[Vision2020] Health care {insurance} reform passed

[Garrett Clevenger]

Andreas writes:


"The two largest of those deals are going to be repealed in reconciliation these week."




From what I understand, the Nebraska deal will be granted to all states now at least for the next several years. It's not being repealed in a real way.


I also understand that the senior giveaway is being paid for by the pharmaceutical industry.  I suppose that's a small price for them to pay considering the billions of tax-dollars they receive from the prescription drug plan.


On a similar note, while the "no viagra for rapists" amendment may have seemed silly to some, I have to wonder why viagra for anybody is being subsidized if that's really the case.


As for my "better" ideas, I'm not an expert and can't provide details, but I can challenge a basic assumption about how health care is paid for that I would want to form the basis of reform.


Why do we think businesses should be obligated to pay for an employee's health care?


While that is a nice benefit, and perhaps a retaining tool, it also is a coercive element for workers.


I'm sure I'm not the only one who didn't want to quit a job because of the health benefits that came with it.


That's a trap that I'd rather do without.  Life is too short to feel trapped by a job's benefits.


Businesses shouldn't be burdened with health care costs. I'm sure they would be glad to be free from that obligation.


So if businesses no longer provide health benefits (or perhaps they would just provide premium benefits if they so choose) the need for a single-payer system opens up.


The problem is the complexity in transitioning from a mostly employer based system to a single payer system, which may not be feasible.  Who would be responsible for paying for the benefits businesses are now obligated to pay? Why should a business who made a choice to provide certain benefits now be allowed to just forget about it?


It seems like it would be more efficient to simplify the whole thing.  Get rid of all the plans and options and fine print.  Keep things consistent.


Instead of people changing from one plan to another which happens if people move to a different state or change jobs, and then having to requalify for a new plan and wonder if the new plan will cover them sufficiently, people would keep their plan their whole life and those plans would be equal across the board for everybody who pays taxes.


A national health care plan would be the revenue source for paying bills (along with premiums and co pays)


Everybody would be covered under a basic plan.


If individuals want a more comprehensive plan, they could pay more.


If a business wants to retain benefit packages, they could provide premium plans to supplement the basic plan a national health care plan would provide.


I'm sure there are models other developed nations have that we could use as a blueprint instead of the novel one we now have which has a lot of problems.
At least with a national health care plan, there would presumably be more accountability as compared to a private health insurer which probably couldn't care less what voters think.
Government, on the other hand, can be shaped by it's citizens.


Garrett Clevenger

--- On Wed, 3/24/10, Andreas Schou <ophite at gmail.com> wrote:

From: Andreas Schou <ophite at gmail.com>
Subject: Re: [Vision2020] Health care {insurance} reform passed
To: "Garrett Clevenger" <garrettmc at verizon.net>
Cc: vision2020 at moscow.com
Date: Wednesday, March 24, 2010, 2:15 PM



You're probably being facetious when you said the Chinese will be paying for the $250 senior giveaway (not the kind where they give seniors away:)




What I meant is that the senior giveaway was a pretty bad idea. It's not paid for 'til 2012, when some of the (small) associated taxes, like the tax on class 1 medical devices, come online. However, given the low year-to-year costs of issuing treasury bills, especially given the international rush to buy American currency, our float of the costs is likely to cost only a couple tens of million dollars. Tens of millions of dollars are a lot of dollars on an absolute scale; on a relative scale, it's peanuts. 

 

Apart from all the deals they had to make to get this bill passed.
The two largest of those deals are going to be repealed in reconciliation these week. 

There's no good reason for the Nebraska deal. There's a good argument, however, that the Louisiana deal should stay. There's a peculiar reason for it. After Hurricane Katrina, the combination of federal disaster-relief money and private insurance payouts increased the median on-paper income in Louisiana by 40%. When this number was inserted into the Medicaid funding formula, it resulted in a drastic reduction in Medicaid funds to Louisiana. From a rational perspective, the insurance payouts weren't "real" income; they were compensation for a massive statewide destruction of wealth. What the "Louisiana Compromise" does is zero out that phantom 40% increase, restoring Medicaid funding at the prior level.


The unanimous
 partisan nature of the passage.
It passed on a unanimously partisan vote because the Republicans made a practical decision to oppose any plan the Democrats proposed, whatever the cost and whatever the plan. From a purely mercenary political perspective, this was a good idea: their unanimous opposition held up the bill for eight more months than it ought to have been. It did, however, prevent even good Republican ideas from being inserted into the bill.

http://www.nationaljournal.com/njmagazine/nj_20100320_9241.php 


And of course the INSURANCE MANDATE (which pisses a lot more than right wingers off (I'm more aligned with dems than repubs so I don't want to see them in power again).

I get that, Garrett. But I can't think of a way to preserve an insurance market without a mandate. To do so, you have to work within a 3.3% profit margin while moving the most expensive cases into the market. In order to balance those risk pools out without drastically driving up costs to the consumer (or the government), there needs to be compulsory participation for healthy people. 

If that doesn't happen, the most rational market participation strategy is to wait until you get sick (and thus have a pre-existing condition) to join the market. That means that the insurance market is a de facto single-payer system, subsidized by the government, where the profits go to private corporations.

Do you have a better idea?
-- ACS
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://mailman.fsr.com/pipermail/vision2020/attachments/20100325/e9d51bcf/attachment-0001.html