Dems Split on Health Care Reform

Sen. Ted Kennedy and Max Baucus have dueling health care reform proposals. Politico has more on Kennedy's plan.

I just got my renewal policy yesterday. My premium is going up a whopping $250.00 per month -- I have no diseases, haven't been sick and didn't change age groups. What gives?

According to Anthem (BCBS) it's because Colorado passed a law last year preventing employers from considering a group's health care risk or prior history. So, according to Anthem, healthy groups have to pay for the less healthy groups. [More...]

Once again, my choice: Pay the extra money or get a plan with lesser coverage. This is the third year in a row I've been faced with this choice, despite being healthy. It's getting old...and prohibitively expensive.

What should the Dems do on health care reform?

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    The Baucus plan is not the solution. (5.00 / 5) (#3)
    by Anne on Fri May 29, 2009 at 09:24:07 PM EST
    Kennedy's is closer, but this quote from the cited NYT article:

    Public opinion polls suggest that many consumers would like to have the choice of a public plan. But insurance companies and Republican lawmakers say a public plan could drive private insurers out of business and lead eventually to a single-payer system run by the government.

    makes it sound like single-payer would be the worst outcome, when in fact, it should be the goal.

    There is no reason why Baucus - and even Obama - should be denying single-payer proponents a seat at the table - if we're going to fix this thing, we should be considering everything, not making sure that the health insurance companies get to keep running things their way.

    I keep hearing about how the cost of health care is draining the life out of the economy, so why wouldn't we want a single-payer plan that could save some $350 million right out of the gate?

    I've gotten to the point where I would rather there be no reform than for them to cobble together a reinvented Big Pharma cash cow that won't be appreciably less expensive, cover more people, or improve the quality of health care.

    I love this part (none / 0) (#54)
    by cal1942 on Sat May 30, 2009 at 01:38:06 AM EST
    lead eventually to a single-payer system run by the government.

    As you said, as if that's a bad thing.

    But who else would run a single payer system. Stating the absolute obvious.  Funny.

    It's also the sound of fear.  I don't really know why they sould be so fearful they're going to win again.

    They'll buy whatever and whoever they need to buy and shift public opinion to oppose reform.

    With no will to reform in the White House the game is already over.  The bad guys have already carried the day.

    Over the years it's become routine.


    My devious plan is to "save Medicare" (5.00 / 4) (#4)
    by andgarden on Fri May 29, 2009 at 09:26:42 PM EST
    by allowing every American to buy in at really cheap rates.

    It's certainly the smartest of the options (none / 0) (#7)
    by Inspector Gadget on Fri May 29, 2009 at 09:30:40 PM EST
    It already exists, just needs expansion. I think Social Security recipients pay less than $100 a month for coverage, and it is very good coverage.

    I think if we had the will, the Republicans (5.00 / 1) (#9)
    by andgarden on Fri May 29, 2009 at 09:35:41 PM EST
    would be impotent to stop it. I mean, what Republican is going to attack Medicare? Their only hope would be to scare old people into thinking that the kids would take all of the medicine or something. (Which would be totally wrong: young healthy people require almost no care at all).

    But first, we'd have to get the (5.00 / 3) (#14)
    by Anne on Fri May 29, 2009 at 09:43:26 PM EST
    Dems - like Baucus - on board, and that is just not happening.  Baucus had single-payer advocates arrested and thrown out of a hearing on health care; if he'd actually invited any of them to participate in the hearing, he wouldn't have had to force them to be heard in the only way left to them.

    Obama's big summit on health care?  It was only after constant badgering that anyone from the single-payer side was even allowed to attend, and it was a grudging invitation issued at the last minute.

    I don't see it happening - the insurance lobby has too much money and they have Dems by the throat.


    See, this isn't single-payer per se (none / 0) (#15)
    by andgarden on Fri May 29, 2009 at 09:46:24 PM EST
    HR 676 scares everyone because it makes private insurance illegal. So my idea is to make the public option Medicare itself. And yes, many Dems would resist even that.

    Indeed, and many on Medicare (none / 0) (#20)
    by Inspector Gadget on Fri May 29, 2009 at 10:14:33 PM EST
    already spend some $200 a month extra to have supplemental insurance....independent insurances could still find a place in the market.

    The beauty of getting everyone on Medicare (5.00 / 1) (#22)
    by andgarden on Fri May 29, 2009 at 10:17:24 PM EST
    Is that Uncle Sam has theoretically limitless capacity to pay for care. Of course, that's what scares the Republicans.

    Some one has (none / 0) (#66)
    by Wile ECoyote on Sat May 30, 2009 at 07:41:22 AM EST
    to pay.  Maybe the gov't will just print money to pay for it.

    If I got the news (none / 0) (#33)
    by cal1942 on Sat May 30, 2009 at 12:02:15 AM EST
    correctly on that "summit", weren't the single payer advocates allowed to attend but not allowed to speak?

    Please correct me if I'm wrong.


    For some reason, I'm thinking that (5.00 / 2) (#75)
    by Anne on Sat May 30, 2009 at 09:29:21 AM EST
    they did speak, very briefly, but there is no record of what they said in the WH transcripts (?) - there was something shady about it, as I recall.

    What makes me so mad is that Baucus and Obama are acting as though they want all the stakeholders in on the brain-storming, that they want to hear all the ideas - and yet, they really do not want the single-payer people at the table, or even in the room.  Or perhaps, I should say that the insurance industry doesn't want anyone horning in on this great thing they have going, where they seem to be the ones in charge.  They are protecting the huge profits they have been making off those who can still afford insurance; neither Obama nor Baucus seem to be at all interested in the simple truth that having insurance doesn't necessarily mean you have the health care you need.  If CARE is the issue, the insurance industry needs to be kept out of the room, or told to sit down and shut up, long enough for this aspect of the issue to get the attention it deserves.  When you start talking about how insurance is failing the people it allegedly covers, it becomes clear that their ideas about reform are only going to be in their interest, and will not improve the system.

