Dems Introduce 852 Page Health Care Bill

The Democrats have introduced an 852 page health care bill. First off, we'd get a Health Czar and another federal agency:

Under the House bill, health insurance would be regulated by a powerful new federal agency, headed by a presidential appointee known as the health choices commissioner.

And we'd get a public health plan, that will be opposed by insurance companies, Republicans, business owners and doctors. Why doctors?

The plan would initially use Medicare fee schedules, paying most doctors and hospitals at Medicare rates, plus about 5 percent. After three years, the health secretary could negotiate with doctors and hospitals....The bill would limit what doctors could charge patients in the public insurance plan, just as Medicare limits what doctors can charge beneficiaries.

It will require everyone to have a qualifying insurance plan and violators have to pay penalties. [More...]

There's no cost estimate provided for the bill. But this doesn't sound good:

House Democrats pledged to offset the cost of their legislation by reducing the growth of Medicare and imposing new, unspecified taxes.

I'll bet they are planning more sin taxes on alcohol, cigarettes, and probably even junk food.

Given the many groups that will oppose the bill, and the Dems saying this bill is a "starting point" for discussion, it's obviously going to be watered down substantially. I wonder whether what we end up with will be an improvement over what we have now. I'm not optimistic.

One thought I have is that the new law, when passed, should apply to members of Congress. During the presidential campaign, I kept hearing the candidates say we are all entitled to the same benefits Congress gets. We should hold them to it... if Congress balks at having the new plan be mandatory for them, it's probably not a good deal for us either.

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    With framing like this... (5.00 / 4) (#1)
    by ruffian on Sat Jun 20, 2009 at 01:32:47 AM EST
    From the LA Times headline:

    The proposal includes a divisive government insurance option

    what could go wrong?

    I've really had it with the use of the word divisive as a predictive adjective. Its only purpose is for self-fulfilling prophesy.

    If the new taxes are on the health insurance benefits provided by employers, I'll withdraw and get my own insurance before I'll pay taxes on income that goes directly to the insurance company, that I have to match anyway to get the benefit.

    There are so many things wrong (5.00 / 4) (#12)
    by Anne on Sat Jun 20, 2009 at 10:06:57 AM EST
    with this plan, it's hard to know where to start, but I'll give it a try.

    First, as long as the plan allows people to keep the plans they have, Congress has no worries about having to have whatever version of the public option makes it into the final bill, because as I understand it, the plan they have is not government insurance, it's private insurance that the government, like a lot of other employers, pays a portion of the premium for.  What the government does, currently, is offer its employees a lot of choice about which plan they want to take, so coverage and premiums and deductibles and co-pays will vary depending on which plan one signs up for.  My understanding is that the gold-plated version, that many in Congress have, is not cheap.

    Second, while it may be true that the idea is to require private insurance companies to write a policy for anyone who applies, and somewhat - at least in this preliminary version - limits rating to keep the cost down, it still may be too expensive for some people who currently do not have insurance.  What this means is that if there is still a public option, it will be the choice of the poorest and sickest - and you can figure out for yourselves what the problems are with that.  How long will it be before we hear about what a drain it is on the government and how it simply cannot be supported for much longer?

    Third, this will be an enormous boon for private insurance, and while I think robustly healthy companies are a good thing, I'm not so sure the people the companies insure will find themselves in equivalently robust physical or economic health - at some point, it will dawn on those who haven't figured it out yet that the point of "re-forming" the system was to improve the delivery of and access to actual CARE, both to those who don't have it and to those who do, and to lower the cost.

    Fourth, I want the Congress and the president to stop talking about American creativity and ingenuity and innovation and entrepreneurial spirit and the courage to be bold, because if they couldn't bring those qualities to bear for the people, they sure as hell have no right to brag about it, or expect others to do as they say.  All I have seen from them on this issue is timidity and fear and stubbornness - and anger when the people had the audacity - there's that word again - to ask for a chance to discuss single payer in a meaningful way.  Never has it been so clear to me that the elected representatives - most of them, anyway - all the way up the chain, who have had no problem taking our money and our votes, have a pathological and institutional inability to LISTEN to the people they purport to represent.  2010 and 2012 should be very interesting elections at this rate.

