188 replies to this topic

[swmr545]

I haven't seen anywhere that the health care bill will decrease the cost of health care. Since there are no provisions to cap what doctors and hospitals can charge, why are we supposed to believe this bill will make health care more affordable? Because Obama said it would?

This will no doubt be answered by some who will say that by insuring everybody and making everybody pay, it will naturally decrease the cost of health care. I thought that about car insurance in California, but I still pay a huge bill even though I've not had an accident in over eight years. And my car isn't an expensive luxury model.

Anyone care to comment and enlighten me?

I am not an expert on this bill, but we had a discussion about it in my comparitive poli sci class the other day and this is what I can offer:

As you stated, the hope is that by using the individual mandate it would begin to drive prices down because there are more people paying into the system. The example used was if you have a company has a $10,000 bill and only 10 people paying, each person has to pay $1,000; however if you have 100 people paying, each person only will pay $100.

As you said, there is no mandate in the bill that requires companies to lower their rates, but that's why we will (eventually) be able to purchase coverage from out of state insurance companies (from my reading, that's to take effect in 2016). The hope of that is the market will self-correct in which if a company is charging too much, then you can go to a company that charges less.

Also, insurance companies will be mandated to spend 85% of their incom on actual health care (according to our prof, they currently spend around 70~75% [I don't remember the exact percentage he gave]), so there's another "hope" idea that with an increase in health care spending by the insurance company will help bring down costs.
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As for your car insurance analogy, the difference between car insurance and health care insurance is that now healtch care is considered to be a basic human right so everyone has now been mandated to purchase health care insurance. Driving a car is considered to be a privilege, so only those that drive a car must buy insurance. Since that's only a limited number of people, the auto insurance companies are still getting away with charging what they want.

Note: the lawsuit(s) are addressing the issue of a universal mandate, and as Bill pointed out, it's a scary thing to have our govt. tell us we must buy something.

Don't know if the link has been posted, but here it is to the text of the bill that was passed:

http://democrats.sen...t-as-passed.pdf

[Robert Giacometti]

I am not an expert on this bill, but we had a discussion about it in my comparitive poli sci class the other day and this is what I can offer:

As you stated, the hope is that by using the individual mandate it would begin to drive prices down because there are more people paying into the system. The example used was if you have a company has a $10,000 bill and only 10 people paying, each person has to pay $1,000; however if you have 100 people paying, each person only will pay $100.

As you said, there is no mandate in the bill that requires companies to lower their rates, but that's why we will (eventually) be able to purchase coverage from out of state insurance companies (from my reading, that's to take effect in 2016). The hope of that is the market will self-correct in which if a company is charging too much, then you can go to a company that charges less.

Insurance is a simple method of spreading the risk amongst all those in the pool. The current pool of people that is insured is probably significantly healthier than the pool that isn't insured and so when Health Care Companies are forced to accept more risk, they will undoubtly raise rates.

There are only a few Health Care Insurance companies out there to buy a policy from and because of the threat and cost of litigation, no other companies will dare enter the market. Less competition, means higher rates for everyone.

I wouldn't be surprised to see Health Insurance Companies put a moratorium on accepting new patients. How can any business stay in business being forced to accept customers that they will loose money on?

This truly is bad legislation!

[Bill Z]

As you said, there is no mandate in the bill that requires companies to lower their rates, but that's why we will (eventually) be able to purchase coverage from out of state insurance companies (from my reading, that's to take effect in 2016). The hope of that is the market will self-correct in which if a company is charging too much, then you can go to a company that charges less.

This isn't as simple as you make it sound.

One, most companies do not offer every single healthcare policies to their employees.

This is partially due to requirements that for "group coverage", a high majority of the employees must go with one carrier. It depends upon the carrier, but it is true.

two, employees hate change and deserve stability. Would you like it if every year, you had to re-enroll with a new insurance carrier to get better rates, but would then have to figure all of the in's & out's of filing claims and how much of what things they cover? Or would you prefer that once you pick a plan, you get to stay with that plan forever if you want.

I will say, of all of the crap I hara about about this bill, there is one thing I do like that I have heard. And that is no denial of coverage for pre-existing conditions if you are switching from group coverage to individual coverage. And while my hopes and expectations are that Kaiser would never do that to me for my Asthma, it is re-assuring to know that legally now they can not.

But despite my liking this feature of the bill, I still am vary concerned that this bill is the tip of the iceberg in our federal government overtaking the healthcare industry and I fear that in the future my wonderful Kaiser coverage will be destroyed. That my doctors won't be able to make independent decisions about my care, that making apppointments will be hard and long waits for availability, etc. And that the response to severe illnesses will be slow resulting in death for many because the system became so big and encumbersome that it lost the ability to respond quickly and effectively when needed.

[SmartMoney]

This truly is bad legislation!

Amen. And it won't take too long for people to wake-up to that fact once things really spiral out of control fiscally.