    Obama says he wants health care done by August...I think it's going to be a disaster.


    Medicare is already under attack (1.00 / 1) (#80)
    by ChiTownMike on Sat May 30, 2009 at 10:56:17 AM EST
    By the medical community. Fewer and fewer doctors accept Medicare because the government keeps cutting what they are paid and then to add insult to injury payment is a slow tedious process.

    Deductible (none / 0) (#11)
    by Natal on Fri May 29, 2009 at 09:39:52 PM EST
    Doesn't Medicare have a $500 deductible and co-pay clause in addition to the monthly premium?

    People on Medicare (5.00 / 3) (#37)
    by cal1942 on Sat May 30, 2009 at 12:10:15 AM EST
    buy additional insurance to cover deductible and co-pays.

    Rates depend on how care is delivered, whether by an HMO, PPO or free choice.

    Some former employers pay the freight as a feature of retirement.  Most retired people pay out of their own pockets.

    This wouldn't be necessary if Congress beefed up Medicare.

    A single-payer system could clear this up.


    People on regular Medicare (5.00 / 1) (#60)
    by caseyOR on Sat May 30, 2009 at 02:36:27 AM EST
    Not on the evil Medicare Advantage, but regular Medicare, pay an annual deductible of $135. Some things, like lab work and mammograms, are then paid totally by Medicare. For others the patient pays 20%.

    Medicare, through the Congress, determines how much providers are paid for everything. Providers who accept Medicare agree not to charge patients more than the amount of payment Medicare has set. This is one of the ways Medicare for All will slow the rise of healthcare costs.


    Totally Agree (5.00 / 1) (#70)
    by justinboston2008 on Sat May 30, 2009 at 08:47:10 AM EST
    I counsel my clients to stay far away from the Medicare Advantage plans. They should be made illegal. Sure they are mandated to cover everything that Medicare covers, but a lot of times they'll deny care and fight it through appeals in the hopes that the patient kicks it before they have to pay. Anthem Colorado is notorious for this.

    Absolutely right - many folks (none / 0) (#91)
    by allimom99 on Sun May 31, 2009 at 09:53:29 AM EST
    who are drawn in because of Medicare Advantage's premiums don't realize that they are giving up their regular Medicare benefits by signing up. The only 'advantage' is the one that accrues to the insurance company.

    The ONLY way to get universal health CARE is to get the insurance companies as they are now constituted out of the mix. Their business models are based on denying care whenever possible, so having universal insurance doesn't mean a thing.

    I want to know what Obama meant when he said if we don't do his plan now, it won't get done at all. I attended a single-payer rally on Friday, and judging from the honking from passersby, and his own actions around this, I can only conclude that he's afraid that single-payer will catch on, and then he won't be able to help out his campaign contributors in the insurance industry.

    It will be interesting to see what happens if Teddy goes up against Obama on this. Kennedy, at least, is genuinely committed to health care. Obama, it seems, not so much. This is a chance for Teddy to make his mark on an issue he's been working for many years. Obama might do well to stay the hell out of his way.


    Probably (none / 0) (#21)
    by Inspector Gadget on Fri May 29, 2009 at 10:16:27 PM EST
    that's most likely why most retired people who can afford it also have supplemental to pay those co-pays and deductibles.

    It was really, really rare for my parents to have to pay anything to a medical facility, and my mom was a regular at numerous doctors.


    Seems like a no-brainer to me. (none / 0) (#78)
    by KeysDan on Sat May 30, 2009 at 10:34:24 AM EST
    Medicare operates as a single payer system; has a tax-base (2.9 percent--equal parts employee/employer contributions and no limit on deductions, unlike social security), a history, since 1965, of low cost and effective administration, no pre-existing condition screens--covers all, no monthly premiums for Part A (hospital), a sliding scale for Part B (medical), for example: for single:$96.40 per month, $85,000 per year, $134.90, 85,00l to 107,000; $19270, $107,00l to $160,000; and $308.30 above $213,000.  Most evaluations of Medicare seem to be very good, with those reservations that exist owing, for the most part,  to health care system and professionals reimbursements.  Even Part D, a Bush legacy, seems to be shaking down with problems readily capable of re-tooling.   The Medigap or supplemental policies still give room for private insurers, albeit not entirely to their liking.

    Really (none / 0) (#10)
    by Ga6thDem on Fri May 29, 2009 at 09:39:36 PM EST
    this is so simple. I just can't imagine why it isnt being proposed....oh, yeah, I seem to remembering Obama mentioning how the insurance companies need a seat at the table.

    Obama's (5.00 / 3) (#41)
    by cal1942 on Sat May 30, 2009 at 12:19:44 AM EST
    answer to a question during a Town Hall meeting was absolutely laughable.

    He said he didn't want to disrupt 1/6th if the economy.

    The only disruption would be the demise of the private health insurance industry.

    Just like the case of the finance industry, sweating bullets to maintain the status quo.  

    Obama supporters: Explain to us about that change thing again.


    You also have an exciting (none / 0) (#65)
    by Militarytracy on Sat May 30, 2009 at 07:34:44 AM EST
    entrepreneurial spirit to compliment your intelligent nerdiness with :)

    Health care costs drive premiums (5.00 / 1) (#8)
    by ThomasA on Fri May 29, 2009 at 09:32:50 PM EST
    There is a well written essay in the New Yorker online, "The Cost Conundrum"' that has some good insights about what is driving the increase in cost of health care and thus premium increases. It is well worth reading http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

    People (5.00 / 4) (#12)
    by Ga6thDem on Fri May 29, 2009 at 09:40:16 PM EST
    on this blog have better ideas about healt care reform than the elected officials in washignton.