    Finally - and I apologize for going on so long - if this battle over health care is as ugly as I think it's going to be, the only bright spot might be that this pathetic effort fails.  Health care may be the iceberg that threatens to sink the ship, but until they can come up with something that doesn't leave us on the health care deck while the insurance companies all head into the life-yachts, they can take their version of reform and shove it.

    Maybe that's the point (none / 0) (#56)
    by jbindc on Mon Jun 22, 2009 at 07:29:55 AM EST
    Finally - and I apologize for going on so long - if this battle over health care is as ugly as I think it's going to be, the only bright spot might be that this pathetic effort fails

    This plan will die a miserable death, the Dems can say "Hey, we tried!" all the while still taking money from Big Pharma and the insurance companies to get re-elected (since incumbents get re-elected at a 90%+ rate), and the Republicans can say they fought off socialized medicine yet again.  It's a win-win for the politicians and once again, everyone else will be left out in the cold.


    Mon ey is a living thing (5.00 / 5) (#15)
    by Dadler on Sat Jun 20, 2009 at 11:19:11 AM EST
    It is God.  It rules us.  It needs offerings of virgins and lambs or we will never survive it's wrath.

    In short, on every issue like health care, issues that are important to all Americans and impact us all, we are such fools it is amazing we can breathe on our own.

    We have money to throw at billionaires and the Military Industrial Complex, money that ultimately destroys its own value because what it is spent on does not benefit even a fraction of Americans, and yet we can't go to a single payer system that we ALL know will be more effective for most Americans.  Only in America do we think every single aspect of life should be profitized.

    We are so phucking stupid it defies explanation.

    The truly weird thing... (5.00 / 3) (#16)
    by lambert on Sat Jun 20, 2009 at 11:36:28 AM EST
    ... is the continual stressing of the idea that people want to keep what "they're accustomed to", with the implication that what people want to hang onto is their insurance company. But most people don't care about their insurance company and its paperwork and its call center; they care about their doctor (if they are lucky enough to have one).

    I don't know why this is, but I can surmise that if you're rich, like the typical Congressperson or CEO, your insurance plan is, in fact, what matters to you, because it's such a Cadillac plan that you don't have to worry about sticking with the doctor that suits you; all the doctors are excellent, so it's the plan that matters -- whether the annual week-long executive check-up is in FL or MI, whether the facility has a golf course, and so forth. And, as usual, the people making policy assume that everybody else is just like them. Perhaps this class-driven disconnect is also the origin of the idea that people want to go shopping for medical care.

    I believe (5.00 / 1) (#17)
    by cal1942 on Sat Jun 20, 2009 at 12:32:58 PM EST
    that the expression 'keeping what they're accustomed to' is a subterfuge to preserve the entirely unnecessary private health insurance companies. The implication being that they are in love with the insurance company.

    I believe you're right, people don't care about the insurance company. It's all about the fact that they have reasonable coverage.  Before I retired my employer provided access to several health insurance plans all from private companies. I only cared that I had coverage, period.

    We've been witnessing every subterfuge and every imaginable excuse to avoid necessary, real reform.


    The definition of "reform" is... (5.00 / 2) (#18)
    by lambert on Sat Jun 20, 2009 at 12:39:43 PM EST
    ... keeping the insurance companies in business.

    If necessary by forcing people to buy their product, and subsidizing that.

    That's "reform" for Versailles, which is not quite the same as "reform" for you.


    Yup (none / 0) (#26)
    by cal1942 on Sat Jun 20, 2009 at 02:32:33 PM EST

    Most people who get insurance through employers (none / 0) (#50)
    by jawbone on Sun Jun 21, 2009 at 10:39:17 PM EST
    have no to very little choice as to what insurance company they have. They get what the employer can afford and offers to them.

    My elderly neighbor had a celebratory party the day she could get out of her employer's HMO insurance, with the plans changing almost yearly, with her having to find new specialists--drove her crazy. When she was eligible for Medicare, she gave a party just for that!

    She was so happy to be free to choose her own doctors.


    Actually Lambert, I have Kaiser and (none / 0) (#19)
    by hairspray on Sat Jun 20, 2009 at 12:42:26 PM EST
    I want to keep it.  I think the whole nation would benefit if Kaiser were the option.  It isn't perfect, but it is the best I have seen including "fee for service" medicare.  As a nurse who worked for the plan when it was considered "socialized" medicine I have seen it grow into a top flight method of delivering cost effective health care.  There are no "bean counters" since the docs make the decisions.  And they make the decisions based on best practices and professional standards which hold up in court if care is denied.  Kaiser is an HMO which uses health education and limits on care that are in the docs hands.  It works.  I have never been denied necessary care. Medicare must cut its costs since it is going broke and it will have to do it by making Medicare an HMO of some sort.

