Then there is of course the increase in SS and FICA rates.
The only part of this bill that could even be ruled unconstitutional is the only provision that the corporatists support, that of the individual mandate. Strip that out and leave all the rest of the provisions governing community rating, barring of recissions and guaranteed issue and renewal and the private insurance companies are screwed seven times from Sunday. The Republicans went all in on Obama failure. And lost. And now are flailing.
Passage of Social Security put the People’s House in Democratic hands for almost every Congress from 1936 to 1994, and the one time Republicans grabbed control in between Harry Truman was able to successfully dub them the “Do Nothing Congress” and have Dems regain control the next election. http://en.wikipedia.org/wiki/80th_United_States_Congress
The Republicans are obviously terrified that they are looking at another half-century in the shade should this bill be perceived as a success, hence the false bravado and desperation tactics. Given the existence of FAUX News and the willingness of the rest of the media to simply adopt the Republicans chosen narrative this might just work out for them, after all 2010 is not 1936. But somewhere ‘Class Traitor’ FDR is smiling down from up above.
Absolutely, your premium is an ante, each pay check, you get paid for your bet only when you get a little sick and then only if the house (monopolist insurer) don’t fold its cards and walk away from you.
The military personnel PAC’s had the house vote TRICARE out of the health reform, by 403 to 0 on Saturday.
I got my e-mail to send a thank you note yesterday.
They got TRICARE for life enacted when recruiting for the senseless rotations was hurting.
I don’t think the folks in the UK understand HIPAA or any protection to privacy in the Privacy Act, which by the way both cover the accumulation of information on individuals in the US.
No such thing as a free lunch. The kids that are covered in this plan will cost the insurance comanies money and will thus cost the subscribers money
So the cost of premiums will rise because of the “kid cst” and because the insurance companies are greedy and want the Republicans in power at all times. The screech monkeys will have a field day and the democratic apoogists will be playing defense from square one. I see no way to fix this or ovrcome it.
Coberly,
maybe I am wrong, but watching the fight and it was an epic fight, the combined power of the industry and the Republican party and the blue dogs and the 60 vote majority seamed unsurmountable many times. The industry lobbyed so openly against the interest of the people and the open support of the Republicans for the industry against the people showed how sure they were of the support of the teapartiers. I don’t see how more imagination would have changed it? Even now, they insist on throwing sand in the wheels. Maybe some lawer can tell me how mandatory health insurance differs from mandatory Social Security? Surly the wealthy will not have to buy insurance, Bill Gates, Soros and Buffet can pay out of pocket.
I hope people like Bruce and others are right and they can now build on the law as it was passed. SS changed a lot and improved over time too and also is constantly in danger to be demolished by the Republicans and others who do not have any domestic policies to speak of, only tax cuts and military spending.
CoRev:
This is not a proposal for a constitutional amendment which mignt pass in a decade. Futhermore once this is the only business in town; like litigation attorney, the docs will aquiese
CoRev:
Raise taxes on who?
Dear sir,
i read some of your blog and you seem to have some strange love for social security, look Mr. Webb, i have no arguements with social security, it seems on the surface to be a well meaning kind of legislation, but what if i do not want to participate? I only make 23,000 dollars a year, but i would rather keep the 1,697 i contribute to social security for my own savings account. Two, you are an asshole “erroneous assumptions”?!?!?! Tell me, from what i have witnessed in the past two years what is erroneous about my assumptions Mr. Webb? You, from your picture on your blog, look to be some ex hippie who may or may not have done a fair amount of drugs during the 60’s and 70’s on the tears and blood of the previous generation with no respect for what has come before you and what will come after. If anything sir, your generation could be labeled perhaps one of the worst, WORST generations to have ever made a mark on the United States! Why would i trust a president to enact some sort of legislation, when his entire platform for his office was based on hope and change? Well i did not vote for him nor John McCain, but i am about out of hope and have had more than enough change. Tell me sir, are we out of Iraq? Have we closed Guantanamo? The only part of his platform he has produced to date is healthcare, which looks to be a giant gift to Insurance companies if you ask me, I do not want to pay for you, or anyone else and i should have the right in this supposedly free country to opt out of being responsible for you and your choices. Stop being a smart ass, and respond with why you believe social security is needed, please explain why people can not save for themselves and must give to the government, who then spends the money, put’s an I.O.U (T Bill) in a lock box and will put you in jail if you do not contribute! This country is broken both in morals and fiscally, i had nothing to do with either but i must bear the burden with dopes like yourself, well i for one sir have had enough so keep your smart ass comments to yourself! RON PAUL IN 2012
“But somewhere ‘Class Traitor’ FDR is smiling down from up above”, Ha you assume he is in heaven! Tell me Mr. Webb, what about his illegal confiscation of gold, which the constitution mandates is the only legal money in the united states?
