This looks like better approach than just a Public option, but I would prefer to open this up to any national organization( eg, Union, Citizen Association, etc.) and not limit this to States. Actually, to obtain sufficient scale, I think it would better not to run this through individual states . We need a national scale system. With so many conflicting views , some 'baby steps' may be necessary to make any progress.
True
Why? Insurers add no value and yet consume something like 20% of the health care dollar.Also, I do think that a public option added to the current set of randomly developed options would eventually drive out the private insurers. I want to retain private insurers....
It's true that a PO would drive private insurers out of business if they continued to do business as they do now. If they changed their business model then there is no reason for them to go out of business.
This would require that private insurers change their business model, which is what a PO would eventually for them to do. But you don't offer a feasible way to do that....but in a systematic way that puts everyone in the same insurance pool. The insurers must take all comers and could NOT exclude anyone. The competition should be based on services offered and service provided.
The current government system is for government employees only. As an employer, the government can decide how to provide insurance for its employees just as any other employer. So it is uncontroversial My company can choose to employ a system like that, so could yours. There is nothing to stop big companies banding together to use their market power to reduce their costs the way the government does. [Perhaps they do, I work for Pfizer and we get free prescription meds, not just Pfizer products, but products from competitors too]
To extend the government employee plan to non-employees does require legislation. Such an extension is a huge threat to health insurers and health care providers. It would be DOA the instant someone proposed it.
I realize that the current federal health care system is only for Govt. workers. I was trying to use this as an example ( for analogy) of a system that seems to be working well with private insurers( eg, Blue Cross) and worker organizations( eg, Unions) as insurers. Their function is to administer the programs with minimum Govt staff for oversight. I don't understand why extending this to all American citizens would threaten Blue Cross or health care providers.
Since the federal model includes an annual open season when each person can change to a different provider, there is built-in competition for providers to attract customers. This is why I do claim that this approach is feasible.The other question is how to fund coverage for those not currently insured, and I still maintain that most( if not all) of these costs could be found by removing the waste in our current non-System.
I agree that it may be DOA , but this approach would provide managed competition and is more attractive to me than a single payer. It seems to me that Single Payer is also DOA, but I could support Single Payer , if it survives and provides a true , rational & national health care system. If everyone is in the same insurance pool, the insurers could no longer cherry pick their customers( they either take all comers , or are not allowed to participate at all. )This would certainly force changes in their business models.
There is no way to get an alternative view of Health care on the Forum since a most posters on here are ideological partisans. You have asked for GOP/Conservative ideas and demanded a plan, well here it is;
http://www.washingtonpost.com/wp-dyn...d=opinionsbox1
Well, there it is alright, but pretty much pure crap.
Let's first lay out the litany of lies -
- tell us how the govt is taking over health care. Do you still believe in Obama death panels as well?Democratic plans for a government takeover..
- sorry, the polls show just the opposite. Look at some sophisticated analysis -The people don't want it. Believe the polls, the town halls, the voters.
http://www.fivethirtyeight.com/2009/...is-likely.html
compare that to this kind of trash -
http://www.theadmonition.com/?p=1611
that obfuscate if not actually lie about what the poll said -Rasmussen Poll: 63% Say Current Plan Better Than Public Option
http://www.rasmussenreports.com/publ..._public_option
but back to Jindal, the Deceiver -Sixty-three percent (63%) of voters nationwide say guaranteeing that no one is forced to change their health insurance coverage is a higher priority than giving consumers the choice of a "public option" health insurance company
- just who are these businesses and families getting new taxes, how much and under what circumstances. Take just a little time and research this and one can only conclude that only assholes would continue to try to foist this meme on peoplenew taxes on businesses and families
- but he doesn't mention that it is budget neutral, does he?$900 billion in new spending
again, with the taxes! Exactly whose health insurance is getting taxed. Hint, do a search of "Cadillac insurance policies" and "CEOs"increased taxes on health insurance
what the hell is this throw away line?products to reduce health-care costs
Pure crap, but lets move on to the proposals - the real crap -
Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs."Okay, ants, those big humans with the size 12 shoes keep stepping on us. So, this is what we are going to do. We are going to form pools of dozens, if not hundreds, of ants. Next time one of those humans step on us, we'll show them!"Jindal is a joke; or, he thinks we are pretty stupid.