[bordercolliefan]

Insurance is a simple method of spreading the risk amongst all those in the pool. The current pool of people that is insured is probably significantly healthier than the pool that isn't insured and so when Health Care Companies are forced to accept more risk, they will undoubtly raise rates.

Actually, your assumption is untrue -- the truth is just the opposite.

A large number of the people who are currently uninsured are young people. They figure they don't need insurance, so they opt not to buy it.

That is how Anthem/Blue Cross explained its 39% rate increase a couple months ago. It said that with the poor economy, healthy people were increasingly opting not to buy insurance. Thus, its pool was becoming sicker and sicker... hence it needed to raise rates drastically. Analysts called this the "death spiral" of insurance... where only people who know they will need to make claims hold onto the insurance.

[Robert Giacometti]

Actually, your assumption is untrue -- the truth is just the opposite.

A large number of the people who are currently uninsured are young people. They figure they don't need insurance, so they opt not to buy it.

That is how Anthem/Blue Cross explained its 39% rate increase a couple months ago. It said that with the poor economy, healthy people were increasingly opting not to buy insurance. Thus, its pool was becoming sicker and sicker... hence it needed to raise rates drastically. Analysts called this the "death spiral" of insurance... where only people who know they will need to make claims hold onto the insurance.

What about all those who can't get insurance because of preexisting conditions or who can't qualify? If these numbers are so insignificant, then we really don't need healtcare reform? I agree with you when you say young people are CHOOSING not to buy insurance, this kinda defeats your arguement that there is crisis of so many uninsured, when they are choosing not to buy.

You can't have it both ways.

Insurance companies aren't weeding out the profitable clients are they? Trust me rates are going up!

[bordercolliefan]

What about all those who can't get insurance because of preexisting conditions or who can't qualify? If these numbers are so insignificant, then we really don't need healtcare reform? I agree with you when you say young people are CHOOSING not to buy insurance, this kinda defeats your arguement that there is crisis of so many uninsured, when they are choosing not to buy.

Well, that's a good point. I guess I don't know what proportion of the uninsured are healthy people uninsured by choice, versus unhealthy people who can't get insurance.

Both groups of people are a problem:

--some of the young healthy people will have accidents, forcing the rest of us to pay for their care;

--as for the people with pre-existing conditions, some of us think it's morally wrong that they and their families be impoverished by health care bills.

[Robert Giacometti]

Well, that's a good point. I guess I don't know what proportion of the uninsured are healthy people uninsured by choice, versus unhealthy people who can't get insurance.

Both groups of people are a problem:

--some of the young healthy people will have accidents, forcing the rest of us to pay for their care;

--as for the people with pre-existing conditions, some of us think it's morally wrong that they and their families be impoverished by health care bills.

Another way to look at is this, is why would the Health Insurance companies NOT want to force everyone into buying their product? I think the answer is the pool of customers who don't have insurance would be too unprofitable.

This is one reason why I think rates will be going up.

[bordercolliefan]

Another way to look at is this, is why would the Health Insurance companies NOT want to force everyone into buying their product? I think the answer is the pool of customers who don't have insurance would be too unprofitable.

I think the health insurers LOVE the universal mandate. That's the carrot to them!

It's the other parts they hate-- the inability to deny based on pre-existing conditions, inability to drop sick people, etc.

Still, I can't argue with your main premise that rates might go up. We keep coming back to the 2 insurmountable problems with our system: (1) multiple, byzantine bureaucracies and (2) private companies' #1 priority of making a profit, even if it's off sick people's backs.

[Bill Z]

Well, that's a good point. I guess I don't know what proportion of the uninsured are healthy people uninsured by choice, versus unhealthy people who can't get insurance.

Both groups of people are a problem:

--some of the young healthy people will have accidents, forcing the rest of us to pay for their care;

--as for the people with pre-existing conditions, some of us think it's morally wrong that they and their families be impoverished by health care bills.

I have mixed emotions on the pre-existing conditions thing, but if everyone has to have healthcare, then it kinda resolves my issue, not that I like the overall result of the solution.

OK, to explain, I see some of our employees that cancel their coverage to save money, and then re-instate it come open enrollment time when they know they have some issue they want dealt with, then after their medical issue is resolved good enough to satisfy them, they go and cancel their coverage again. So, to me, that is wrong that they do that. So it does bother me the young healthy people feel they don't need to pay for coverage now, but will buy it later when they might need it as older people do tend to have more that ails them. The tough cold hearted side of me feels, tough, if you slacked when you were younger, then you don't deserve to be saved now that you are older, if you had paid for insurance your whole life, then you deserve to be covered. Reward those who have been responsible and don't reward those who were irresponsible.