    Health insurance (5.00 / 3) (#64)
    by Bemused on Sat May 30, 2009 at 07:33:57 AM EST
     is by far my single largest expense. I have two employees and their families and my family in the plan. Last year I switched plans to one with a $5000 annual deductible per family,  because the premium cost (I pay it all for my employees) was going to rise to about $3600 a month ($43,000 a year!!!-- for a total of 9 people).

      Even with the huge deductible, health insurance is costing me about 2400 a month (over $28,000 a year). I gave my employees  raises to cover their increased out of pocket expenses but still come out better under the new plan, but the premiums are going to be raised on this plan by 15% in August and the costs will keep rising in the future almost certainly

       I've  always provided my employees with health insurance and my employees both being single mothers with young children prefer complete coverage to higher salaries and both have worked for me for many years now so I bite the bullet. For a solo, however,  such as myself whose revenues fluctuate rather significantly from quarter to quarter and year to year, making payroll and trust taxes and insurance at times leaves me with sometimes  rather lengthy periods where my expenses exceed my revenues even though I keep my other fixed overhead quite low.

      I've been practicing long enough to be able to weather such periods with reserves but in light of the layoffs and reduced hiring by law firms I imagine many displaced or unhired attorneys who might otherwise hang out a shingle and work for themselves will either decide they simply can't do it or will be unable to provide health coverage for employees.

      That's not good for the economy.  I don't think it's good for the profession which might benefit from more solo and small firm practices and it's probably bad for legal service consumers  as well because it hinders the establishment of smaller firms which could provide more price competition.   I speak about the legal profession because that's what I know, but that's likely true across the board.

    Do you not get it Jeralyn? (5.00 / 1) (#85)
    by diogenes on Sat May 30, 2009 at 08:58:03 PM EST
    Under a single payor government plan, we all pay the same in taxes regardless of how healthy we are and get the same health insurance.  That's how Medicare and the British NHS work.  Isn't that what liberals want?  Basically instead of your premium to Anthem subsidizing unhealthy people your taxes will subsidize unhealthy people.  That's fine if that's what you want, but you don't seem so thrilled by it.

    Are you getting your coverage as an (none / 0) (#1)
    by Inspector Gadget on Fri May 29, 2009 at 09:15:28 PM EST
    individual, or are you in a group plan?

    group, small employer (none / 0) (#16)
    by Jeralyn on Fri May 29, 2009 at 09:54:44 PM EST
    I am the employer and the employee.

    I recall we all talked about your plan (none / 0) (#24)
    by Inspector Gadget on Fri May 29, 2009 at 10:22:41 PM EST
    last year. Did you do the HSA?

    yes, and it's wonderful (none / 0) (#42)
    by Jeralyn on Sat May 30, 2009 at 12:27:35 AM EST
    I don't want to give it up. It covers 100% of everything from brand name and generic drugs to doctors to tests to preventive care. If I needed to stay in the hospital or have surgery, 100% is covered.

    But...I put $2,900 in the HSA and you can't pay premiums out of that. So it's $750 x 12 (I can't bring myself to do the math right now) plus $2,000 -- that's a lot of money for health insurance. Especially since disability insurance is separate and also expensive.


    HSA's confuse me, but (none / 0) (#45)
    by Inspector Gadget on Sat May 30, 2009 at 12:52:06 AM EST
    the fantastic part seems to be a universal thought for those who have them AND don't have any medical problems show up. So, even at the higher rates, don't you get to keep the lion's share of your premiums for future medical needs no matter what?

    Do you assign a beneficiary to the value of the account in the event you experience a sudden or accidental death and still have money in the account? It seems like those are more an investment toward future needs. Do they earn interest?

    I've only known one person who regretted making the HSA decision because a series of broken bones and unexpected illnesses hit and they all ended up out of pocket in addition to the higher premiums.


    Yes (none / 0) (#47)
    by Jeralyn on Sat May 30, 2009 at 12:58:59 AM EST
    If your medical expenses are less than your deductible and you don't use all your contribution, it carries over. It's like an IRA. You can put $2,000 a year into it ($2,900 if it's your first year and you are over a certain age.) You can assign a beneficiary.

    It's good for people who never get sick and those who get very sick. Your friend's out-of-pocket expenses should have ended when he reached his deductible. The deductibles start at $1,500 and go up to $5,000. The premium is lower for the higher deductibles.

    The other benefit is you don't pay taxes on the income used to make the contribution. And you can use your HSA to pay for any health expenses regardless of whether your policy covers them. So you can use it to pay the dentist, or for over the counter drugs and medical supplies, and you are paying with before tax dollars.


    I wouldn't go (none / 0) (#2)
    by Natal on Fri May 29, 2009 at 09:18:11 PM EST
    for less coverage. As Woody Allen purportedly said: "They call them the golden years, but it's all downhill."

    I have Blue Shield coverage (none / 0) (#5)
    by Inspector Gadget on Fri May 29, 2009 at 09:27:50 PM EST
    through work. No variation of premiums by age group, and my employer pays $290 a month for full coverage medical, dental and vision per person. It's great coverage, too.

    You can often get the better prices by buying your insurance through membership groups, i.e., Chamber of Commerce, industry associations you belong to (if they have a group policy for membership), etc.

    I think that reasoning sounds like Anthem is twisting reality...most of their plans are paid for by corporations, and it's highly unlikely the corporations are being charged differently for those who use more of their benefits.

    The fact is that the healthy have always been carrying the burden of the unhealthy and they didn't need a law to make it so.

    The sick and the OLD (none / 0) (#6)
    by andgarden on Fri May 29, 2009 at 09:30:26 PM EST
    and old people vote.