Oh, gee, I get to take my high-priced policy with me. Oh, gee, what an incentive for the insurers to lower my payments-- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
Is Jindal a moron, or does he just believe we are?
Studies of the two biggest states with malpractice reform, CA and TX, show that sure enough malpractice suits have gone down, BUT absolutely NO impact on the cost of health care or health insurance in those two states --- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
http://www.allbusiness.com/insurance...2865340-1.html
As the authors said -
How many people do you know who blindly buy into this myth without the least amount of effort of checking if it is true?"The results of this study suggest that there are no insurance premium savings that accrue to consumers. Are there other benefits to consumers? If these cannot be identified, it is difficult to see a justification for the loss of legal rights."
The rest of Jindal's bright ideas are either something everyone has already gotten behind (e.g., pre-existing conditions) or the same warmed-over crap that hasn't done much for anybody but those making 6-figures (e.g. HSAs).
I am sick of these lying pukes like Jindal.
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
Although before you turn up your nose at "Cadillac plans", I note that a commentator on NPR late last week actually defined them and pointed out that they, unlike ordinary Medicare, include Dental and Vision coverage.
Unless you enjoy the sight of blind and toothless seniors, let's start talking about extending those "Cadillac" features - actually more like Family Sedan features - to all and stop ragging on those of us with the great good fortune that we do NOT have to go blind and toothless.
Though I guess I'd better get those cataracts removed before it's medically necessary if that's a "Cadillac" benefits that us idle rich (retired bookkeepers) are going to be stripped of.
How to spot a shill, by John Michael Greer: "What you watch for is (a) a brand new commenter who (b) has nothing to say about the topic under discussion but (c) trots out a smoothly written opinion piece that (d) hits all the standard talking points currently being used by a specific political or corporate interest, while (e) avoiding any other points anyone else has made on that subject."
"If the shoe fits..." The Grey Badger.
here is an overview of "cadillac plans" that gets to what you are saying; although I don't think it says nearly enough about the $40K plus per year plans that the Wall St. types have for themselves and their families -
http://www.washingtonpost.com/wp-dyn...093004730.html
It looks like the Committee tried to address the issues that you've raised.
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
In regard to tort reform - as noted above, so far, where it has occurred, it has not saved anyone a nickle on health insurance costs or health care costs; although it has taken away legal rights of the 'little people.'
In regard to interstate competition - Exxon, Chevron, and BP all compete across state lines, but I'm not so sure that has much to do with the price of gasoline. The big insurers would just love to get the states out of the way and then have their way with the smaller and regional insurers, who in turn, woluld just love to be bought-out by the big nationals so their CEOs could then retire to the Riveria.
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
Does anyone really love Delaware and South Dakota for their credit card laws?
So called "interstate competetion" without a public option would result in a system much like what we see in credit cards-a race to the bottom.
I can already imagine states lowering their consumer protection standards in hopes of landing a handful of healthcare call center jobs.
To put it another way, the insurance conglomerates would like nothing better than to incorporate their health insurance subsidaries in low standard states like Mississippi and Alabama while being able to charge higher state rates.
Also, as PW notes, so called "tort reform" does not lower rates. It only lowers the number of options patients have when procedures go wrong.
Last edited by herbal tee; 10-05-2009 at 02:34 PM.
I hadn't even thought of that analogy to the credit card insurers. I think its a good one. The other comparison is when folks suggest more reg oversight (rather, than a competing public option) will get the insurers to tow the line - yea, the last couple of years have clearly shown how great that worked with the finance industry.
