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<p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">"The two largest of those deals are going to be repealed in reconciliation these week."</p>
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</div><p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">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 It's not being repealed in a real way.</p>
</td></tr></tbody></table></blockquote><div><br></div><div>Sort of. Not really. There's a substantial increase in federal support for the expansion in Medicare, but not total coverage. </div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex;">
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<p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">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.</p>
</td></tr></tbody></table></blockquote><div><br></div><div>Well, sort of. They don't necessarily "receive" anything, except insofar as they "receive" money whenever anyone buys their products.</div>
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<p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">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.</p>
</td></tr></tbody></table></blockquote><div><br></div><div>It's not really the case. There is, of course, nothing in the bill about Viagra and whether it would be covered. Congress doesn't have time to write down everything that may and may not be offered through any given plan; however, I suspect that a parallel regulation will be written once it reaches the executive level. The bill's given that rulemaking authority to HHS. </div>
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<p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">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.</p>
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<p style="margin:0.0px 0.0px 0.0px 0.0px;font:12.0px Helvetica">The problem is the complexity in transitioning from a mostly employer based system to a single payer system, which may not be feasible. </p></td></tr></tbody></table>
</blockquote><div><br>This is the transitional plan. </div><div><br></div><div>In 2014, individuals and small employers can offload their employees on the government-regulated insurance exchanges, trading in their tax credit for an employee-directed subsidy. In 2017, even large employers can join the exchanges and do the same thing. The expectation is that by 2020, all Americans will be using insurance exchanges to purchase their insurance. And while there's currently no federally-operated public option, nothing's stopping nonprofit insurance co-ops (like Washington's GroupHealth) and state-run public plans from joining the exchanges themselves. Presuming that public and nonprofit plans can outcompete the market -- and I believe they can -- we'll have a market without for-profit insurers. </div>
<div><br></div><div>The ACA, by the way, isn't completely novel. The Swiss have an almost-identical plan, and the Dutch have a similar plan. Both seem to work relatively well.</div><div><br></div><div>-- ACS</div><div>
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