    Real health care reform, not the bilge (5.00 / 2) (#27)
    by caseyOR on Sat Jun 20, 2009 at 03:03:42 PM EST
    Baucus and his pals are pushing, would resolve the looming Medicare problems. And there would be no need to convert Medicare to an HMO. In fact, an HMO would be a good way to kill Medicare.

    I am on Medicare. For all its faults, it is the best health care plan I have ever had, and I had Kaiser at one time. For me, Medicare is better than Kaiser ever was. A big plus for Medicare? You go to whatever doctor you want. I know people talk about how hard it is to find doctors who accept Medicare. That has never been a problem for me. And, frankly, I think that accusation is one of those things that gets hyped constantly, and thus, seems to be a much bigger problem than it really is.

    Another plus? I know what is covered. I have never had to fight with Medicare over claims denials. They do not have an army of employees tasked with denying claims and canceling policies.

    The best public option, IMO, would be to tweak Medicare so that prevention has a bigger part; cover things that don't usually arise with an older population (like OB); add dental and vision (who decided people don't need good teeth and the ability to see?); raise payments to doctors a bit, not a whole lot; eliminate co-pays; and open Medicare to anyone who wants in.


    Medicare is "fee for service" (none / 0) (#31)
    by hairspray on Sat Jun 20, 2009 at 05:45:02 PM EST
    and it is near broke.  What the feds have done is cut, cut and cut doc and hospital reimbursement trying to hold costs down. And the costs need to be held down.  Doctors in the US are paid 2-5X more than in other industrialized nations. And there are too many hospitals for the system.  Obama should be trying to fix medicare by opening it up to young and healthy so their infusion of money can bring solvency back to the system. It will for a while, until private insurance shrinks so much and the population shifts to public options. That will take time.  Fee for service is preferable to HMO but the country cannot aford it if the population gets too old and technology too advanced and available and that is happening.

    You know, that's a good idea (1.00 / 0) (#34)
    by jimakaPPJ on Sat Jun 20, 2009 at 08:57:18 PM EST
    Medicare, which I and my spouse have been in for over 4 years, works quite well. You may want to get a supplemental policy to pay for what Medicare does not, and you will find that the Rx drug plan will cost you around $4300/year/person if you have any kind of need for heart, blood pressure or lung meds, but that is still a bargain as compared to what we had.

    In addition, I think we need a POS national sales tax, say 7%, to pick up the slack. That way everyone pays. If you want to address the fairness issue, unprepared food, utilities, autos of a certain age, etc., can be exempted.


    I expected it to be difficult when my husband (none / 0) (#41)
    by splashy on Sun Jun 21, 2009 at 04:06:24 AM EST
    Went on Medicare, because of people saying it was hard to find a doctor, but just about every doctor I called were very happy to accept him. He was able to choose the one he wanted, no problem.

    I have gotten help with Breastcare, and they won't even let you go to a doctor any more. You have to go to a clinic where there are no doctors.

    Medicare part D is a bit difficult, with all that paper they send you and confusing lists of drugs and pharmacies. Fortunately my husband isn't using any drugs, so we don't have to wade through all that "choosing a provider" stuff to get the best deal. It looks like a real pain in the rear.


    Then I think you are the lucky exception... (none / 0) (#29)
    by lambert on Sat Jun 20, 2009 at 04:45:02 PM EST
    ... and not the rule.

    No I am not. And what are your (none / 0) (#32)
    by hairspray on Sat Jun 20, 2009 at 05:48:20 PM EST
    qualifications for saying that?  I am not a Kaiser employee, but once was for about 10 years.  I have been covered by them off and on for over 45 years.  In addition I was the nurse secretary for the medical director for a couple of years so I know how the system works inside and out. I also taught health care delivery at a university for years, so I am not a fluke.

    Perhaps the key is this statement (5.00 / 1) (#42)
    by splashy on Sun Jun 21, 2009 at 04:16:31 AM EST
    In addition I was the nurse secretary for the medical director for a couple of years so I know how the system works inside and out.