On tort reform - proponents, at least the ones who are pushed beyond the mere assumption that it does something, will say that it will take time to see lower health care and health insurance costs - that doctors practice defensive medicine by rote and it will take time to change the habit. Conceptually, I can see that, and I can see the theory of tort reform. I might even support it, if with clear assurances for the little guy who is going to pay for the 'medical mistake' done to him. What really bothers me is when tort reform is whipped out as a panacea for all medical cost ills and as an attempt to be a conversation show stopper. That's not a serious discussion, that's misdirection, at best.
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
There's another factor too, and that is the applicability of tort reform to everything else.
The corporatists, be they blue dogs of endangered spiecies elephants want tort reform to apply to everything. If they can get a toehold in healthcare law, they will try to extend it to other parts of the economy. The only way to punish a multibillion dollar conglomerate is with large figure judgments and settlements. Otherwise, you get cost/benefit analysis being done to determine how many people can die/be injured before the bad publicity from defective products/services cuts too deeply into profits.
Gad, these big insurers are really stupid or their hubris is just unbelievable -
http://sickforprofit.com/posts/
With a total population of just over 1.3 million, this can have a big impact on how two Senators, Snowe and Collins, vote. This gives every reason for those two independent Repugs to vote way to the Left on health reform. What Blue Dog is then going to vote to the right of them and stay in the Dem caucus?A wild story out of Maine.
Anthem Health Plans of Maine, a subsidiary of WellPoint, is suing the state because they want to increase premium rates by 18.5% on their 12,000 individual insurance policy holders, so they can guarantee themselves a 3% profit margin. This story shows how silly it would be to solely rely on regulation to rein in insurance industry practices.
Like many other states, Anthem Health Plans hold a monopoly on the individual insurance market in Maine, controlling 79% of all the plans. Also like many other states, they are licensed to sell insurance through the Department of Insurance, who must clear all rate increases prior to implementation. Originally, Anthem Health Plans were a nonprofit Blue Cross and Blue Shield corporation licensed to practice in Maine since 1939. In 1999, Anthem bought the business and began to operate it as a for-profit company. Since that point, Anthem has raised premium rates 10 times, and 8 of those times have been double-digit rate increases.
Jan-99: 20.4%
Nov-99: 15.7%
Jan-01: 23.5%
Feb-02: 12.7%
Jan-03: 3.4%
Mar-05: 14.5%
Mar-06: 16.3%
Jan-07: 16.7%
Jul-07: 1.3%
Jan-08: 12.5%
The average individual Maine rate-payer is paying four times as much for insurance than they did ten years ago.
But this isn’t good enough for Anthem Health Plans. They first proposed a 14.5% rate increase for its individual insurance products, then they revised it up to 18.1% and finally 18.5%. This is an average increase. Some plans would see increase of 24.5%, some 38.4%, and for its Preventive Care and Supplemental Care Accident rider, which is part of 1/3 of all their policies, Anthem proposed a rate increase of 58.2%. This amounts to Maine consumers paying $12 million more in annual premium dollars for the exact same level of benefits.
Anthem isn’t hurting for profit. Their Maine operations have generated an average annual return of $70 million dollars over the last five years. Anthem paid dividends to their parent company, WellPoint, of $75 million dollars last year alone, and $152 million since 2006. Their nine highest-paid employees totaled over $4.3 million in compensation. The individual market, while a smaller portion of their overall business, still generated $5.4 million in profit over the last two years.
The reason Anthem desires these rate raises is because their actuarial charts show they can guarantee a 3% profit through this increase. That’s an estimate, however, and in 8 of the last 10 years the profit margin achieved has actually been higher. The Maine Superintendent of Insurance ruled in May 2009 that the 3% profit and risk margin sought was “excessive and unfairly discriminatory,” as per the laws of the state, and instead approved a rate increase of 10.9% for Anthem. Given the recession, the financial health of the company, and the years of large rate increases, there was no way she could approve anything higher.
