LA Times: The Baucus Bill

[Winehole23]

Sen. Max Baucus unveils his healthcare overhaul plan (http://www.latimes.com/news/nationworld/nation/healthcare/la-na-health-baucus17-2009sep17,0,3042131.story)

Baucus' proposal would require all Americans to get insurance, but it does not include a public option. Key Republicans reject the plan.

http://www.latimes.com/media/photo/2009-09/49294770.jpg Sen. Max Baucus is touting his healthcare plan as a road map for agreement. (Haraz N. Ghanbari / Associated Press






By Noam N. Levey and Janet Hook September 16, 2009 | 8:32 a.m.





Reporting from Washington - Amid fresh signs of tensions among Democrats over healthcare, a leading senator today released the last major proposal that Congress will consider as it attempts to refashion the American healthcare system, a $856-billion bill that includes a mix of sweeping new insurance regulations but no new government insurance plan.

The legislation from Sen. Max Baucus (D-Mont.) fell short of his goal of charting a legislative course that could bring Republicans and Democrats together for the most ambitious overhaul of the health system since the 1960s.

Under the bill, nearly everyone would be required to get insurance or pay a penalty. But insurers, in turn, would not be able to deny coverage to people with preexisting medical conditions or to cancel policies after people got sick, as happens in the current system.

And the federal government would offer subsidies to help lower-income people buy coverage.

Three key GOP lawmakers who had been working with Baucus for months have rejected his bill, all but ensuring that any healthcare legislation that passes this year will win no more than one or two Republican votes.

There are also signs that Baucus' proposal faces trouble among liberal Democrats, who have demanded that Congress allow the government to offer health insurance plans to the public in competition with private insurers.

The completion of Baucus' bill marks the end of one phase of the healthcare debate in which senior congressional Democrats developed a series of three healthcare proposals -- one in the House and two in the Senate. Now, Democratic leaders on Capitol Hill will work to unify their party behind a final bill that could pass the House and Senate and make it to President Obama's desk.

Baucus today touted his plan as a road map for agreement.

"We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn't add a dime to the deficit," the senator said. "Now we can finally pass legislation that will rein in healthcare costs and deliver quality, affordable care to the American people."

Few expect that will happen with much GOP support.

Senate Minority Leader Mitch McConnell (R-Ky.) blasted the Baucus bill. "Americans don't think a bigger role for government in healthcare would improve the system," he said. "Yet despite this, every proposal we've seen would lead to a vast expansion of the government's role in the healthcare system."

Many Democrats already believe that Baucus' bill does not have enough of a role for government, arguing that a government-sponsored health plan would be the best way to ensure that consumers who are not covered through work will be able to find an insurance plan they can afford.

Healthcare bills developed by senior House Democrats and by the Senate health committee both include provisions to create a so-called public option.

The Baucus bill instead would create of a series of private health insurance cooperatives, which Baucus and other centrist Democrats say could offer the same protections as a new government plan.

Other debates are flaring over how to penalize employers who do not provide coverage, how much aid the government should give to consumers to help them buy insurance and how to pay for the final package.

To help pay for his bill, Baucus is proposing a series of new excise tax on insurance plans worth more than $8,000 for singles and $21,000 for families, and new fees on insurers, drug makers, device makers and clinical labs.

In contrast, House Democrats rely heavily in their healthcare legislation on a new surtax on high-income taxpayers.

Despite some substantial differences with the other Democratic health bills, however, Baucus' proposal also underscores the broader consensus about how to revamp the nation's ailing health system to expand coverage and tackle rising costs.

The Baucus legislation -- like the other two Democratic health bills -- is designed to largely preserve the current system of employment-based health coverage.

Layered on top of that system, the legislation would create a series of highly regulated, state-based insurance marketplaces, or exchange, where millions of people who do not get coverage from their employer or from the government would be able to shop for insurance.

These people would be able to select from a range of plans offered by private insurers, as well as one potentially offered by a member-owned cooperative.