    Old people were not always old (5.00 / 2) (#62)
    by MO Blue on Sat May 30, 2009 at 07:09:23 AM EST
    IOW when we were young and healthy, we paid for the sick and the old just like you youngsters do now.

    That is how life cycles work. If you are lucky and the politicians don't "fix" medicare until it becomes private insurance, youngsters will help support your care if you are sick or old.  


    $250?! (none / 0) (#13)
    by nycstray on Fri May 29, 2009 at 09:42:31 PM EST
    Wow. And I was floored when they wanted to raise mine 90ish a month.

    That's just nuts.

    And next year when I do change age groups (5.00 / 1) (#17)
    by Jeralyn on Fri May 29, 2009 at 09:57:06 PM EST
    will be another $250. In a year, my insurance will be $1,000 a month. And, it's a high deductible plan.  This is so crazy.

    That just puts a big pit in my tummy (none / 0) (#19)
    by nycstray on Fri May 29, 2009 at 10:03:11 PM EST
    That's about what I pay for rent, bills and pet meats.

    There's something really wrong with (none / 0) (#23)
    by Inspector Gadget on Fri May 29, 2009 at 10:21:41 PM EST
    that. There are only 3 employees where I work, and the employer pays only $290 a month for each of us...medical, dental and vision all included.

    I have connections....I'm going to investigate this next week.


    let me know (none / 0) (#25)
    by Jeralyn on Fri May 29, 2009 at 10:33:31 PM EST
    by email what info you need. I have a really good agent and Anthem sent me all its plans and rates for comparison. Some were $1,200 a month. The lowest was $500 something and it was like why bother having insurance given the co-pays.

    Don't forget these increases may be only for Colorado because we got the new law.


    I'm starting to think they suck you in with low initial rates and then bleed you dry over the next few years becuase we're too lazy to shop for a better deal.

    Yeah (none / 0) (#67)
    by Ga6thDem on Sat May 30, 2009 at 07:47:04 AM EST
    we had BCBS and that's what they did. It was cheap the first year but then they raised it every year.

    have you checked (none / 0) (#28)
    by TeresaInSnow2 on Fri May 29, 2009 at 11:04:53 PM EST
    to see if you can get a better rate as an individual insured person than you can as an employer with you as the employee.

    You can go directly to the Anthem site and search the plans yourself....they don't include the July increase, but still, you can compare the rate you currently have with what an individual plan rate is now and that would give you an idea.

    Here's a link: Link


    Yup, here's a quote from (none / 0) (#29)
    by TeresaInSnow2 on Fri May 29, 2009 at 11:18:51 PM EST
    one of the articles you linked to above.  

    Ironically, HB 1355 may end up penalizing the less-healthy groups, Emanuelson said, since the healthy groups can qualify for less-expensive options such as individual coverage or health savings plans.

    I suspect you're not really getting a good group rate as a group of 1, and you might be getting a worse rate than you would in an individual plan.

    Definitely check out the individual plan rates.


    I will do that (none / 0) (#38)
    by Jeralyn on Sat May 30, 2009 at 12:13:56 AM EST
    When I got the group, it was much cheaper than the individual rates, but maybe that's changed. Thanks for the suggestion. I'll also call my agent.

    If you do (none / 0) (#73)
    by TeresaInSnow2 on Sat May 30, 2009 at 09:13:07 AM EST
    find that individual insurance is less expensive, make sure you also know the laws in your state regarding situations under which they can raise your individual rates.

    In my state (Washington), we individual insurees are grouped according to our age only (or age+smoker for those where that applies), and our rates can't go up just because we become sick (with cancer, etc).

    In your state, it might be that they can raise individual rates based on catastrophic illness and a group policy might afford you more protection.

    Just another bit of speculation after sleeping on my individual insurance suggestion, but all in the interest of making sure all angles are covered.

    Please let us know what ended up working the best.


    Rates and even availability (none / 0) (#30)
    by gyrfalcon on Fri May 29, 2009 at 11:35:08 PM EST
    are heavily affected by state laws.  In Mass. before the universal coverage program started, various well-meaning state laws, like requiring coverage for preexisting conditions, meant insurance cos weren't willing to offer individual plans at anything even remotely affordable, and there literally were zero groups a self-employed person could join to get group coverage.

    So just because somebody in another state can get a good price for insurance from company X, that does not mean a similar rate will be available from the same company in your state.

    The ins. cos. want the government to take all responsibility for people with those "preexisting conditions" so they don't have to, and also pit the well against the not so well.


    You are very right, and (none / 0) (#36)
    by Inspector Gadget on Sat May 30, 2009 at 12:09:33 AM EST
    just because you have Anthem BCBS coverage through your employer does not mean you have the same coverage as someone else who has Anthem BCBS through a different employer. These things can be custom designed by each employer.

    Brokers can often write policies in other states, so many are fully versed in the options available around the country.

    TheresainSnow2 is also very right in her assessment that how one classifies themselves is a big part of what you will pay. I've worked for employers who joined the Chamber of Commerce just to get in on their group medical plan. Industry associations will often do the same thing for their members. Those provide much larger groups to get the better rates.


    "What's going on?" (none / 0) (#18)
    by mcl on Fri May 29, 2009 at 10:02:48 PM EST
    What's going on is that health care costs in America are skyrocketing by 20% per annum, on average. This means that every 78 months your health insurance bill will double. If you can afford health insurance today, wait 78 months: you won't be able to then. Obama's plan won't fix this.

    Here's a fascinating article in the New Yorker which suggests that the problem isn't unhealthy people, and that even moving to single-payer won't fix the problem.

    Everyone says UHC will save us loads of money and make HC much more affordable.

    Well, say it costs $X/year to pay for everyone's health care.

    And say 10% of that is excess "fat" (corporate profit that would be "saved" if the corps were no longer involved, ie, single payer).