    For someone that knows what they are doing, it may be great, but what about those that don't or that can't figure it out for whatever reason?

    There are many things like that in the world, where those that don't know are penalized because no one will help them get a better deal.

    For instance, I don't pay full price for a "package deal" with our satellite dish provider, because I went through all their FAQs and found a less expensive deal that didn't have a bunch of channels - it's bare bones with local channels. Someone that didn't have website access, persistence, and reading ability wouldn't have found it. We would have been paying at least twice as much, which we couldn't have afforded.

    Since things have gone digital, we would have completely lost all TV access if I hadn't found that less expensive option, because we can't get anything with a converter box or on our relatively new LCD tv that has a built in converter, and just can't pay for a new antenna which might still not work.

    Health care is so much more important, it seems just wrong to expect people to figure out all the ins and outs, especially if they think they have and when they get sick find out they haven't. It's too much to ask.

    Sorry for the long post. I may have gotten a bit carried away, but hopefully made a decent point.


    Huh? (none / 0) (#33)
    by lambert on Sat Jun 20, 2009 at 06:18:12 PM EST
    You say it yourself -- Kaiser's your plan. I accept your description of it, I just don't think all plans are nearly so good. There are always bright spots and exceptions, and I think Kaiser might be one.

    It has a good non profit model (none / 0) (#35)
    by hairspray on Sat Jun 20, 2009 at 09:24:07 PM EST
    heavily frontloaded with prevention.  In addition to that the docs do not make money ordering stuff.  In fact they try to keep the costs down by working with the patients and other doctors to use best practices for determining care. And they do not cover certain things like cosmetic surgery unless it is for burns or deformities.  it is a great model and I wish the country would go in that direction instead of all this other garbage the "free enterprise" maniacs always promote.

    Leave cosmetic surgery to the profit-based model (5.00 / 1) (#44)
    by lambert on Sun Jun 21, 2009 at 10:14:48 AM EST
    There will always be a space for that!

    Just take the profit out of providing actual health care.


    Just switched to Kaiser (none / 0) (#47)
    by otherlisa on Sun Jun 21, 2009 at 04:05:09 PM EST
    I'm on COBRA and was able to change my election at the beginning of the year. Months of hilarity followed because of the COBRA administrator's incompetence, but I now have a Kaiser card and everything. Looking forward to trying the system and very much hoping that it's good and that if so, I'll be able to get a plan after COBRA runs out. That part scares me, a lot.

    The best advice I can give you is (none / 0) (#53)
    by hairspray on Mon Jun 22, 2009 at 01:32:09 AM EST
    to get situated with an internist right away.  Or if you are a young female, a gynecologist. You can choose different ones if you are not happy with a choice, although they do give you several options and pictures and bios of a few to start with.  Then make an appointment and have a good initial appointment.  Get onto the Kaiser website and make a few contacts with the MD. Once you are a patient with your own doctor, you just go to that person and he/she will front for you and find you referrals and generally  be your case manager. It is important to find a doc you like.  This will put you into the system.  Very important to get this right.  Good Luck!

    I signed up with a doc (none / 0) (#58)
    by otherlisa on Mon Jun 22, 2009 at 04:33:03 PM EST
    a female doc, a family practioner - seemed to make more sense for me than Internal medicine as I don't have any significant health issues (though the insurance companies disagree...sigh...). I hope that was the right choice!

    Thanks for the advice, it's a little intimidating navigating a new system, and I'm a doctor-avoider anyway.


    I think you did fine. An internist is the (none / 0) (#59)
    by hairspray on Mon Jun 22, 2009 at 07:53:06 PM EST
    usual general practitioner in Kaiser.  GP's are hard to find.  Some women use OB/gyn since they are childbearing and the bulk of their issues are related to those situations. Sometimes nurse practitioners will do.  It all depends on the patient and their needs.  But in order to see an opthalmologist, or gastroenterologist, for example, you must have a primary care giver and the ones I listed are considered primary care.  Just be sure to make some contacts with her so she knows you and your problems.  That way if something comes up, she is already aware of you. My experience with "hen" medics is that they are more available and listen better.  That is a generalization, but if you don't like her be sure to move around.  I did and it paid off.

    Do for-profit regular health insurance plans cover (none / 0) (#51)
    by jawbone on Sun Jun 21, 2009 at 10:48:44 PM EST
    elective plastic surgery? I thought none did.