Like other legislation, the bill would also substantially expand eligibility for Medicaid, the 44-year-old state-federal health insurance program for the poor, which in some states currently covers only poor children and their families.

Under all the Democratic bills, Medicaid would be opened to all of America's poorest residents, regardless of their family status.

Provisions in Baucus' bill would also set up a series of new initiatives in Medicare to make that gargantuan federal program more efficient, including incentives for hospitals to reduce re-admissions and for doctors to do more to coordinate their patients' care.

These initiatives, though the least controversial parts of the healthcare legislation, are seen by many experts as crucial to reducing the growth in Medicare spending, which threatens to essentially bankrupt the program by 2017.

[LnGrrrR]

To be fair, the article should read, "Key Republicans would reject ANY plan." :lol

[LnGrrrR]

Under all the Democratic bills, Medicaid would be opened to all of America's poorest residents, regardless of their family status.


Even illegals?!? *preparing pitchfork and torch*

[101A]

Provisions in Baucus' bill would also set up a series of new initiatives in Medicare to make that gargantuan federal program more efficient, including incentives for hospitals to reduce re-admissions and for doctors to do more to coordinate their patients' care.

Why does this have to be included ONLY in a MAJOR piece of legislation? Why can't they just pass the bill that's gonna save $500 Billion (Obama's numbers) in Medicare because it should just be done?

I can only assume becuase it's bullshit.

[coyotes_geek]

Under the bill, nearly everyone would be required to get insurance or pay a penalty. But insurers, in turn, would not be able to deny coverage to people with preexisting medical conditions or to cancel policies after people got sick, as happens in the current system.

I'm pretty much okay with this part. While in an ideal world I'd like to support the freedom of Americans to choose whether or not to have healthcare the reality is that they're going to end up in emergency rooms and we'll end up taking care of them anyways. Since there's no way for the taxpayer to be free from financial obligations to those people, those people lose out on the freedom to not participate.

Insurers cancelling policies when people get sick is utterly douchebaggish, so stopping them from doing that is fine by me. Pretty much the only valid reason to cancel someone's policy should be non-payment of premiums, or fraud.

I'm okay with not allowing insurance companies to reject pre-existing conditions provided that those people are asked to pay higher premiums than the rest of us. The overweight smoker should be paying more for his insurance than the marathon runner.


And the federal government would offer subsidies to help lower-income people buy coverage.

An expense that's destined to run amok and threaten the entire system.


"We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn't add a dime to the deficit,"

If that's true then somewhere in here is $856 billion of tax hikes.


The Baucus bill instead would create of a series of private health insurance cooperatives, which Baucus and other centrist Democrats say could offer the same protections as a new government plan.

Much better than the public option, but I'd have to see how they're set up and how much taxpayer support they'd receive before having a final opinion.


To help pay for his bill, Baucus is proposing a series of new excise tax on insurance plans worth more than $8,000 for singles and $21,000 for families, and new fees on insurers, drug makers, device makers and clinical labs.

Higher costs or lowered quality of care for the already insured.


In contrast, House Democrats rely heavily in their healthcare legislation on a new surtax on high-income taxpayers.

Naturally.


Layered on top of that system, the legislation would create a series of highly regulated, state-based insurance marketplaces, or exchange, where millions of people who do not get coverage from their employer or from the government would be able to shop for insurance.

These people would be able to select from a range of plans offered by private insurers, as well as one potentially offered by a member-owned cooperative.

Don't have a problem with this in theory, but again it would depend on how these were set up.



Like other legislation, the bill would also substantially expand eligibility for Medicaid, the 44-year-old state-federal health insurance program for the poor, which in some states currently covers only poor children and their families.

Under all the Democratic bills, Medicaid would be opened to all of America's poorest residents, regardless of their family status.

Expanding a program that we already can't fund.


Provisions in Baucus' bill would also set up a series of new initiatives in Medicare to make that gargantuan federal program more efficient, including incentives for hospitals to reduce re-admissions and for doctors to do more to coordinate their patients' care.

