As I understand the Current Health Plan Proposal (Please correct if I'm wrong)

[101A]

1. Employers can keep offering their current coverage - if they drop coverage (and if they have an aggregate payroll over $400K annually), the company will pay an 8% payroll tax to help fund the new government plan.

2. If a person finds themselves without coverage, there will be a new mandate to purchase coverage for themselves and their families. If they still choose not to, they will be saddled with a 2.5% tax penalty.

3. The fed. will set up a "marketplace" for these people to buy coverage - included in it will be a government, or "publicly funded" option. Additionally, there will be new regulations at the federal level toward insurers regarding individual plans; making them not subject to pre-x, not allowing them to drop people who get to sick (a straw man these days, btw), and mandating certain benefits; in short, making the individual marketplace look much more like the current group (or employer provided) marketplace.

4. There are additional regulations included which are intended to control costs; mandatory well visits (physicals, mammograms etc....) End of life cousnselling, etc....

What I don't know is a vital piece of this; will there be a public option for employers to purchase for their employees? If not, then this ultimately changes the over all landscape of healthcare very, very little. Most people get their coverage from their employers, and will continue to do so. Employers will not, en masse, drop the coverage they currently offer, and force their employees to purchase coverage themselves - unless the individual plans are cheaper than the employee portion of the premium in the employers plan (usually restricted as to how high that can be at the state level).

I am trying NOT to make this an opinion thread; just an informational one. If anybody has anything to add about what is ACTUALLY in the plan circulating through congress, please post it; if you want to debate something; start a new thread.

[Supergirl]

1. Employers can keep offering their current coverage - if they drop coverage (and if they have an aggregate payroll over $400K annually), the company will pay an 8% payroll tax to help fund the new government plan.

2. If a person finds themselves without coverage, there will be a new mandate to purchase coverage for themselves and their families. If they still choose not to, they will be saddled with a 2.5% tax penalty.

3. The fed. will set up a "marketplace" for these people to buy coverage - included in it will be a government, or "publicly funded" option. Additionally, there will be new regulations at the federal level toward insurers regarding individual plans; making them not subject to pre-x, not allowing them to drop people who get to sick (a straw man these days, btw), and mandating certain benefits; in short, making the individual marketplace look much more like the current group (or employer provided) marketplace.

4. There are additional regulations included which are intended to control costs; mandatory well visits (physicals, mammograms etc....) End of life cousnselling, etc....

What I don't know is a vital piece of this; will there be a public option for employers to purchase for their employees? If not, then this ultimately changes the over all landscape of healthcare very, very little. Most people get their coverage from their employers, and will continue to do so. Employers will not, en masse, drop the coverage they currently offer, and force their employees to purchase coverage themselves - unless the individual plans are cheaper than the employee portion of the premium in the employers plan (usually restricted as to how high that can be at the state level).

I am trying NOT to make this an opinion thread; just an informational one. If anybody has anything to add about what is ACTUALLY in the plan circulating through congress, please post it; if you want to debate something; start a new thread.

This is a pretty good summary, but you are wrong in thinking most employers provide insurance currently. They don't. Some of the largest employers (Wal Mart, McDonald's, etc) provide NO INSURANCE.

This is basically the plan we have in Massachusetts, and it's worked out pretty well so far, although it's still being tweaked.

No, I don't think employers will be able to buy insurance from the gov't for their employees.

[101A]

No, I don't think employers will be able to buy insurance from the gov't for their employees.

Thank you.

[101A]

This is a pretty good summary, but you are wrong in thinking most employers provide insurance currently. They don't. Some of the largest employers (Wal Mart, McDonald's, etc) provide NO INSURANCE.



Then it looks like Wal-Mart, McDonalds, etc....are going to have an 8% increase in their payroll if this passes.

[Shelly]

This is a pretty good summary, but you are wrong in thinking most employers provide insurance currently. They don't. Some of the largest employers (Wal Mart, McDonald's, etc) provide NO INSURANCE.



huh? Or are you saying benefits are for management only?