    So we go single payer and save, what, exactly?

    Well, we save 0.1X. HC would still cost 0.9X.

    Sorry, but in the grand scheme of things, 10% is chump change. HC would still be prohibitively expensive. J's ins premium would only go up $225/month instead of $250. That should make you sleep better at night.

    Where's the beef?

    Also, HC is the one growth industry in our economy right now, the one bright spot, and has been basically the only consistent growth industry our nation's had for a long time (very broad strokes).

    Are we sure we want to eff with it like that?

    Overhead is (5.00 / 3) (#31)
    by gyrfalcon on Fri May 29, 2009 at 11:39:38 PM EST
    more like 3O percent, not 10 percent.

    Nobody says single payer would be cheap, just that it would cost far less than the system we have now (as every country in the world that has it demonstrates).

    Unless you figure in the hundreds of thousands of insurance company employees who'd have to be supported somehow when they were thrown out of work.


    You do have to consider those people (none / 0) (#32)
    by andgarden on Fri May 29, 2009 at 11:49:08 PM EST
    Looking at it as a cost issue is probably a loser. I think the prism of justice is the right one.

    Well, we gleefully (5.00 / 1) (#46)
    by cal1942 on Sat May 30, 2009 at 12:58:37 AM EST
    implement foolish trade policies and then put money into paying some workers displaced by trade.

    The point is that the private health insurance system is seriously weakening the country.  

    Remove that thorn in the side and the economy would benefit in many other areas.  An improved economic base will employ more people.

    The bottom line is that the health care payment system needs to be changed drastically in order for the nation to regain strength, vigor and jobs.


    gradually, yes (none / 0) (#48)
    by andgarden on Sat May 30, 2009 at 01:17:40 AM EST
    But I will not join you in backing legislation that requires many thousands of people to be fired overnight.

    Apparently (none / 0) (#50)
    by cal1942 on Sat May 30, 2009 at 01:23:23 AM EST
    you missed this little part

    paying some workers displaced by trade.

    Wouldn't take much imagination to impement a similar program.


    HR 676 as written does no such thing (none / 0) (#51)
    by andgarden on Sat May 30, 2009 at 01:30:04 AM EST
    Actually, to correct myself: (none / 0) (#55)
    by andgarden on Sat May 30, 2009 at 01:47:00 AM EST

    (e) First Priority in Retraining and Job Placement; 2 Years of Salary Parity Benefits- The Program shall provide that clerical, administrative, and billing personnel in insurance companies, doctors offices, hospitals, nursing facilities, and other facilities whose jobs are eliminated due to reduced administration--

    (1) should have first priority in retraining and job placement in the new system; and

    (2) shall be eligible to receive two years of USNHC employment transition benefits with each year's benefit equal to salary earned during the last 12 months of employment, but shall not exceed $100,000 per year.

    This is something. But there are clearly still going to be a lot of people out of work and thrown into upheaval.

    It's got to be more gradual.


    You keep asserting that the (5.00 / 1) (#81)
    by inclusiveheart on Sat May 30, 2009 at 12:20:23 PM EST
    people currently in private insurance will be jobless when the fact is that if there is an expansion of a government plan, there will be some 40-60 million more people to serve and the government will necessarily have to hire people - with experience - to manage the plans.  I'll argue that there will be more jobs, not fewer given that that would be a ten to twenty percent increase in people needing insurance services.

    This is (none / 0) (#93)
    by cal1942 on Mon Jun 01, 2009 at 11:04:55 PM EST
    very generous, far more generous than workers displaced by trade.

    Apparently you didn't read the text of your post. The amount of upheaval, people without pay, it would seem, would be negligable.

    Two years and an economy that could turn the corner without the drag of the private health insurance industry should be adequate time to re-employ.

    If this isn't good enough for you then there's no way of achieving critically necessary reform.

    What you are suggesting (gradualism) may very well be a poison pill to reform.


    So (none / 0) (#56)
    by cal1942 on Sat May 30, 2009 at 01:48:40 AM EST
    Doesn't mean such a provision couldn't be made.

    The only thing that's set in stone is that there isn't going to be any real reform anyway.

    Ain't gonna happen.


    I agree (none / 0) (#34)
    by gyrfalcon on Sat May 30, 2009 at 12:02:52 AM EST
    But realistically, I think the prospect of the effect of dismantling in one blow an entire industry and throwing its employees out is the major reason single-payer is completely out of the picture in this country for the foreseeable future.

    It's simply inconceivable-- even to me, and I'm 100 percent for single-payer as the only logical way to deal with health care.


    I kinda freaked out the first time (5.00 / 1) (#35)
    by andgarden on Sat May 30, 2009 at 12:06:28 AM EST
    I actually read the text of HR 676. It explicitly makes private health insurance illegal.

    That's just not going to fly.


    No, it's not going to fly. (none / 0) (#40)
    by Inspector Gadget on Sat May 30, 2009 at 12:19:12 AM EST
    Even Australia has private insurance available for people who want to pay for it...they are the only ones who get to bypass the referral process from a GP to a specialist and they don't have to wait in line for procedures.

    Shutting down the insurance industry (5.00 / 1) (#43)
    by andgarden on Sat May 30, 2009 at 12:27:40 AM EST
    would lead to massive layoffs. Talking about shutting down the insurance industry is rather like shutting down the auto industry.

    The big difference is that unlike with autos, Americans have nowhere else to turn for their healthcare, so there's currently no good way to improve the industry. The best bet is that a public option slowly competes it out of business (or more likely into a much smaller premium business).


    I agree (5.00 / 1) (#72)
    by justinboston2008 on Sat May 30, 2009 at 09:04:33 AM EST
    Making private insurance illegal would be a non starter. I am all for UHC and if I have the option to dump my Blue Cross plan for Medicare or something comparable, I would do it in a heart beat. People deserve the option to choose and while I think a government plan would be the best choice. If someone wants to put their eggs in a for profit insurance company basket so be it.