    I recall a friend here in NJ had "good" insurance, but the company gave her an incredibly rough time getting reconstruction surgery for her double mastectomy. Not medically necessary.

    Now that's cold.


    My husband is on Medicare and (none / 0) (#48)
    by suzieg on Sun Jun 21, 2009 at 08:24:05 PM EST
    cannot find a GP. The doctor he had seen for the past 21 years sent him a letter telling him he no longer accepts medicare patients only the ones from medicare advantage plans!

    With more cuts coming from Obama, it will be next to impossible to find any doctors who want to accept medicare patients.


    Can he join Medicare Senior Advantage (none / 0) (#54)
    by hairspray on Mon Jun 22, 2009 at 01:34:31 AM EST
    at a good HMO like Kaiser?  That kind of system guarantees him a large number of doctors who will treat him.  But only look for a non=profit HMO with good ratings from the public polls.

    Here's the Poll I Would Like To See (5.00 / 1) (#28)
    by bob h on Sat Jun 20, 2009 at 03:46:04 PM EST
    Would you prefer to enroll in a Public Plan or in a private plan if the cost is the same?  My guess 75% for the former.

    If the public plan cost the same as private (none / 0) (#30)
    by nycstray on Sat Jun 20, 2009 at 05:07:59 PM EST
    why bother with reform at all? Sounds like we would be back to square one, but with a mandate.

    If bona fide public plan cost the same as private (none / 0) (#52)
    by jawbone on Sun Jun 21, 2009 at 10:50:56 PM EST
    it would probably cover much more. That 2% overhead vs. 30% should make a difference.

    According to a new poll, 72% of Americans (none / 0) (#36)
    by caseyOR on Sat Jun 20, 2009 at 09:34:26 PM EST
    support a [public, government run type health care plan, like Medicare http://www.nytimes.com/2009/06/21/health/policy/21poll.html?_r=1&partner=rss&emc=rss ], for everyone. Voters are willing to pay higher taxes to provide health care for everyone, even if they like their own current insurance.

    The poll also reveals that Americans overwhelmingly think Democrats are the better party to deal with health care; even 25% of Republicans agree with that.

    So, what's the matter with Congress? As Digby noted, it is hard to get 72% of Americans to agree on the color of the sky. For god's sake, Obama, Democrats, wake up, smell the overwhelming public support, and do the right thing.

    Why, why, why is Obama making this so hard?


    J, sorry about the link (none / 0) (#37)
    by caseyOR on Sat Jun 20, 2009 at 09:35:36 PM EST
    I thought I did it right.

    When the people really revolt and demand (5.00 / 1) (#46)
    by TomLincoln on Sun Jun 21, 2009 at 04:03:14 PM EST
    a move to single payer, then we will have a chance at health care reform. The latest idea presented by one of our Republican-lite Dems, of the public option consisting of cooperatives, was quickly applauded by several Republicans, which in and of itself tells you how effective that option will be. Obama needs to push the buttons hard on a real public option. If he does not, I think he can forget about another term. Talk, talk, talk is nice and all, but people want real results when it comes to health care reform.

    Many physicians refuse to accept (none / 0) (#2)
    by oculus on Sat Jun 20, 2009 at 03:41:55 AM EST
    Medicare patients because the reimbursement is very low.  

    I like your last paragraph, Jeralyn.  Great idea.

    Exactly (5.00 / 1) (#3)
    by Slado on Sat Jun 20, 2009 at 06:05:25 AM EST
    The gov't will try to trim cost by lowering it's pay out rates and denying services.

    How can the Federal gov't afford to do anything right now.

    We can't have it all.   The 785 billion is being wasted and now we want to take tax dollars and poor them down the endless health care black hole.

    It's not going to pass and if it does it will be so water downed it will be irrelevent.

    Are you excited that we're going to have yet another new federal agency under Obama?

    I'm sure not.


    I read the flip (5.00 / 1) (#4)
    by Slado on Sat Jun 20, 2009 at 06:07:36 AM EST
    and couldn't agree with you more.

    However a congressman was on mornign Joe the other day and basically said that they health plan they had was very expensive and the federal government couldn't afford to give that to every american.    



    Maybe the American taxpayers (5.00 / 4) (#7)
    by MO Blue on Sat Jun 20, 2009 at 07:20:18 AM EST
    cannot afford to continue to pay for a very expensive health care plan for Congress and that benefit should be eliminated. The savings could be used to pay for better health care for average citizens.