Wal-Mart (http://walmartstores.com/Careers/7750.aspx)

McDonald's (http://www.aboutmcdonalds.com/mcd/careers/employee_benefits.html)

[Crookshanks]

Supergirl buys into the Obama propaganda - don't confuse her with facts. And I've heard differing opinions on the Massachusetts plan - many people don't like it and they say it's NOT working.

[sam1617]

This is a pretty good summary, but you are wrong in thinking most employers provide insurance currently. They don't. Some of the largest employers (Wal Mart, McDonald's, etc) provide NO INSURANCE.

This is basically the plan we have in Massachusetts, and it's worked out pretty well so far, although it's still being tweaked.

No, I don't think employers will be able to buy insurance from the gov't for their employees.

For working out pretty well so far, this article doesn't make it sounds so good...

http://www.boston.com/news/local/massachusetts/articles/2009/05/28/more_mass_residents_report_trouble_paying_medical_ bills/

[Spursmania]

The analysis is too simplistic and doesn't even begin to address the various interests and changes that would occur in the system. Many of these points have been addressed in various threads.

After all, the bill is 1,000 pages long, hardly encompassing of only 3-4 points. As a matter of fact, the President couldn't even explain it well last night nor did he explain how this would be paid for.

[Spursmania]

Massachussets plan is failing

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/03/02/mass_healthcare_reform_is_failing_us/

[Spursmania]

This is basically the plan we have in Massachusetts, and it's worked out pretty well so far, although it's still being tweaked.



Massachussets sued over costs of health care

http://www.nytimes.com/2009/07/16/us/16hospital.html


Working well, huh:rolleyes

[Supergirl]

then it looks like wal-mart, mcdonalds, etc....are going to have an 8% increase in their payroll if this passes.

good

[Supergirl]

Massachussets sued over costs of health care

http://www.nytimes.com/2009/07/16/us/16hospital.html


Working well, huh:rolleyes

I heard about this lawsuit. Do you know the backstory behind it? BMC is the only hospital in downtown Boston, serving by far the poorest and most unhealthy parts of the city - that's where every victim of gang violence goes, they treat vast numbers of HIV positive people, and have huge numbers of people suffering from diabetes-related illness.

Medicare payments needed to be reigned in, because as Atul Gawande's article (http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande) highlights, it *IS* a big part of the problem. But something needs to be done to offset the burden BMC is carrying. I am glad they are suing, and the result will be some sort of arrangement will be made. It's one of the tweaks in the system that will have to be worked out.

Did you notice the quote in the article:

"We filed this suit more in sorrow than in anger,” said Elaine Ullian, the hospital’s chief executive. “We believe in health care reform to the bottom of our toes, but it was never, ever supposed to be financed on the backs of the poor, and that’s what has happened in Massachusetts."

[Marcus Bryant]

Then it looks like Wal-Mart, McDonalds, etc....are going to have an 8% increase in their payroll if this passes.

And a decrease in their employees.

[sam1617]

good

They are just going to fire people to make up with the cost, lower salaries, or increase prices. Or more likely, they will do all three.

[Spursmania]

We fought against tyranny in our Civil War. We wanted less government. Now, we want the government to take over health care because of health care costs not because of the care we're given. This bill takes over the care we're given not the costs.
Will this bill add to our deficit? Will this bill help this recession? Will our taxes increase? Will this bill give us more quality of care? Will this bill assure our old parents will still be treated as well as they are now? Will this bill lead to rationing?(If you say no, you must come from different planet because there is already a shortage of doctors-please wake up!)

This bill does absolutely nothing to address the real issues of cost control. This bill is an expensive costly experiment. Look how well the government ran medicare/medicaid? One will be bankrupt in 7 years. And, we want to trust the government to administer our entire health care system? (For those who say no-do you realize, a board made up of people chosen from the administration will decide for us which procedures we could get and which ones we can't). This bill takes away our individual rights to obtain medical care whenever we need it or want it.

[Wild Cobra]

Well, I wish the crybabies would better themselves and get a job that provides healtcare rather than demand I pay more taxes for them.

My God Man... Get a clue. If there isn't something to strive for, why should someone better themselves? Freebies do not promote the general welfare.

