Patterico's Pontifications

3/15/2010

Health Care 101

Filed under: Health Care,Media Bias — DRJ @ 10:56 am



[Guest post by DRJ]

Now that passage of government health care seems possible, the AP has decided to point out some minor problems:

“It took lawmakers a year to shape President Barack Obama’s health care bill. If it finally passes Congress, it’ll take the better part of a decade to write the user manual for consumers and doctors, employers and insurance companies.

Some health insurance consumer protections would go into place immediately, significant but limited in scope. The big expansion in coverage comes in four years. More than 30 million people would sign up, with most getting tax credits to help pay premiums. Ripple effects continue well after Obama has to leave office in 2017, if he’s re-elected.

But even if the 2,700-plus-page bill passes, it’s only the end of the beginning. The Obama blueprint will be carried out under less-than-ideal circumstances. Rising medical costs and an aging population will keep squeezing the federal budget. Lawmakers will have to revisit hard choices they sidestepped.

“This is going to play out over a generation,” said Andrew Hyman, who oversees health insurance research for the nonpartisan Robert Wood Johnson Foundation. “It will address how people get coverage, how health care is delivered, and how health care is paid for.”

It’s like a really expensive health care supermarket for middle class American workers:

“Starting in 2014, self-employed people and those whose employers don’t offer coverage would be able to pick a plan through a health insurance exchange, like a supermarket. It’s modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could also join.

More than 30 million people would buy coverage through state exchanges, and nearly 6 in 10 would be eligible for help with their premiums. The new tax credits would be computed according to income and other household characteristics. The money would go straight to the insurer. To consumers it would look like a discount — generous for lower-income families, less so for those solidly in the middle class.

For example, a family of four making $44,000 would pay $2,763 in premiums _about 6 percent of its income_ for a policy worth $9,435.

But a similar family making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That may be less than a mortgage, but it’s more than a car payment.

Once the exchanges open, most Americans would be required to carry health insurance or pay a fine. Medicaid would be expanded to cover childless adults living near poverty.”

It’s the Obama campaign all over again. The media only does its job after the decision is made.

— DRJ

46 Responses to “Health Care 101”

  1. They could just borrow the money from Social Security. All it takes is [a little piece of paper] sent to a Parkersburg, West Virgina office. Who knew we have been going bankrupt?

    Corwin (ea9428)

  2. Perhaps the media is being “fed” some of the weaknesses and pitfalls of the “bill” to help give cover to the Dems for when they suddenly decide to go back to the drawing board in order to go incremental, or to temporarily suspend work on health care reform to focus on jobs. I do think the combination of public opinion, no cost controls, reconciliation iffyness, and the Slaughter process stuff even has a lot of Dems worried– and they are looking for a way out to back down without totally losing face. One can hope, anyway.

    elissa (6ae89f)

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  4. The big expansion in coverage comes in four years.

    This is why I’m perplexed by the Dems belief that passing the bill will help them, because people will get to see all the wonderful stuff that’s in the bill.

    In order to create the fiction that this mess is budget neutral they had to start the tax collecting at once while deferring the benefits (such as they are) for several years. So even if we assume that the bill will eventually work wonders for Americans heal, its passage is not going to help the Democrats in November.

    Subotai (a40355)

  5. The bill does nothing to cut costs except rationing. All the incentives are as bad or worse. All the rent seekers have their gimme included in the mandates for everyone. There will be no high deductible option. Everything will be first dollar coverage but rationed. Do you know what that is ? It is price controls. Remember how well that worked before ?

    I saw an interesting statistic in the blog post by Wolff a radiologist and cousin of Obama. He wrote that 42% of doctors now do NOT accept Medicare. I didn’t know it was that high now. Guess what it will be in two years if this goes through.

    Mike K (2cf494)

  6. At least the AP acknowledged the possibility Obama might not get re-elected. A big step for them.

    skwiself (7c068a)

  7. “It’s like a really expensive health care supermarket for middle class American workers:”

    You really didn’t know about this part of the plan? I mean, the whole idea from the beginning was to set up the individual market as exchanges and have people get subsidies to purchase health care there. The discussions were: what kind of exchanges, who goes in them, and what kind of subsidies are provided.