    That said, the profit motives of these companies are killing people every day. Managed care is fine until you need it. Once you become sick with a chronic disease or cancer, it becomes a nightmare.


    What? (none / 0) (#49)
    by cal1942 on Sat May 30, 2009 at 01:17:46 AM EST
    Talking about shutting down the insurance industry is rather like shutting down the auto industry.

    Geezuz. Where to start.

    Keeping it real simple.  Industry A (autos) is crucial to the technological base of the nation.  An actual creator of wealth.  Industry B (private health insurance) sucks the vitals out of the nation adding no value whatsoever to health care.

    Inasmuch as employment is concerned replacing manufacturing jobs is a hell of a lot more difficult than replacing a basic job in the insurance industry.

    Ain't no comparison.


    I guess this is why I can never be a radical (none / 0) (#52)
    by andgarden on Sat May 30, 2009 at 01:34:02 AM EST

    If you think firing the many thousands of people who work for healthcare companies en masse would be any less painful to them and to the economy than it would be with similar firings at auto manufacturers, then you obviously haven't really thought about it at all. You've just managed to transfer your (justified) hate for health insurance companies to the little people who work there.


    Leftist? (5.00 / 2) (#59)
    by cal1942 on Sat May 30, 2009 at 02:29:01 AM EST

    Haven't thought about it at all eh?  I kinda have thought about it.  A lot.  Certainly more thought than you gave regarding the auto industry when your hatred of automobiles and/or American manufacturers (or whatever that was) was a topic some months ago.

    Large numbers of displaced people can be supported and moved into other jobs.  In fact should be handled on a case by case basis.  Something we've never really done but ought to do.

    If you think I've given this little or no thought then you should really examine your own thought process.  You've obviously given the matter no thought at all.

    Comparing the impact of massive job loss in the two industries is instructive.  

    Jobs in the health insurance industry are scattered throughout the nation in many many communities.  In very few communities does that industry represent the most critical or largest employer.  Jobs losses are more easily absorbed in a community that hasn't been eviserated by the demise of a single employer.  Some people would find other work.  For those who can't find other work a loss due to policy program can lend significant support until economic expansion absorbs the balance. Many job skills used in insurance companies are also available in other industries.

    Manufacturing, specifically auto manufacturing, has a presence in many places but where it's most concentrated entire communities can, are and have been all but totally destroyed.  I can give you a list of vacation spots where you can see the damage first hand if you like. I warn you it isn't pretty.  A seriously damaged community can't absorb the loss of thousands of jobs in the community's principle economic activity.  Other businesses fail, even those not directly related to autos.  The community deteriorates all the more.  And it's not just business closures it's schools, public infrastructure and maybe almost as bad as any of it is the loss of hope.  Crime of course increases, substance abuse increases, spousal abuse, child abuse, etc.  There's nowhere to go.  Many factory job skills don't easily transfer to other employment opportunities.

    We're killing our nation one community at a time and a contributing factor is the private health insurance industry.


    Bad argument (none / 0) (#57)
    by mcl on Sat May 30, 2009 at 02:09:23 AM EST
    We could apply the same bad argument to drug dealers. "If you think firing the many thousands of people who work for drug dealers en masse would be any less painful to them and to the economy than it would be with similar firings at auto manufacturers, then you obviously haven't really thought about it at all."

    Drug dealers have families to support, after all.

    These kinds of bogus arguments have long been discredited. The fantastical notion that some parasitic and destructive industry (the tobacco industry, 19th century industries that depended on child labor, the health insurance industry, etc.) must be preserved merely because it employs a lot of people is a classic failure of basic reasoning.

    For the ultimate disproof, apply your arugment to slavery. We can't eliminate slavery in America -- think of all the people whose livelihoods depends on it!  Slave catchers, slave masters, people who forge the chains for the slaves, people who manufacture the whips and thumbscrews with which to punish the slaves...why, it would disrupt our entire economy.



    HR 676 does not throw employees to the wolves (none / 0) (#58)
    by caseyOR on Sat May 30, 2009 at 02:28:42 AM EST
    HR 676 provides funds for retraining health insurance workers and gives them the equivalent of unemployment for up to two years. Also, some of the workers could get jobs with Medicare. If the whole country is on Medicare, they will have to hire more staff.

    One of the many things I like about HR 676 is that Conyers has thought a lot of this stuff through. He doesn't have anything for overpaid insurance executives, but he does plan for the workers.


    Wouldn't a new HCS need to absorb (none / 0) (#53)
    by nycstray on Sat May 30, 2009 at 01:36:39 AM EST
    a percentage of those workers?

    Or we can do what all the big corps do when they send thousands of jobs overseas . . .  offer them retraining ;)


    A single payer system would have (none / 0) (#63)
    by MO Blue on Sat May 30, 2009 at 07:28:20 AM EST
    to absorb some employees of the insurance companies to do the work. There would be some staff reductions due to economy of scale and some poor, poor overpaid CEOs might have to collect their golden parachutes. Also, some of the back office and data processing functions may have already been outsourced to India.

    The insurance industry is not comprised of only health care insurance (cars, homes, boats, pets etc.) so the talk of destroying the industry is IMO a definite overstatement.


    Bright Spot? (5.00 / 3) (#44)
    by cal1942 on Sat May 30, 2009 at 12:48:39 AM EST
    Sucking the innards out of American manufacturing is a bright spot.  Really.

    There are additional savings beyond the insurer's profits.

    Providers shell out less money in overhead because there is only one plan to be dealt with instead of the varying requirements for multiple insurers.

    Thirty percent of health care costs are administrative.