[SnakeBoy]

As I understand the current healthcare plan proposal....

http://www.blogcdn.com/www.downloadsquad.com/media/2007/05/try_again.jpg

[Yonivore]

House healthcare talks break down in anger (http://thehill.com/leading-the-news/house-healthcare-talks-break-down-in-anger-2009-07-24.html)

Another misdirection by the Obama administration is that Republicans are obstructing healthcare reform. They're not...Democrats don't need Republicans to pass anything through the House or Senate.

They're pissing off the Blue Dog Democrats...that's what's holding up the deal.

[jack sommerset]

I think Obama smoked to much weed. "Hey man, lets get everyone free health care man, yeah, free healthcare for everyone man, pass that joint man" The added bonus to this stupid fag idea is the goverment is broke. "Lets tax soda man, yeah, tax soda, lots of people drink soda man, pass that joint man" Perhaps if he would pass that joint to me I might agree with some of this dudes policies.

[Yonivore]

Obama channels Seinfeld:

Zh3ln3swL7Q

[Jacob1983]

Bush was better at handling the war on terror and the war in Iraq than Obama is when it comes to health care reform. That's how bad Obama sucks ass when it comes to health care reform.

[Wild Cobra]

Bush was better at handling the war on terror and the war in Iraq than Obama is when it comes to health care reform. That's how bad Obama sucks ass when it comes to health care reform.
I agree. He's already worse than President Carter ever was I think.

[ElNono]

What I don't know is a vital piece of this; will there be a public option for employers to purchase for their employees? If not, then this ultimately changes the over all landscape of healthcare very, very little. Most people get their coverage from their employers, and will continue to do so. Employers will not, en masse, drop the coverage they currently offer, and force their employees to purchase coverage themselves - unless the individual plans are cheaper than the employee portion of the premium in the employers plan (usually restricted as to how high that can be at the state level).

This NY Editorial here (http://www.nytimes.com/2009/07/26/opinion/26sun1.html?pagewanted=1) mentions in passing that the House version of the bill does allows employers to purchase the public option from the exchange.
The entire editorial is an interesting read IMHO, even if you don't agree with reform...

[Yonivore]

This NY Editorial here (http://www.nytimes.com/2009/07/26/opinion/26sun1.html?pagewanted=1) mentions in passing that the House version of the bill does allows employers to purchase the public option from the exchange.
The entire editorial is an interesting read IMHO, even if you don't agree with reform...
A public option will kill the existing insurance industry and the way medical care is currently provisioned. Commercial insurance companies will not be able to compete with a government-run "public option" and will, in pretty short order, go out of business as everyone switches over to the "public option."

It changes everything. You end up with a single-payer system, unaccountable to anyone and not responsible for making a profit. You end up with VA healthcare.

[ElNono]

A public option will kill the existing insurance industry and the way medical care is currently provisioned. Commercial insurance companies will not be able to compete with a government-run "public option" and will, in pretty short order, go out of business as everyone switches over to the "public option."

It changes everything. You end up with a single-payer system, unaccountable to anyone and not responsible for making a profit. You end up with VA healthcare.

Opinion. Certainly respectable and debatable, but opinion nonetheless.

[boutons_deux]

Yoni lies are blaring full blast.

[Wild Cobra]

Opinion. Certainly respectable and debatable, but opinion nonetheless.
If you look at the math, it would be real ignorant to think otherwise.

[ElNono]

If you look at the math, it would be real ignorant to think otherwise.

I look at how companies like Apple that offer added value at a premium do very well, and the math does add up pretty well.

[spurster]

Here is the NYT view on what the proposed health care does.

http://www.nytimes.com/2009/07/26/opinion/26sun1.html

July 26, 2009
Editorial
Health Care Reform and You

The health care reform bills moving through Congress look as though they would do a good job of providing coverage for millions of uninsured Americans. But what would they do for the far greater number of people who already have insurance? As President Obama noted in his news conference last week, many of them are wondering: "What's in this for me? How does my family stand to benefit from health insurance reform?"

Many crucial decisions on coverage and financing have yet to be made, but the general direction of the legislation is clear enough to make some educated guesses about the likely winners and losers.