    What reporting were you reading that failed to tell you this? Stuff about Death Panels?

    imdw (499eb8)

  8. Pelosi was blabbering on about how “artists” who are otherwise unemployed will be so much better off under this bill because they’ll have healthcare coverage. Of course, they’ll have healthcare coverage because they’ll be forced to buy it whether they like it or not, and fined if they don’t.

    I get the disturbing feeling that if the Dem leadership was quizzed about what’s in the bill, they’d get an F.

    Subotai (a40355)

  9. It’s modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could also join.

    So why won’t federal employees be required to use this wonderful new system along with the rest of us?

    Subotai (a40355)

  10. “So why won’t federal employees be required to use this wonderful new system along with the rest of us?”

    The exchange is only for people in the individual and small market. You’re actually not allowed to be in the exchange if you have large group insurance, such as with a large employer.

    imdw (829dfa)

  11. imdw:

    You really just comment here because there’s nothing else in life for you, is there?

    It’s sad and I’m sorry. I wish someone could do something for you.

    Ag80 (f67beb)

  12. ““It’s like a really expensive health care supermarket for middle class American workers:”

    You really didn’t know about this part of the plan? I mean, the whole idea from the beginning was to set up the individual market as exchanges and have people get subsidies to purchase health care there. The discussions were: what kind of exchanges, who goes in them, and what kind of subsidies are provided.

    What reporting were you reading that failed to tell you this? Stuff about Death Panels?

    Comment by imdw — 3/15/2010 @ 12:21 pm”

    Actually it is not a health care payer supermarket. Its a welfare scheme. There is no insurance component to it. The premiums are not based on risks but rather on social engineering considerations. Its a tax. And a fraudulently labeled tax which shows that even the democrats are ashamed of themselves and don’t have the courage of their convictions in honestly calling it what it is. The “insurance premium” figures mentioned are all pie-in-the-sky since once the mandatory provisions are implemented no one knows what the insurance companies will have to charge to cover their risks. The punishment rate will have to be nearly the same if not more than the cost of the ‘insurance’ to induce people to fork over 10% of income to subsidize others for what is clearly not a basic core function of government. It would be cheaper for the to pay the penalty. Already there are warnings the US may lose its Aaa rating. If it does the cost of funds to government to finance all these income redistribution schemes will become unsustainable. Already Social Security is tapping Al Gore’s famous lockbox.
    By the way what reporting did you read that this was not another welfare scheme?

    Comment by Mike K — 3/15/2010 @ 12:13 pm: If this figure is true it is eye popping. In ten years based on that figure if this bill passes the number will easily exceed 60% of the doctors not to mention that there will be a shortage of doctors a few years later when the number of new doctors decrease dramatically.

    cubanbob (409ac2)

  13. AG80 is right, the correct reaction to imdw is to pity that there’s no one in his life to get him some help.

    It’s funny to point out how he’s wrong, or just nasty and pathetic, but the longer you consider it, the less funny it is. He spends more time on this blog than I do at my job.

    Dustin (b54cdc)

  14. What reporting were you reading that failed to tell you this? Stuff about Death Panels?

    Who wants to bet that imadouchebag will use “Death Panels” at least two more times today? He’s already got the Trifecta.

    Dmac (ca1d8c)

  15. “By the way what reporting did you read that this was not another welfare scheme?”

    I read some facebook posts about it. THey had dmac’s favorite word.

    imdw (bffa1b)

  16. I mean, the whole idea from the beginning was to set up the individual market as exchanges and have people get subsidies to purchase health care there.

    For the last time, this is not about purchasing health care; it’s about purchasing health insurance. There’s a difference between the two. Please learn the difference, and stop confusing the two.

    Some chump (050674)

  17. Some chump – it is not an accident that they conflate the two.

    I am interested how the plans that have been grandfathered in will be effected should they decide to change coverage, or heaven forbid, raise rates.

    JD (cfb3e8)

  18. I mean, the whole idea from the beginning was to set up the individual market as exchanges and have people get subsidies to purchase health care there.

    That was not and is not “the whole idea from the beginning”. The whole idea from the beginning was and still is a health-care system run and paid for by the Federal government via tax money. This “exchange” nonsense is merely a way-station on the road to that goal.

    Subotai (a40355)

  19. and don’t forget the Bush Tax Cuts expire in 291 days…
    and the 10% bracket gets the biggest increase to 15%
    Tax those bastards back to the stone age!!!!!!!!!