    The bottom line is that we spend nearly twice as much per person as the second most expensive nationalized foreign plan and are less healthy.

    Some commenters have offered links to article in various magazines that tell us:  single payer won't really save, high costs are unavoidable so just STFU, etc.  I hope people realize that the health insurance industry is fighting back with everything.  If they can buy Congress just think about how much cheaper it is to buy writers and magazine publishers. The people who breathlessly posted these links seem to have forgotten that health insurance companies do run ads in print media and television.

    We go through this every damn time.  The industry's propaganda machine gets cranked up and spews out trash on every front even in those venues that we would otherwise trust.  Bingo, they've won again.  A few years later people complain bitterly and want reform and again the industry springs into action.

    One of the many reasons we don't get real reform is that many of us are so terribly gullible.

    If you don't think that "progressives" are gullible then you've already forgotten the Democratic primaries.


    Thirty percent of health care costs (5.00 / 1) (#86)
    by sarcastic unnamed one on Sat May 30, 2009 at 09:03:10 PM EST
    Thirty percent of health care costs are administrative.
    And what would be the % under single payer? Hint: 0% is incorrect.

    Medicare does it at 3% - (4.00 / 3) (#88)
    by Anne on Sat May 30, 2009 at 09:16:34 PM EST
    no reason to think an expanded Medicare-for-All program would not continue to keep administrative costs at 3%.

    It's not zero, but it's a whole lot less than 30%; lower my annual premium by 27% and I go from $6,800 to $4,964 - on a quarterly basis, from $1,700 to $1,241.  And if that's my only cost - if I have no deductible, and no co-pays, the savings gets even bigger.  Imagine what I could do with that savings, where I could spend the $1,800+ that has been freed up.

    Multiply that among all the people who have insurance, all the businesses writing checks for premiums, and I don't see how it does not have a positive effect on the economy.


    how does 27% reduction square with (5.00 / 1) (#89)
    by sarcastic unnamed one on Sat May 30, 2009 at 09:53:49 PM EST
    an increase of 2,600,000 additional salaries that will need to be paid?
    From Harper's Index, April 2009
    (sources; National Nurses Organizing Committee [Oakland]; U.S. Bureau of Labor Statistics)
    Estimated number of jobs that would be created under U.S. single-payer healthcare system: 2,6000,000.

    I took that to mean that jobs "created" (3.50 / 2) (#90)
    by Anne on Sat May 30, 2009 at 10:09:02 PM EST
    under single-payer would accommodate those no longer working in the private insurance industry.

    I think, as others have pointed out, that there will have to be more people hired to administer what could be millions more people enrolling in a Medicare-type plan - and those people would - or could - come directly out of the private insurance sector.


    Overhead under a single payer plan would be (3.00 / 1) (#92)
    by allimom99 on Sun May 31, 2009 at 10:15:46 AM EST
    much lower than private insuruers. Having a single payer would enable streamlining of record-keeping, for one thing. This is one of the reasons a majority of doctors now support single payer.

    Another point you miss is that premiums would be paid by EVERYONE, including the 20-somethings who think they'll never get sick. There would be a MUCH larger group to spread the risk over.

    Actuarially, a smaller percentage would require expensive treatment than is the case now, reducing per-person costs. Access to preventive care will put a huge dent in the expense of the uninsured using the emrgency room for primary care. Problems will be detected earlier on, before drastic measures are needed. I could go on.

    The rally I was at on Friday consisted mostly of medical professionals. UHC would allow them to spend their valuable time tking care of their patients, rather than on the phone with some clown in utilization review who has no medical training arguing about why their patient should get a treatment. Remember, the UR guy's bonus is predicated on DENYING CARE.


    Hospitals here are laying off (none / 0) (#39)
    by Inspector Gadget on Sat May 30, 2009 at 12:16:49 AM EST
    and the last hospital stay my mother experienced at the beginning of May was very obvious they were running day and night on a minimal staff. I believe less than 1/3 of the beds on the entire floor were occupied the entire 10 days. This is a brand new wing where every room is private...I think they were preparing for the old prediction that the baby boomers would be feeding their wallets at record pace.

    This industry can't survive any better than another when unemployment is so high. The public hospitals will be overcrowded and the private hospitals will be understaffed and low inpatient occupancy.


    It Could Be That The Market (none / 0) (#61)
    by bob h on Sat May 30, 2009 at 05:14:09 AM EST
    collapse has so depleted their capital base of stocks and bonds that they are trying to rebuild by taking it out of the hides of their customers.  This seems to be going on with homeowner's insurance, as well.

    HMOs don't make their money from insurance (none / 0) (#68)
    by Exeter on Sat May 30, 2009 at 08:15:44 AM EST
    They make their money from investments and mostly the stock market-- and that is obviously down right now.

    Yes! (none / 0) (#69)
    by jbindc on Sat May 30, 2009 at 08:42:51 AM EST
    I got an EOB from my carrier this morning.  I'm fairly healthy, so when I opened it up and saw that I am going to owe $157.00 for going to the doctor a couple of weeks ago for what was a minor respiratory infection (for which I was prescribed Z-pac), I almost fell off my chair. This $157 was AFTER the $340 originally charged for visit, and lab tests (a throat swab and nasal swab to check for swine flu, which apparently is now standard practice). Now, I understand I haven't met my deductible yet, but $340 for 10 minutes of a NURSE PRACTIONER'S time (didn't even see and MD), for them to tell me I had an infection (which, I knew, by the way - I'd had it for 6 weeks), and to prescribe me a $10 prescription???  How are families doing it with no insurance????


    One of the better reasons (none / 0) (#71)
    by TeresaInSnow2 on Sat May 30, 2009 at 08:55:35 AM EST
    to have  insurance is because the "insurance negotiated" rates for doctor's visits and medical care.  In my particular case, insurance whacks about 30-50% off of the doctor's original charges....which sounds about the same as your experience.