WHAT ARE THE ELEMENTS OF REFORM? The House bill and a similar bill in the Senate would require virtually all Americans to carry health insurance with specified minimum benefits or pay a penalty. They would require all but the smallest businesses to provide and subsidize insurance that meets minimum standards for their workers or pay a fee for failing to do so.

The reforms would help the poorest of the uninsured by expanding Medicaid. Some middle-class Americans — earning up to three or four times the poverty level, or $66,000 to $88,000 for a family of four — would get subsidies to help them buy coverage through new health insurance exchanges, national or state, which would offer a menu of policies from different companies.

IS THERE HELP FOR THE INSURED? Many insured people need help almost as much as the uninsured. Premiums and out-of-pocket spending for health care have been rising far faster than wages. Millions of people are 'underinsured' - their policies don't come close to covering their medical bills. Many postpone medical care or don't fill prescriptions because they can't afford to pay their share of the costs. And many declare personal bankruptcy because they are unable to pay big medical debts.

The reform effort should help ease the burdens of many of them, some more quickly than others. The legislation seems almost certain to include a new marketplace, the so-called health insurance exchange. Since there will be tens of millions of new subscribers, virtually all major insurers are expected to offer policies through an exchange. To participate, these companies would have to agree to provide a specified level of benefits, and they would set premiums at rates more comparable to group rates for big employers than to the exorbitant rates typically charged for individual coverage.

Under the House bill, the exchanges would start operating in 2013. They would be open initially to people who lack any insurance; to the 13 million people who have bought individual policies from insurance companies, which often charge them high rates for relatively skimpy coverage; and to employees of small businesses, who often pay high rates for their group policies, especially if a few of their co-workers have run up high medical bills. By the third year, larger businesses might be allowed to shift their workers to an exchange. All told, the Congressional Budget Office estimates that 36 million people would be covered by policies purchased on an exchange by 2019.

IS THERE MORE SECURITY FOR ALL? As part of health reform, all insurance companies would be more tightly regulated. For Americans who are never quite certain that their policies will come through for them when needed, that is very good news.

The House bill, for example, would require that all new policies sold on or off the exchanges must offer yet-to-be-determined -Y΄essential benefits.‘ It would prohibit those policies from excluding or charging higher rates to people with pre-existing conditions and would bar the companies from rescinding policies after people come down with a serious illness. It would also prohibit insurers from setting annual or lifetime limits on what a policy would pay. All this would kick in immediately for all new policies. These rules would start in 2013 for policies purchased on the exchange, and, after a grace period, would apply to employer-provided plans as well.

WHO PAYS? Current estimates suggest that it would cost in the neighborhood of $1 trillion over 10 years to extend coverage to tens of millions of uninsured Americans. Under current plans, half or more of that would be covered by reducing payments to providers within the giant Medicare program, but the rest would require new taxes or revenue sources.

If President Obama and House Democratic leaders have their way, the entire tax burden would be dropped on families earning more than $250,000 or $350,000 or $1 million a year, depending on who's talking. There is strong opposition in the Senate, and it seems likely that at least some burden would fall on the less wealthy.

Many Americans reflexively reject the idea of any new taxes — especially to pay for others' health insurance. They should remember that if this reform effort fails, there is little hope of reining in the relentless rise of health care costs. That means their own premiums and out-of-pocket medical expenses will continue to soar faster than their wages. And they will end up paying higher taxes anyway, to cover a swelling federal deficit driven by escalating Medicare and Medicaid costs.

WHO WON'T BE HAPPY? Healthy young people who might prefer not to buy insurance at all will probably be forced to by a federal mandate. That is all to the good. When such people get into a bad accident or contract a serious illness, they often can't pay the cost of their care, and the rest of us bear their burden. Moreover, conscripting healthy people into the insured pool would help reduce the premiums for sicker people.

Less clear is what financial burden middle-income Americans would bear when forced to buy coverage. There are concerns that the subsidies ultimately approved by Congress might not be generous enough.

WHAT IF I HAVE GOOD GROUP COVERAGE? The main gain for these people is greater security. If they got laid off or chose to leave their jobs, they would no longer be faced with the exorbitant costs of individually bought insurance but could buy new policies through the insurance exchanges at affordable rates.

President Obama has also pledged that if you like your current insurance you can keep it.