These initiatives, though the least controversial parts of the healthcare legislation, are seen by many experts as crucial to reducing the growth in Medicare spending, which threatens to essentially bankrupt the program by 2017.

Sounds like a bunch of smoke and mirrors to play the over-used, under-delivered politician promise of paying for new programs through "eliminating fraud and waste".

[Winehole23]

Nice breakdown, CS. I enjoy the topicality. :tu

[coyotes_geek]

A couple of problems I see (what I see being limited to what's in the OP) is that this plan still doesn't do anything to address what we're going to do with those who don't have insurance. With the govt making it law to have insurance the uninsured should primarily consist of illegals. But there's still going to be those who don't have insurance for one reason or another. What do we do with them?

Also, how do we enforce the law requiring people to be insured?

[boutons_deux]

mandate = "40M new (subsidized) clients for Baucus' $$ contributors"

no public option = 40M new clients can only buy from Baucus' $$ contributors.

How fucking transparent can he get? :lol

[fyatuk]

I'm pretty much okay with this part. While in an ideal world I'd like to support the freedom of Americans to choose whether or not to have healthcare the reality is that they're going to end up in emergency rooms and we'll end up taking care of them anyways. Since there's no way for the taxpayer to be free from financial obligations to those people, those people lose out on the freedom to not participate.

BS. I object to being forced to purchase anything, especially something that involves something I haven't done in over 2 decades (visit a doctors office under an insurance plan, I was 10 the last time).

In reality, the majority of people who are even remotely responsible do not go to emergency rooms. It is not an inevitability that someone who doesn't have insurance will end up in an emergency room so don't treat it as such.

There's also the fact that requiring insurance basically amounts to a subsidy for the industry, which is just plain asinine.


Insurers cancelling policies when people get sick is utterly douchebaggish, so stopping them from doing that is fine by me. Pretty much the only valid reason to cancel someone's policy should be non-payment of premiums, or fraud.

Are you talking just cancellation, or non-renewal as well? Also, add in insured request to valid reasons to cancel.


I'm okay with not allowing insurance companies to reject pre-existing conditions provided that those people are asked to pay higher premiums than the rest of us. The overweight smoker should be paying more for his insurance than the marathon runner.

As long as insurance companies are allowed to adjust cost per risk factor, there's no real problem with not allowing rejection due to pre-existing condition. Of course, what it will amount to is the people with pre-existing conditions won't be able to afford a plan anyway (and so will end up uncovered, and potentially having to pay a fine if insurance is compulsory).

[boutons_deux]

btw, I'm for a

1. strong public option

2. a mandate (every resident must be insured, or like uninsured drivers, get penalized)

4. full amnesty for illegal aliens, after they pay a fine for , and get in line for residency permits behind legit applicants for residency permits.

5. sealing the borders

6. a national ID card and national residency cards (for non-citizens) that must always be carried, just like a DL+insurance papers for drivers.

7. really nasty fines for employers who employ illegals.

[coyotes_geek]

BS. I object to being forced to purchase anything, especially something that involves something I haven't done in over 2 decades (visit a doctors office under an insurance plan, I was 10 the last time).

In reality, the majority of people who are even remotely responsible do not go to emergency rooms. It is not an inevitability that someone who doesn't have insurance will end up in an emergency room so don't treat it as such.

There's also the fact that requiring insurance basically amounts to a subsidy for the industry, which is just plain asinine.

Unless there's legislation that prevents hospitals from treating people without coverage (or cash I suppose) then there's no way to limit the consequences of not having insurance to just the people who don't have insurance. I agree it doesn't seem fair for me to tell you that you have to buy insurance, but then I don't think it's fair for me to have to foot the bill if you end up in an emergency room. Unfortunately there's no win-win situation here, so someone has to give up something.


Are you talking just cancellation, or non-renewal as well? Also, add in insured request to valid reasons to cancel.