    Every time I pay that nasty premium, I remember that this "negotiation process" is part of what I pay for.  

    It's really a way to rip off people who don't have insurance, but fortunately, oh, so fortunately, you and I aren't ones of them.


    Some of the hospitals in my area (none / 0) (#74)
    by MO Blue on Sat May 30, 2009 at 09:19:59 AM EST
    are offering discounted rates for the uninsured. Since I do have insurance (overpriced as it is), I don't know how deep the discounts are compared to those negotiated by the insurance companies. They also offer some need based discounts for all patients regardless of insurance status. These discounts are available for those who are in the lower income brackets but are not quite destitute enough to qualify for Medicaid.

    Also, the physicians associated with one of the leading universities is offering 10 to 15% discounts on outstanding balances after insurance payments if you pay by debit or credit card. It is possible that his discount might be higher on larger outstanding balances.

    It always pays to ask if there is any type of discount available no matter what your insurance status.


    medicare supplemental (none / 0) (#76)
    by Molly Pitcher on Sat May 30, 2009 at 09:40:19 AM EST
    Retirees here have their medicare supplemental paid by the state.  Survivors pay for their own.  It is not cheap: $354 per month.  And it does pay all deductibles and copays, and you will not be billed anything so long as Medicare does not deny the claim (whether they pay anything or not.)  Yes, it is expensive--until you see that the standard alternative with deductibles and copays is close to $336 a month.  You'd have to pretty dumb not to take the supplemental option.

    Jobs created by Single Payer HC (none / 0) (#77)
    by Dadler on Sat May 30, 2009 at 09:58:53 AM EST
    From Harper's Index, April 2009
    (sources; National Nurses Organizing Committee [Oakland]; U.S. Bureau of Labor Statistics)

    Estimated number of jobs that would be created under U.S. single-payer healthcare system: 2,6000,000.

    Ratio of this to the total number of U.S. jobs lost laster year: 1:1

    Really? (none / 0) (#87)
    by sarcastic unnamed one on Sat May 30, 2009 at 09:07:31 PM EST
    With single payer there would be a 2,600,000 INCREASE in the number of workers that it takes to provide our HC? How does that = 30% REDUCTION in costs people seem to think we'd achieve?

    I just don't get it.... (none / 0) (#79)
    by kdog on Sat May 30, 2009 at 10:44:25 AM EST
    My boss is crying they jacked the rates for my outfits sh*tty coverage 18% this year, we had a little meeting about it and we decided to go with even sh*ttier, cheaper coverage rather than get an increase passed on.  I figure the sh*ttier bare-bones coverage to come is probably like what we'd get from a state-run program...so I'm left wondering what the f*ck is the difference, bottom line is if you've got no dough ya can't get sick...same as 10, 20, 50, 150 years ago...the song remains the same.

    About all I know for sure is insurance companies don't have the power to regulate your diet or consumption of substances considered dangerous, or behavior considered dangerous, and the state does.  That's what worries me most about about a state-run system...when they're paying (with our money, or funny fresh off the printer money), the state will regulate our lives even more, either through criminal code or oppressive taxation, in the name of cost-efficiency. Maybe I'm just paranoid...but if that's the deal I don't want it, I'll roll the dice and keep what freedom we have left.

    I mean look at social security...what started as a noble goal of a safety net turned into a federal id number/tracking system, and god help ya if you don't have a card/number.  If they knew that then, I think the people would have balked.  What kind of hidden misery will state-run health care bring?

    Now if people were being turned away from emergency rooms and left to bleed to death on the sidewalk, then yeah, something must be done.  But that is not the case...at least not yet.

    There is more to fear than just getting sick...like getting further tyrannized and babied.  Something to think about at least, and I think it wise to always expect the worst case scenario when Uncle Sam is involved.  

    But shouldn't people also.... (none / 0) (#84)
    by Dadler on Sat May 30, 2009 at 01:39:19 PM EST
    ...have the freedom to choose a single-payer plan?  Or should they just have the "freedom" to choose only corporate plans?



    Reform the FDA...It's a start! (none / 0) (#82)
    by Nathaniel on Sat May 30, 2009 at 01:19:30 PM EST
    Healthcare reform/Universal healthcare:
    So some in the government are itching to 'reform' healthcare?  Okay.  Let's do it, but with a little twist!  Let the government create and regulate a "brand new" aspect of healthcare that would cut costs, actually benefit patients, and create new competition for big pharmaceutical companies.  I'm talking about herbal/plant medicine.  The practice of mainstream medicine doesn't usually recognize tradtional medicines as viable options for treatment.  And why not?  (Aren't we supposed to becoming more "green" as a nation?)  Plant medicine been around for thousands of years and generally has a better track record than a major corporation's product.  Yes there are pro's and con's, but plant medicine isn't considered a normal treatment option when you visit your doctor.  Patients should have the option and doctors should be able to offer it.
    Let the government re-define what the FDA calls "medicine" and it's accepted practice.  It's a small start to a very big problem.  If only someone in this new administration would have the courage AND vision to make it happen.

    This was an issue awhile back (none / 0) (#83)
    by nycstray on Sat May 30, 2009 at 01:30:15 PM EST
    iirc, they don't want the FDA to over regulate them. As I recall, they fought it. My problem would be, until the FDA is turned into a properly functioning agency with their current duties, get's out of industries' back pocket and expands to be able to handle more inspections etc, keep them the heck away. I have both vets and doctors who are practiced in alternative medicine. It's not for everyone, but for those that want it, they can find it. My Dr.s all practice traditional medicine, so insurance should still cover visits and most procedures. I've never gone broke getting plant "medicines" for myself or my pets, so not having an insurance co-pay or whatever it's called for prescriptions isn't much of an issue for me.