So Anthem sued the state. But not after filing revised rates at a 10.9% increase so they could get that going while they litigated for an even higher rate.
The Superintendent of Insurance explained in a court filing that there is no statute mandating that Maine must provide Anthem or any other insurer with a guaranteed profit. Given Anthem’s ability as a large operation to cut costs, just as any family must do during a recession, the Superintendent argued there is nothing preventing them from making a profit with a 10.9% rate of premium increase. But Maine is under no obligation to guarantee one. That would be a “socialized profit,” which Anthem is asserting the right to without any legal basis in fact. Furthermore, policyholders have contributed $17.4 million in profit to Anthem’s bottom line over the past decade, which should be more than enough to cover potential losses from just the individual insurance line this year.
Anthem argued that they were discriminated against relative to other companies in Maine because one other individual insurer was provided a 3% profit and risk margin (that company, MEGA, asked for 2.2% rate increase back in 2007, a far different scenario). This, the corporation said, violated their equal protection rights under the federal and state Constitutions. This is a laughable claim, that the state must guarantee a profit for every insurance company licensed to provide a product. It’s nowhere to be found in the Maine Insurance Code, and the Superintendent of Insurance is allowed under Maine law to consider each company’s situation individually. In this case, she ruled that a 18.5% increase in premiums would be unfair and excessive.
This is a very revealing case. Those arguing against a public option claim that insurance regulations alone will be sufficient to provide an affordable product for everyone. Here’s a case where Maine is attempting to regulate the industry, and the industry sues the state in an effort to grab more profit. While claiming to be on the side of reform, they will fight tooth and nail, and can be expected to do so for every regulation in the national health care bill, right down the line.
Brave New Films has put together a video exposing the practices of Anthem and its parent company WellPoint. You can send your friends in Maine the news about this lawsuit, to highlight this practice. Maine Superior Court will consider this case on Wednesday.
What were these big insurers smoking?!
Great timing!!!
Last edited by playwrite; 10-05-2009 at 05:07 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
Because standards of healthcare are much lower in most Southern states (more obesity, more diabetes, more alcoholism, and lesser reliance upon preventive measures) health insurance in such states as Mississippi and Alabama would be necessarily higher than those in ... Iowa.
The greatest evil is not now done in those sordid "dens of crime" (or) even in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered... in clean, carpeted, warmed and well-lighted offices, by (those) who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the office of a thoroughly nasty business concern."
― C.S. Lewis, The Screwtape Letters
I'm not really refering to premiums so much as I am refering to the quality standards that the companies would have to meet.
Rest assured that any race to the bottom under a state system without a real national minimum in standards would be in quality only, not in the price the public pays.
And, oh baby, its a-lookin good -
http://thehill.com/homenews/senate/6...public-option#
...decision time will loom for Reid, who has said he plans to merge the Finance Committee version with the one passed by the Health, Education, Labor and Pensions (HELP) Committee in July. The majority leader has said he plans to consult Baucus — with whom he enjoys a generally good relationship — along with HELP Committee Chairman Tom Harkin (D-Iowa) and the White House.
But the Nevada senator’s input will be critical. Having deferred the issue to Baucus this summer, Reid signaled on Thursday that he is prepared to join Sens. Charles Schumer (D-N.Y.) and John Rockefeller (D-W.Va.), who both pushed a public option amendment that failed in a committee vote last Tuesday.
“We are going to have a public option before this bill goes to the president's desk," Reid said in a conference call with constituents on Thursday, as reported by the Las Vegas Sun. “I believe the public option is so vitally important to create a level playing field and prevent the insurance companies from taking advantage of us.”
"The Devil enters the prompter's box and the play is ready to start" - R. Service
“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke
"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman
If you meet a magic pony on the road, kill it. - Playwrite
Hooray!!!!!!! Blue Dogs will have little choice when its their own behinds on the line in the next election cycle.