Just cancellation by the insurance company. Individuals should certainly have the right to cancel or not renew their own policies should they so choose. Although in the event that coverage does become legally mandated, one could only cancel if they were going to be covered on a different plan.


As long as insurance companies are allowed to adjust cost per risk factor, there's no real problem with not allowing rejection due to pre-existing condition. Of course, what it will amount to is the people with pre-existing conditions won't be able to afford a plan anyway (and so will end up uncovered, and potentially having to pay a fine if insurance is compulsory).

Probably, but that situation doesn't seem any worse than things are now.

[Crookshanks]

Why do you assume that if a person without insurance ends up in the emergency room, the taxpayers have to foot the bill? The hospital will bill the person directly and people without insurance can set up payment plans. It's only the irresponsible people who don't pay - so we're going to force them to buy insurance? If they won't pay for their medical bill, what makes you think they're going to pay an insurance premium?

[coyotes_geek]

Why do you assume that if a person without insurance ends up in the emergency room, the taxpayers have to foot the bill? The hospital will bill the person directly and people without insurance can set up payment plans. It's only the irresponsible people who don't pay - so we're going to force them to buy insurance? If they won't pay for their medical bill, what makes you think they're going to pay an insurance premium?

If that's the case then what's the point of trying to get more people insured?

[LnGrrrR]

BS. I object to being forced to purchase anything, especially something that involves something I haven't done in over 2 decades (visit a doctors office under an insurance plan, I was 10 the last time).

Assuming your home hasn't been burgled or burnt down in the past 2 decades, do you also object to taxes for firefighters or policemen?

[DarkReign]

Assuming your home hasn't been burgled or burnt down in the past 2 decades, do you also object to taxes for firefighters or policemen?

Because you should go to the doctor deos not mean you should be forced to pay for the possibility.

There is the matter of personal choice that everyone seems to just completely overlook when it comes to Healthcare.

[DarkReign]

Why do you assume that if a person without insurance ends up in the emergency room, the taxpayers have to foot the bill? The hospital will bill the person directly and people without insurance can set up payment plans. It's only the irresponsible people who don't pay - so we're going to force them to buy insurance? If they won't pay for their medical bill, what makes you think they're going to pay an insurance premium?

Cant argue that, but ultimately, the taxpayer does end up paying the hospital in a round-about sort of way (hospitals have many different ways fo absorbing lost revenue to uninsured patients, none of them really legal).

[2centsworth]

Why does this have to be included ONLY in a MAJOR piece of legislation? Why can't they just pass the bill that's gonna save $500 Billion (Obama's numbers) in Medicare because it should just be done?

I can only assume becuase it's bullshit.
I agree, but now we're both racist.

[DarkReign]

I agree, but now we're both racist.

http://open.salon.com/blog/behind_blue_eyes/2008/10/24/files/thatsracistgm751224856460.gif

[boutons_deux]

"I can only assume becuase it's bullshit."

Of course it's bullshit. $500B saved in Medicare/Medicaid outlays is $500B revenues lost by health care system/providers.

Magik Negro got the AMA/docs to support health care reform by agreeing NOT to cut his planned $225B/10 years in docs' payments. total bullshit.

"Controlling costs" means lowering SOMEBODY's revenues. Those somebody's have $Bs to fight their revenue reduction.

[Winehole23]

Actually, it means raising taxes, whether by excises on insurance companies (Baucus bill), or soaking the rich (House bill). Expecting corresponding cuts elsewhere is a bit pollyanna-ish.

[fyatuk]

Assuming your home hasn't been burgled or burnt down in the past 2 decades, do you also object to taxes for firefighters or policemen?

No, I don't.

I also wouldn't have a problem with the government completely taking over emergency healthcare services and running it off of taxes.

Here's the difference: In your example, I pay the government the provide people and equipment for protective services.

In this one: I'm being punished because I refuse to pay a private company for a service I don't use.

On a side note, in the past 2 decades my house has been burgaled twice, my truck has been broken into about 10 times, and a fire broke out just outside my house. Police and fire department were completely useless on all occassions, and stupidity in the fire department almost made it a close call preventing my house from actually catching on fire.