    Is there a way to officially petition the government for that change?

    If congressional members had to deal with the rising costs and frustrations of being denied services recommended by their doctors by the insurance companies, maybe we would get real health care reform.


    I'm with you on that! (none / 0) (#25)
    by Inspector Gadget on Sat Jun 20, 2009 at 02:11:34 PM EST
    It's pretty amazing to see the same people who TAKE a fantastic medical plan FROM us show themselves as incapable of providing even a mediocre plan for all. They also make enough money to pay their own premiums.

    Full employment, I guess.. (none / 0) (#6)
    by oculus on Sat Jun 20, 2009 at 06:28:07 AM EST
    Also a new federal agency to watch over credit cards and home loans on behalf of consumers.  Awwk.

    I think the only result of the health care reform will be to tax employees' current contributions from employers


    One other result that I think will (none / 0) (#8)
    by MO Blue on Sat Jun 20, 2009 at 07:25:04 AM EST
    come out of the so called health care reform will be a give away to the private insurance companies. They will be able to increase their profits due to a larger pool of customers through mandated coverage. Pigs will fly before they reduce premiums because of the larger pool.

    Not if there is a good public (5.00 / 1) (#22)
    by hairspray on Sat Jun 20, 2009 at 12:51:33 PM EST
    option.  A robust public option like Kennedy wants will give the insurance company some REAL competition and over time I suspect it will shrink the industry. And that is what is needed. In time a variety of options will emerge, like non profits which will also add to the mix making plans more cost effective without using the insurance companies favorite trick, "cherry picking."  The bad insurance companies will no longer be able to award high CEO salaries and stockholder benefits.  Health care should be non-profit.  It is unconscionable to reward poor care with higher profits.

    A ROBUST public option is not (none / 0) (#24)
    by MO Blue on Sat Jun 20, 2009 at 01:07:10 PM EST
    what seems to be gaining ground in Congress, especially in the Senate. The Baucus plan which exclude any public option, let alone a robust one, seems to be the flavor of the day in the Senate with many so called Dems aligning with the Republicans to make sure that this reform is a give away to the insurance companies.

    "robust public option" (none / 0) (#38)
    by diogenes on Sat Jun 20, 2009 at 10:47:45 PM EST
    The public option is a company which will pay less than many private insurance companies and will not have to keep reserves (i.e. my pension has to be funded, whereas Social Security is massively unfunded) or be regulated the same way.  

    Non-profit? (none / 0) (#57)
    by TomLincoln on Mon Jun 22, 2009 at 07:43:00 AM EST
    For many years we had our largest "private" health care insurer that was a non-profit corporation. That only meant they did not distribute dividends, etc., but it did not mean that top company personnel were not making a ton of money, or that the company was charging premiums that only covered their costs. Far from it. They hoarded money like crazy and in the end switched to become a for profit corporation. Do not confuse non-profit with a real viable public option.

    Many new Federal Agencies (none / 0) (#21)
    by cal1942 on Sat Jun 20, 2009 at 12:47:37 PM EST
    were created during the 1930s when we were in a lot worse condition than we are now.

    Actually health care is not (none / 0) (#55)
    by hairspray on Mon Jun 22, 2009 at 01:37:57 AM EST
    a bottomless hole.  If it is a good model with prevention, it is cost effective.  A well society is a functioning society.  When people are ill and untreated the society pays in other ways with reduced productivity for starters.

    Actually where I live (none / 0) (#39)
    by splashy on Sun Jun 21, 2009 at 03:20:32 AM EST
    Most are very happy to take Medicare patients. If it weren't for Medicare, most in my area that are over 65 wouldn't get any care at all.

    My husband went on Medicare a year or so ago - it was like night and day. He was treated so much better than before, without any health insurance. It was a vast improvement - well except for that Part D, which is very confusing and paper heavy.


    It depends..... (none / 0) (#43)
    by NYShooter on Sun Jun 21, 2009 at 05:15:45 AM EST
    Some doctors try to steer away from Medicare patients because they feel the fee schedule is somewhat low; others are willing to trade off lower fees for the relative ease of being reimbursed.

    Basically, Medicare was not conceived, nor is its business model designed, for the purpose of screwing its customers.

    Forgive me; I don't like sounding rude, but I don't know any other way to say it.