    Frank Drackman (7ee2ca)

  20. Boy Wonder today at a health care rally – read it and weep:

    “…your employer, it’s estimated would see premiums fall by as much as 3000 percent so they could give you a raise!”

    Molon Labe (640aad)

  21. Once again, there are simple reforms that would do a lot to start the cost curve going less up, if not down.

    One- Make the Medicare payment for physician services a fixed subsidy but allow doctors to charge more. This is called “balance billing” and is illegal. Even the NY Times got this wrong in an article about “concierge medicine,” which tried to explain the movement to cash practice by primary care docs. First they used “concierge” to imply that only the rich could afford this. Second, they got the facts wrong by implying that doctors could charge extra now.

    Two- Establish a fund for catastrophic illness that pays only for treatment of that illness. This is what the French do. The fund would cover real illness, like cancer and diabetes. Things like fibromylagia that plagues the workers comp world would not be covered.

    Three- Require scientific basis for treatment. That is implied by such panels as NICE in England but they are riddled with politics. Real science would eliminate chiropractic and aromatherapy and all sorts of “treatments” that are included in Medicaid by strong lobbies. I don’t care if people want to pay for these services on their own. Since insurance began to pay for this, chiropractors make more than MDs. Often, a lot more.

    Four- Exchanges are a good idea if they are NOT subsidized but are a system for individual buyers and small business buyers of insurance.

    Five- Force freedom of Information style disclosure of insurance and Medicare payment to physicians and hospitals. This will allow real free market negotiation of fees and charges by the high deductible customer who wants to know what the prices really are. Right now, many patients do not know how to read EOB forms or are not allowed to see the real payment for their care. They often pay more for the “20% deductible” than the insurance company pays for the “80%” share it tells you it is paying. Fees and charges should be available on the internet and/or posted in the office.

    That would be real reform.

    Mike K (2cf494)

  22. Mike K – they have little to no interest in real reform.

    JD (656d48)

  23. Reform = Government takeover.

    Dmac (ca1d8c)

  24. imdw – BHO himself brought on talk of death panels with his personal anecdotitis.

    daleyrocks (718861)

  25. Change = Government Takeover

    Accountability = Strict Government Regulation

    daleyrocks (718861)

  26. I see that Obama is still attempting to defraud Americans by claiming non-existant “savings” and fairy dust reductions in premiums.

    He’s quite brazen.

    SPQR (26be8b)

  27. “…your employer, it’s estimated would see premiums fall by as much as 3000 percent so they could give you a raise!”

    Estimated by who? Obama’s daughter?

    Subotai (a40355)

  28. imdw

    so people who currently don’t buy health care insurance are going to flock in droves to buy in now?

    by the way, the woman who Obama is featuring whose cancer has returned?
    Had cancer, went into remission… and then dropped her coverage and now it has returned…

    Sad.

    but who in the hell drops insurance coverage after being treated for cancer?

    holy crap

    The lady probably paid less than $20K into the system before she took out hundreds of thousands of $$ in coverage… so she cancels?
    With a big mofo of a pre existing condition?

    Not to be mean, but the chemo must of made her cognitive skills all jodido.

    Note to self: if it is me with cancer on my insurance rap sheet, work for med ins. as first priority.

    Steve G (909b57)

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  30. imdw:

    “It’s like a really expensive health care supermarket for middle class American workers:”

    You really didn’t know about this part of the plan? I mean, the whole idea from the beginning was to set up the individual market as exchanges and have people get subsidies to purchase health care there. The discussions were: what kind of exchanges, who goes in them, and what kind of subsidies are provided.

    What reporting were you reading that failed to tell you this? Stuff about Death Panels?

    I know the reform bill establishes health care markets. The point of this sentence was to introduce the quote and emphasize that health care is going to be “really expensive” for the “middle class.”

    DRJ (daa62a)

  31. The government has for years required insurance companies to pay for a pap smear test and a mammogram for women every year. When it looked like the government would start having to pay for those they suddenly came out and said that that was unnecassary.

    Have Blue (854a6e)

  32. “so people who currently don’t buy health care insurance are going to flock in droves to buy in now?”

    There are some estimates of how many uninsured this reaches. IIRC, not all were reached, but of those who were, some were covered by medicaid and some would be getting insurance due to the mandate.

    imdw (de7003)

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