I actually had to fight the fire myself for about 20-30 minutes to keep everything from burning, then they used high pressure water on a magnesium fire and lit a tree on fire. It was pretty ridiculous considering there is a fire station about 1.5 miles from my house that doesn't serve my street. Then of course we got charged a wad for placing a 911 call.

[nuclearfm]

To be fair, the article should read, "Key Republicans would reject ANY plan." :lol

It's true. The GOP is catering to irrationality, because it makes them look good.

[nuclearfm]

To recap, this has no public option and many GOP members are against it.

[coyotes_geek]

Because you should go to the doctor deos not mean you should be forced to pay for the possibility.

There is the matter of personal choice that everyone seems to just completely overlook when it comes to Healthcare.

Should drivers have the freedom to choose not to buy liability insurance? Seems to me like you could draw some kind of parallel betwen auto insurance and healthcare insurance. If I choose not to buy car insurance and I crash into you, my freedom of choice caused you direct financial harm. Is it really any different if I choose not to buy health insurance and as a result you get harmed financially either through higher taxes or higher insurance premiums when the hospital overcharges your insurance provider? I'm all for freedom of choice, but not when that choice ends up in making someone else responsible for your actions.

[coyotes_geek]

No, I don't.

I also wouldn't have a problem with the government completely taking over emergency healthcare services and running it off of taxes.

Here's the difference: In your example, I pay the government the provide people and equipment for protective services.

In this one: I'm being punished because I refuse to pay a private company for a service I don't use.

The problem with your analogy though is that you say you don't use the service, but you'll change your mind the instant you need it. If you get into a car wreck you're not going to tell the EMS to just leave you on the side of the road because you don't have insurance. You're going to use the service and then it becomes a crap shoot whether or not the hospital is going to be able to recoup the cost of that service from you. If they can't, someone is getting stuck paying your bill.


On a side note, in the past 2 decades my house has been burgaled twice, my truck has been broken into about 10 times, and a fire broke out just outside my house. Police and fire department were completely useless on all occassions, and stupidity in the fire department almost made it a close call preventing my house from actually catching on fire.

I actually had to fight the fire myself for about 20-30 minutes to keep everything from burning, then they used high pressure water on a magnesium fire and lit a tree on fire. It was pretty ridiculous considering there is a fire station about 1.5 miles from my house that doesn't serve my street. Then of course we got charged a wad for placing a 911 call.

This is more of an issue of the quality of service you received opposed to whether or not you used the service. You got crap service, but you still used the service.

[fyatuk]

The problem with your analogy though is that you say you don't use the service, but you'll change your mind the instant you need it. If you get into a car wreck you're not going to tell the EMS to just leave you on the side of the road because you don't have insurance. You're going to use the service and then it becomes a crap shoot whether or not the hospital is going to be able to recoup the cost of that service from you. If they can't, someone is getting stuck paying your bill.

If something like that happens (and yes, I would rather be left on the road than taken to the ER, which reminds me, need to make sure I have a DNR on file), then I should be held responsible. I should be billed, my tax refunds confiscated, my wages liened, and estate confiscated when I died, etc. The only way society is getting stuck with an ER bill related to me is if I die and my brother refuses to pay it, otherwise I'll find a way.

And like I said, if you want to increases taxes to pay for emergency healthcare, I have no problem with that (hence, I have no problem with the current system). The problem I have is being fined for not supporting a private company. It's complete non-sense.


This is more of an issue of the quality of service you received opposed to whether or not you used the service. You got crap service, but you still used the service.

That was more of an anecdotal story than any sort of argument, hence "on a side note." Still think we shouldn't have been charged the 911 dispatch fee with it taking them so long to get there, though.

[LnGrrrR]

Because you should go to the doctor deos not mean you should be forced to pay for the possibility.

There is the matter of personal choice that everyone seems to just completely overlook when it comes to Healthcare.