If it worked to reduce costs, that means less money for insurers and health care providers. Any reform that works is a threat. The preference is to implement "reform" that makes things worse and claim no one could have known this would happen. Such a failure ought to dampen enthusiasm for further reform. Nonrich Americans will come to accept that the days of their lives are threescore years and ten, and learn to do with less medical care, as do most people in the world. Americans are not Europeans.
It IS single payer. Who foots most of the bill for employer-provided health insurance? The employer, which in this case is the government. Expand the plan to cover everybody and its single-payer, which was already declared DOA at the start of the debate.I agree that it may be DOA , but this approach would provide managed competition and is more attractive to me than a single payer.
Last edited by Mikebert; 10-05-2009 at 08:00 PM.
I cannot wait to watch Senator Reid try hold a 60 vote majority and all that needs to be done is picked off a ONE conservative Blue Dog vote. How much campaign donations and pet projects will have to be offered to get it. Olympia Snowe is no longer a given for a 60th vote if the public option is offered on the Senate version.
It will come down to one central vote on to end a Republican filibuster agaisnt health care reform. If every Democrat votes to give the bill an up or down vote and then vote their conscience, thats fine with me. All you then need is 50 votes.
Comments follow (quotes from the cited article)
My company’s insurance costs $23,000 per family. Most individuals who can afford that have no trouble getting insurance. Small businesses that can afford to pay this much for their employees can get insurance. How does this help individuals and small businesses that cannot afford large business costs?Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
We already have this. My old boss is currently paying that $23K to keep his old insurance.Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
Lawsuits are less than 1% of the cost. This is a talking point.Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
Where is the money to “incentivize” companies to take on folks with pre-existing conditions. A better idea would be to let folks buy into Medicare.Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
Private enterprise would have created these things if they were possible or desirable in our current systemTransparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today's system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.
See aboveElectronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
Individuals have no power to negotiate fee for service. This just lets people pay for ridiculously overpriced medical care with before tax dollars, but the costs will remain ridiculous. Where will the money for this come from?Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
This is already being done.Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
Adding young adults to the pool does nothing to help reduce costs unless you charge them the regular price. Letting them freeload on their parents plan will raise everyone else’s premiums to cover the freeloaders.Cover young adults: A large portion of the uninsured are people who cannot afford coverage after they have "aged out" of their parents' policies. Permitting young people to stay on their parents' plans longer would reduce the number of uninsured and keep healthy people in insurance risk pools -- helping to lower premiums for everyone.
Where does the money come from?Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage):
What billions are spent by the Federal Government on the uninsured? If the government was spending billions on the uninsured, why then they would be insured, like the poor are through the Medicaid government insurance plan.Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system.
This is another talking point; the old "fraud and waste" the reduction of which was going to balance the budget in the 1970's, and then in the 1980's, and then in the 2000's.
Yes, and the choice they need to make is do without if you don't have insurance.We should trust American families to make choices for themselves
Update on FEHB program--If Blue Cross can't control costs, they will lose customers:
http://www.federaltimes.com/index.php?S=4307259
...Feds irate over health cost hikes By STEPHEN LOSEY
October 05, 2009
"This may be the year that Debra leaves Blue Cross and Blue Shield. Facing a 12.4 percent increase in her family premium —an increase of $44.38 per month — and rising costs for prescriptions for her and her husband, she and other federal employees are vowing to shop around during this year’s heath insurance open season.
“This is the year to go shopping,” said Colleen Murphy, president of Asparity Decision Solutions, which operates a Web site that allows federal employees to compare health insurances options. 'As we’re talking to federal employees and agency benefit offices, people are saying that, at some point, their insurance premiums hit a point where they need to look at something else,' Murphy said. 'The good thing about [the Federal Employees Health Benefits Program] is that federal employees have lots more options than in the private sector.'
Of more than 10 national and hundreds of regional insurance plans offered to federal employees, all but a few are rising for 2010. Among the plans offering lower prices or flat growth are three GEHA options, two APWU Consumer Driven Health Plan options, and two Rural Carrier Benefit Plan options."...