    Contact your local Health Department (none / 0) (#45)
    by jimakaPPJ on Sun Jun 21, 2009 at 11:23:49 AM EST
    and you will most likely find several groups that will help you understand Medicare Part D.

    Or just try Google.


    my oncologist has a sign in her waiting room (none / 0) (#49)
    by suzieg on Sun Jun 21, 2009 at 08:28:24 PM EST
    advising that she no longer accepts patients who are insured  under a medicare advantage plan...

    This fits with TL's posting (none / 0) (#5)
    by Wile ECoyote on Sat Jun 20, 2009 at 06:16:29 AM EST
    on the 15th about Tort Reform.

    Lower payments to Doctors+Less money for malpractice insurance+tort reform=lower malpractice awards.  

    Of course when we go totally socialized medicine then the gov't will not allow lawsuits period.

    A women will be president, (none / 0) (#9)
    by MO Blue on Sat Jun 20, 2009 at 07:29:57 AM EST
    all members of Congress will be female or members of the gay community and the SCOTUS will all be liberals before the U.S. goes to socialized medicine.

    Ian Welsh analyzes Baucus' (none / 0) (#10)
    by MO Blue on Sat Jun 20, 2009 at 07:47:13 AM EST
    new healthcare plan.

    Worse than the American Health Insurance Plan.

    UNder the plan Congresspeople are allowed to (none / 0) (#11)
    by BobTinKY on Sat Jun 20, 2009 at 10:05:41 AM EST
    keep what they have, so there would be no impact on them for having created a lousy "public" option.  Not until election time anyway.

    I do not understand how subsidizing less fortunate folks to join a robust public plan can cost more than paying their  premiums for private insurance, particularly if the private insurers do not face real competition from the public option.  

    I predict a bad bill will make it ot the floor, folks like us will rasie Hell, putting these officials on notice of losing their jobs, and a real option will utlimately be passed.  

    Despite initial skepticism (none / 0) (#13)
    by Coral on Sat Jun 20, 2009 at 10:10:47 AM EST
    about Obama, I had expected more & better on health care and financial reform.

    It's demoralizing. It will be especially, as the results of this type of legislation begin to affect his constituency and all those eager, energetic, young people who worked so hard to get him elected.

    I am bitterly disappointed and angry at how this is all playing out.

    I guess I missed it... (none / 0) (#14)
    by EL seattle on Sat Jun 20, 2009 at 11:11:02 AM EST
    ... but has anyone seen a link to a .PDF of this bill yet?  The NYT story has several links to "similar articles" about various subjects, but I didn't see a link to actual bill.

    My initial concern about the way the plan (as described by the NYT) seems to want to have some cake:

    The public plan would receive an unspecified amount of start-up money from the federal government. After that, it would have to be self-sustaining.

    ...and eat it, too:

    The bill would expand Medicaid to cover millions of people with incomes below 133 percent of the poverty level ($14,400 for an individual, $29,330 for a family of four). The cost would be borne by the federal government.
    (etc., etc.)

    If the goal is for the whole plan to be self-sustaining in some way, I think they should directly address the imbalances that seem to exist in the overall venture before they use the "self-sustaining" phrase to refer to any single individual part of the program.

    If "self-sustaining" was the goal... (5.00 / 1) (#20)
    by lambert on Sat Jun 20, 2009 at 12:45:09 PM EST
    ... then single payer would be part of the discussion. With administrative costs of 3% vs 30% for CEO salaries, profit, and call centers to deny you care, single payer saves $350 billion a year on administration. Anybody that leaves that much money on the table isn't really talking about "sustainability."

    Rather, the point of the "reforms" is to keep the insurance companies in business by forcing everyone to buy their product with a mandate, with a subsidy to the insurance companies for those who can't.


    Like Medicare part D (5.00 / 1) (#23)
    by cal1942 on Sat Jun 20, 2009 at 12:59:22 PM EST
    was a boon to the pharmaceutical industry this bill may well be a boon to the health insurance industry.

    Loathe to make important reforms we're squandering our strenth.  This is the road to second rate status as a nation.


    In many states Medicaid won't cover adults without (none / 0) (#40)
    by splashy on Sun Jun 21, 2009 at 03:52:37 AM EST
    Children at all. They are completely left out in the cold.

    For those that rail against the poor having children, look at that big incentive to have them. Why would that be?