No, you're missing my point.

The point is that, one day, he MIGHT have to go to the emergency room. Just as he might one day have need of police or firefighting service.

[coyotes_geek]

If something like that happens (and yes, I would rather be left on the road than taken to the ER, which reminds me, need to make sure I have a DNR on file), then I should be held responsible. I should be billed, my tax refunds confiscated, my wages liened, and estate confiscated when I died, etc. The only way society is getting stuck with an ER bill related to me is if I die and my brother refuses to pay it, otherwise I'll find a way.

And like I said, if you want to increases taxes to pay for emergency healthcare, I have no problem with that (hence, I have no problem with the current system). The problem I have is being fined for not supporting a private company. It's complete non-sense.


Fair enough. And I think there's some merit to what you said that I bolded above. Giving hospitals some legal mechanisms to recoup payments from those who don't pay for the care they received would probably do a lot of good in terms of controlling costs.

[LnGrrrR]

I also wouldn't have a problem with the government completely taking over emergency healthcare services and running it off of taxes.

Here's the difference: In your example, I pay the government the provide people and equipment for protective services.

In this one: I'm being punished because I refuse to pay a private company for a service I don't use.


Fair enough. That's a valid objection.

[fyatuk]

Fair enough. That's a valid objection.

It's quite a bit syntactical, but it's a principle issue.

I actually have no problems with the so called public options. A lot of people don't realize it, but we already have several such things happening in Texas. Any flood policy is required to go through the National Flood Insurance Program. All windstorm policies in Texas go through TWIA (an exchange, much like what's talked about in HB3200). And Texas also has Texas Mutual Insurance Company, a government sponsored entity available for all covering Workers Comp insurance.

Honestly, creating an exchange and requiring individual policyholders to go through it makes a lot of sense, until you start adding in the facist control HB3200 grants.

Of course, I'd much prefer wider and better use of HSAs, since probably (my own estimate) 95% of people would be better off taking the money they and their employers pay into an "insurance" plan and putting it into savings, and the savings from lack of agency commissions and insurance company overhead would probably pay the difference on the other 5%.


Fair enough. And I think there's some merit to what you said that I bolded above. Giving hospitals some legal mechanisms to recoup payments from those who don't pay for the care they received would probably do a lot of good in terms of controlling costs.

Quite true. It makes no sense to me that they don't have such abilities. Of course, it also makes no sense that PLUS loans are non-transferable. I tried my hardest to get them to transfer the PLUS loan to my name when mom died, but they wouldn't do it and wrote it off instead.

[MannyIsGod]

Fuck this shit. This plan is fucking horrible and any mandate without a public option is a crock of shit meant to do nothing more than line the pockets of private insurance companies. I swear to fucking god Obama needs to step the fuck up and not let this pass or he will never meet any expectations I have for his presidency.

This is probably worse than no "reform"

[Yonivore]

The Left has to face the sad truth...

ObamaCare is going the way of HillaryCare. Good riddance.

Now, can we talk about some common sense reforms?

[Yonivore]

Fuck this shit. This plan is fucking horrible and any mandate without a public option is a crock of shit meant to do nothing more than line the pockets of private insurance companies. I swear to fucking god Obama needs to step the fuck up and not let this pass or he will never meet any expectations I have for his presidency.

This is probably worse than no "reform"
To date, everything proposed by Democrats has been worse than no reform. That's what we've been telling you.

[boutons_deux]

"common sense reforms"

of course! who can be against common sense?

Now, give us your details, or maybe just the Big Picture.

[Yonivore]

"common sense reforms"

of course! who can be against common sense?

Now, give us your details, or maybe just the Big Picture.
The three main reforms would involve:

Tort reform to reduce the incidence of "defensive" medicine and to reduce the cost of malpractice insurance.

Relax regulations prohibiting insurance companies to sell across state lines.

Provide tax breaks for privately purchased insurance plans just like those afforded employer-based group plans or, better yet, offer no tax break for either.