Right now employers are free to change or even drop your coverage at any time. Under likely reforms, they would remain free to do so, provided they paid a penalty to help offset the cost for their workers who would then buy coverage through an exchange. Under the House reform bill, all employers would eventually be allowed to enroll their workers in insurance exchanges that would offer an array of policies to choose from, including a public plan whose premiums would almost certainly be lower than those of competing private plans.

Some employers might well conclude that it is a better deal — for them or for you — to subsidize your coverage on the exchange rather than in your current plan. If so, you might end up with better or cheaper coverage. You would probably also have a wider choice of plans, since most employers offer only one or two options.

WILL I PAY LESS? Two factors could help drive down the premiums for those who are insured. In the short-term, if reform manages to cover most of the uninsured, that should greatly reduce the amount of charity care delivered by hospitals and eliminate the need for the hospitals to shift such costs to patients who have private insurance. One oft-cited study estimates that cost-shifting to cover care for the uninsured adds about $1,000 to a family's annual insurance premiums; other experts think it may be a few hundred dollars. In theory, eliminating most charity care should help hold down or even reduce the premiums charged for private insurance. When, if ever, that might happen is unclear.

In the long run, if reform efforts slow the growth of health care costs, then the increase in insurance costs should ease as well. And if the new health insurance exchanges — and possibly a new public plan — inject more competition into markets that are often dominated by one or two big private insurance companies, that, too, could help bring down premiums. But these are big question marks, and the effects seem distant.

WILL MY CARE SUFFER? Critics have raised the specter that health care will be -Y΄rationed‘ to save money. The truth is that health care is already rationed. No insurance, public or private, covers everything at any cost. That will not change any time soon.

It is true that the long-term goal of health reform is to get rid of the fee-for-service system in which patients often get very expensive care but not necessarily the best care. Virtually all experts blame the system for runaway health care costs because it pays doctors and hospitals for each service they perform, thus providing a financial incentive to order excessive tests or treatments, some of which harm the patients.

An earlier wave of managed care plans concentrated on reining in costs and aroused a backlash among angry beneficiaries who were denied the care they wanted. The most expensive treatment is not always the best treatment. The reform bills call for research and pilot programs to find ways to both control costs and improve patients' care.

The bills would alter payment incentives in Medicare to reduce needless readmissions to hospitals. They would promote comparative effectiveness research to determine which treatments are best but would not force doctors to use them. And they call for pilot programs in Medicare to test the best ways for doctors to manage and coordinate a patient's total care.

Any changes in the organization of care would take time to percolate from Medicare throughout the health care system. They are unlikely to affect most people in the immediate future.

WHAT DOES IT MEAN FOR OLDER AMERICANS? People over 65 are already covered by Medicare and would seem to have little to gain. But many of the chronically ill elderly who use lots of drugs could save significant money. The drug industry has already agreed to provide 50 percent discounts on brand-name drugs to Medicare beneficiaries who have reached the so-called "doughnut hole" where they must pay the full cost of their medicines. The House reform bill would gradually phase out the doughnut hole entirely, thus making it less likely that beneficiaries will stop taking their drugs once they have to pay the whole cost.

Not everyone in Medicare will be happy. The prospective losers are likely to include many people enrolled in the private plans that participate in Medicare, known as Medicare Advantage plans. They are heavily subsidized, and to pay for reform, Congress is likely to reduce or do away with those subsidies. If so, many of these plans are apt to charge their clients more for their current policies or offer them fewer benefits. The subsidies are hard to justify when the care could be delivered more cheaply in traditional Medicare, and the subsidies force up the premiums for the beneficiaries in traditional Medicare to cover their cost.

Reformers are planning to finance universal coverage in large part by saving money in the traditional Medicare program, raising the question of whether all beneficiaries will face a reduction in benefits. President Obama insisted that benefits won't be reduced, they'll simply be delivered in more efficient ways, like better coordination of care, elimination of duplicate tests and reliance on treatments known to work best.

The AARP, the main lobby for older Americans, has praised the emerging bills and thrown its weight behind the cause. All of this suggests to us that the great majority of Americans - those with insurance and those without - would benefit from health care reform.