[SmartMoney]

Well, I guess the Democrats are happy now. God help us.

http://www.dakotavoi...y-fidel-castro/

[Bill Z]

Here is what our illustrious representative has to say about the new healthcare bill:

Dear Constiuent,

Since the President signed the Senate health care bill into law on Tuesday, I have received numerous calls and e-mails from my constituents asking, “What does this bill mean for me?” and “What’s next?” While it remains unclear how many of the provisions in the 2400 page bill and its 150 page companion, the so-called “Reconciliation Bill,” will be implemented, I wanted to provide you with a timeline of some of the changes you can expect over the next few years.

The greatest immediate change is that individuals with preexisting conditions will be able to purchase health care coverage without risk of being denied or cancelled. This was a goal of all the alternative legislative proposals.

A $2.3 billion tax on all prescription drugs begins immediately. On July 1, 2010, a new 10 percent tax on indoor tanning services begins.

Six months from now, unmarried adult children 26 and under can stay on their parents’ health insurance plans.

Starting this year and continuing in 2011, substantial cuts will be made to Medicare. Overall, $530 billion will be cut from Medicare over the next ten years. This is of great concern to me, as many of my constituents already have difficulty in finding Medicare providers to care for them. Additionally, this will restrict and/or eliminate the Medicare Advantage program, affecting over 41,000 seniors in my district alone. Moreover, the bill does not address the physician reimbursement issue (so-called “doc fix”). Under existing law, reimbursement rates for Medicare providers would be cut by 20 percent or more on March 31, 2010.

One aspect of the health care bill that has not been adequately considered relates to its impact on the number of doctors who will be necessary to provide care for the newly insured. A study published in the New England Journal of Medicine found that 46 percent of the country’s primary care physicians indicated they would leave the practice of medicine altogether if Congress passed the proposed health care overhaul bill.

In 2011, Medicaid eligibility will be expanded. The chief deputy director for California's Medicaid health care programs estimates that this will cost California's state government an additional $2 to $3 billion per year. At the same time, the rate of reimbursement for services under Medicaid is even lower than for Medicare – in many cases considerably less than what it actually costs physicians to perform those services. As a result, providers are increasingly reluctant to take Medicaid patients. Enrolling more patients under a program that is already overburdened will likely lead to longer wait times and rationing of care. Access to “coverage” does not necessarily equal access to care.

In 2013, a new 2.3 percent tax will be imposed on medical devices, including wheelchairs, artificial hips and knees, crutches, scalpels, stethoscopes, and hospital beds. The tax will total $20 billion over 10 years. The nonpartisan Congressional Research Service notes that, “For ordinary medical devices with many producers, the tax should be fully passed on to consumers, although some of the cost, depending on the device, will be paid by insurers and lead to higher insurance payments, still ultimately falling on consumers.” I am thus concerned that taxing medical devices will be passed on to patients and adversely affect health care innovation.

Beginning in 2014, government-run health insurance exchanges will be created and the requirement that all individuals are enrolled in a health insurance plan is implemented. Ironically, while this bill was touted as “health insurance reform,” insurance companies participating in the exchanges will be the recipients of $460 billion in refundable tax credits. The Congressional Budget Office (CBO) projects that health insurance premiums could go up as much as 27 to 30 percent for those purchasing insurance under the government-created exchanges. Americans who do not qualify for subsidies yet who are unable to afford health care coverage will be faced with additional civil penalties for noncompliance with the new federal mandate to purchase coverage.

Also in 2014, employers who do not offer health benefits approved by the Secretary of Health and Human Services must pay a fine of $3,000 per employee. This amount is reduced to $2,000 per person if all employees in the company are moved to the government-run exchange. A recent article in the Wall Street Journal highlights some of the problems with the employer tax penalties in the bill. For example, the Caterpillar company said the bill would cost the company $100 million or more in the first year alone. Far from being a “job creator,” this bill is likely to lead to lay-offs. The employer provisions under the bill are of concern to me, as unemployment in some areas of my district is already 15 percent. Penalizing employers at a time when new jobs are so desperately needed will only make it more difficult for Americans to recover from the economic crisis.

This is only a small taste of the changes that can be expected under the recently enacted health care overhaul law. As I receive more details regarding implementation of the bill, I will share that information with you. Next week I will answer the question, “What now?”

Sincerely,

Daniel E. Lungren
Member of Congress

[bordercolliefan]

Health insurance is not a basic human right. Basic, fundamental rights are those that the government cannot take from you. The freedom to speak, the freedom to worship, the freedom to marry (I know - for some), the freedom to procreate, the right to be free from warrantless searches, etc . . .

Saying that health care is among these dilutes the value of our fundamental rights guaranteed by the constitution. If you are a poli-sci student - I would hope you would challenge statements like this.

You are confusing human rights versus constitutional rights.

Constitutional rights are those defined in whatever constitution we happen to be talking about.

Human rights is a more amorphous, moral concept. If you ask the United Nations or European Union, they will give you a broader definition of human rights than, say, the average Republican in America might.