[baseline bum]

Fuck this shit. This plan is fucking horrible and any mandate without a public option is a crock of shit meant to do nothing more than line the pockets of private insurance companies. I swear to fucking god Obama needs to step the fuck up and not let this pass or he will never meet any expectations I have for his presidency.

This is probably worse than no "reform"

If they pass this trash I will stay home in the 2010 elections, and if Obama signs it, he'll never get my vote in 2012 (even if Palin gets the republican nomination). If this is the kind of garbage the democrats are going to come up with as some half-assed lip-service reform bill, then I hope they get slaughtered in 2010.

[boutons_deux]

Baucaus' plan is fully bi-partisan, both parties hate it.

[NoOptionB]

Calm down guys. You think Obama has gone this far, already fucking his chances in 2010, to give up and still have his 2010 arms race fucked up but now with no reward? He went hard when he did not have to go hard. He is the most powerful man in the world. You don't think he can get Snow and others to sell their soul? C'mon.

They will do something. Last resort, your coward President will backdoor it some how.

Besides, he's still got 7 more years to try.

[nuclearfm]

Fuck this shit. This plan is fucking horrible and any mandate without a public option is a crock of shit meant to do nothing more than line the pockets of private insurance companies. I swear to fucking god Obama needs to step the fuck up and not let this pass or he will never meet any expectations I have for his presidency.

This is probably worse than no "reform"


I would agree with you but the primary ground shifting this bill does is create numerous npo's. NPO's operate a lot better than the govt and private for profit health insurance companies. Look no further than Minnesota. they spend 91% of insurance dollars on care, mostly through NPO's. Everyone else gets 78%

This is the best alternative we have. It works. It really will.

[nuclearfm]

Baucaus' plan is fully bi-partisan, both parties hate it.

They are against it because it makes no one rich, that's a lot of the money driving this in the first place. The for profit insurance companies aren't on board with this at all.

[nuclearfm]

The three main reforms would involve:

Tort reform to reduce the incidence of "defensive" medicine and to reduce the cost of malpractice insurance.

Relax regulations prohibiting insurance companies to sell across state lines.

Provide tax breaks for privately purchased insurance plans just like those afforded employer-based group plans or, better yet, offer no tax break for either.

Tort reform does little for costs, we've seen that Especially in TX. Study after study shows that costs associated with malpractice lawsuits make up 1% to 2% of the nation's $2.5 trillion annual health-care bill and that tort reform would barely make a dent in the total.
http://www.businessweek.com/magazine/content/09_39/b4148030880703.htm

Tell anyone who had severe life limiting malpractice performed on them that they are only worth $250,000. One can only hope you're never in that situation.

Fixing medical malpractice fixes tort issues. Anything else is having lowered expectations.

[boutons_deux]

"Tort reform to reduce the incidence of "defensive" medicine and to reduce the cost of malpractice insurance."

that didn't work in TX, why would it work nationally. Tort reform, like Acorn, is just another right-wing red herring.

"Relax regulations prohibiting insurance companies to sell across state lines."

How much would this save? how would it save anything? The big insurance companies are already NATIONAL companies with consolidated overheads.

"Provide tax breaks for privately purchased insurance plans just like those afforded employer-based group plans or, better yet, offer no tax break for either."

yes, extremely unfair that self-provided health insurance isn't subsidized like employer-provided, but "no tax break" is simply impossible.

And of course, Yoni wants to maintain the status quo of the US being ripped off by the health profit industry. Yoni's simple logic is "it's the most expensive in the world therefore it's the best in the world"

aka, motivated reasoning, the objective is "The USA is the best in the world in everything, therefore the US health care system must be the best and any supporting Yoni-rat-shit reasong proves it"

[SouthernFried]

Damn the insurance companies...they just want our money and make profits.

It's obvious the govt doesn't want our money.

[fyatuk]

"Relax regulations prohibiting insurance companies to sell across state lines."

How much would this save? how would it save anything? The big insurance companies are already NATIONAL companies with consolidated overheads.