CoRev,
Military don’t qualify for Tricare life if they don’t have part B. just as Seniors buy supplemental insurance or Medicare Advantage. Seniors are most likely to have pre-conditions, age alone is a pre-condition. They buy part B and C and D because it is the best if not the only thing on the market. If they could get individual private insurance it would be outrageously expensive. What insurance wants to insure old and sick people?
Ummmm… the constitution of the United States uses the world “gold” exactly once, in a statement indicating that
“No State shall enter into any Treaty, Alliance, or Confederation; grant Letters of Marque and Reprisal; coin Money; emit Bills of Credit; make any Thing but gold and silver Coin a Tender in Payment of Debts; pass any Bill of Attainder, ex post facto Law, or Law impairing the Obligation of Contracts, or grant any Title of Nobility.”
That’s section 10 of Article I, and is titled “Powers Prohibited of States”. States — not the Federal Government.
It’s called “reading”. Go figure.
This is the model our Progressive/Lib/Dem Congress critters are pursuing. From CDR Salamander here: http://cdrsalamander.blogspot.com/2010/03/about-last-night.html
“From a friend in Germany – a view of where you are going, IF, you get a system as good as the German one. Look at the cars – that should give you an idea.
As someone who has lived in Germany as a civilian on the economy for 20 years, let me tell you what you’re in for.
My income is taxed at 52%.I pay $8 / gallon for gasoline, most of which is tax. 18% VAT on almost everything. I pay $1000 / month for my private health insurance policy. Whenever I call a new doctor for an appointment, the first question is, “do you have private or government health insurance?” Of course, I always get an appointment, and I get very good care. Ah… but even with all that, pre-exisiting conditions are not covered. Enjoy!”
“
Run, Depemnds on the state, but ususally on everyone. It is needed to the increased demand for medicaid, and the reduced Fed. subsidy. The real story will be in the increased HC costs. Higher insurance rates, higher prices for medical aids, higher costs for some luxuries (tanning, etc.), and above higher costs for Drs visits, when you realize you can not get in on medicaid/medicare.
So will there be better access to healthcare? Probably not, especially for the short term, 5-10 years.
CoRev,
That’s a good essay you linked to. I encourage others to read it, if for nothing else than to understand the opposition to government run healthcare.
CoRev,
That’s a good essay you linked to. I encourage others to read it, if for nothing else than to understand the oobjections to the “abstraction.”
CoRev,
That’s a good essay you linked to. I encourage others to read it, if for nothing else than to understand the objections to the “abstraction.”
Still prefer the governmnet to not have access to this, as they constanly abuse people’s private information.
This is Bruce
You are doubling down here. And babbling. When you are open for a fact and number based discussion then come on back. As it is all you have is the standard Glibertarian rap.
Trucker some of us pass moral judgements not on the basis of profit and loss but on what is the right thing to do.
Everyone one of us has been in a Truck Stop where there is a jar as the cashier raising money for some kid whose parents have ran through their savings and lifetime limits on their insurance plan because their kid got cancer and they are hoping passersby will drop in a buck or a quarter. Most of us who live in small city, small town and rural America are more than familiar with community fundraisers for some family laid low because Mom got badly sick while Dad lost his job at the mill.
We are the richest country in the world and we are raising cash for kids operations by fucking community bakesales? Ya think there might be something a little off about that picture?
CoRev appealing to some half-coherent wing-nut blowhard who admits up front he hasn’t blogged on this much because he doesn’t know anything about it as a source of what Progressives are “pursuing” is pretty moronic. He certainly doesn’t speak for me. Nor do I take an anecdote from an anonymous ‘German friend’ as being necessarily accurate or complete.
Plus the guy caps if off (obviously chanelling Rush) by informing us that all the rich people are going to decamp to Costa Rica. A country, which you guessed it has a fully Socialized Medical system.
Can you at least make a gesture towards making your arguments evidence based?
Bruce
Bruce,
Be nice to CoRev. He’s grasping at straws with straw arguments because he’s becoming desperate. Note, however, that he does at least try to provide a “fact” based argument, though his facts are based on an anecdote. He’s trying hard to be the more rational of the reactionary crowd. Given that his competition is Cantab and Sammy, I’d ssy that he’s dooing an admirable job of it though not an adequate one. We can’t expect too much from reactionary rhetoric. It’s meant to rebuff and confound. It’s not meant to make valid points.
http://economicedge.blogspot.com/2010/03/damon-vrabel-renaissance-20.html
go figure