BS. You must not know much about the insurance company. Each state has their own laws and offices regarding insurance. To operate in a state, you have to comply to those laws, and pay to have a license saying you can sell in each state. In fact, many have a child company to operate in each of the states they have a lot of buisiness in specifically because of that.

Having a bunch of different forms (at least one for each state you are in), plus the cost of keeping your registrations and licenses up to date is pretty hefty.

In fact, insurance companies have repeatedly asked for regulation to be taken over by the government specifically because it is a big cost with them. Granted, they just want to take the savings as extra profit, but it is a very big deal and could make a huge difference in rate increases.

[boutons_deux]

"could make a huge difference in rate increases."

ok, anybody got any calculations?

With 5% - 7% health insurance rises/year for the last decade, and projected to be the same for next decade (2010 is supposed to cost $30K/year for family of 4), does ANYBODY seriously believe making insurance companies subject only to federal regulations rather than state regulations will see any reduction in insurance rates?

Did tort reform cause doctors to reduce their charge to patients?
reduce defensive testing?
reduce insurance rate to doctors?
reduce the payout of insurance companies to malpractice victims?

[LnGrrrR]

BS. You must not know much about the insurance company. Each state has their own laws and offices regarding insurance. To operate in a state, you have to comply to those laws, and pay to have a license saying you can sell in each state. In fact, many have a child company to operate in each of the states they have a lot of buisiness in specifically because of that.

Having a bunch of different forms (at least one for each state you are in), plus the cost of keeping your registrations and licenses up to date is pretty hefty.

In fact, insurance companies have repeatedly asked for regulation to be taken over by the government specifically because it is a big cost with them. Granted, they just want to take the savings as extra profit, but it is a very big deal and could make a huge difference in rate increases.

Then you're getting into the issue of state's rights vs government....which is a whole new battle to fight.

[fyatuk]

Love how you slid from federal vs state regulation to tort reform, but since you asked.


Did tort reform cause doctors to reduce their charge to patients?
reduce defensive testing?
reduce insurance rate to doctors?
reduce the payout of insurance companies to malpractice victims?

Read:
http://docisinblog.com/index.php/2009/07/27/texas-tort-reform/

reduced number of lawsuits, reduced medical liability rates, increase number of practicing physicians, Texas is no longer a state with a liability crisis (becoming the first state to be removed from the AMA's list), doctors more willing to perform procedures...

And again:
http://blogs.wsj.com/health/2008/05/19/doctors-flock-to-texas-after-tort-reform/

7000 new doctors in 3 years. Malpractice lawsuits dropped off some 90% (from nearly 1200 the year before tort reform, to 184 in 2007). Mentions the increase in complaints to TMB, but associates that with increased regulatory oversight granted in the legislation.

Here's more:
http://www.atra.org/wrap/files.cgi/7964_howworks.html

There's some claims it's unconstitutional though:

http://www.texarkanagazette.com/news/localnews/2009/04/05/lawsuit-challenges-tort-reform-in-texas-2.php

"Did tort reform cause doctors to reduce their charge to patients?"

No (it wasn't meant to and Doctors have used the savings to buy new equipment and hire more staff)

"reduce defensive testing?"

Unclear (but doctors are more willing to use riskier procedures that have been commonly used in other states)

"reduce insurance rate to doctors?"

Yes, by a significant amount.

"reduce the payout of insurance companies to malpractice victims?"

Don't know, but considering the sharp drop in malpractice lawsuits, it's very probable.

[fyatuk]

Then you're getting into the issue of state's rights vs government....which is a whole new battle to fight.

Quite true. It's a matter of whether or not you want it to fall under interstate commerce or not.

I'd say it does (company in one state selling products in another), in which case the federal government should have the right to set standards. Of course, the federal government could probably only set minimum standards, much like minimum wage laws (which should be considered unconstitutional).

In most cases, as long as the state law is at least as strict as the federal, then the state law trumps the federal.