Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by Redux

CBO also said premiums wont increase for most Americans and the plan is deficit neutral at the least and will likely result in deficit reduction long term...and you discount both.

Basically the CBO has updated their info. According to their own statements as posted they do not think that there will be NO increases... Deficit neutral is bullshit for those who are going to pay increased premiums and co-pays. So stop with your White House talking points and lies from the the Administration. So far they have failed.

So I do like how you cherry pick CBO data.

No Cherry Picking, only a post of the latest update of the CBO response as of Jan 2010.

Originally Posted by TheMercenary

Basically the CBO has updated their info. According to their own statements as posted they do not think that there will be NO increases... Deficit neutral is bullshit for those who are going to pay increased premiums and co-pays. So stop with your White House talking points and lies from the the Administration. So far they have failed.

No Cherry Picking, only a post of the latest update of the CBO response as of Jan 2010.

Of course you are cherry picking.

Updated their information? Nope.

The latest CBO letter you posted was in regard to ONE component, ONE specific level of coverage (bronze) to be offered through the Exchange (which you think is a fantasy) in response to a request from ONE senator.

It supplements.....not replaces or updates. It doesnt change the overall "score" that CBO provided on the overall Senate bill that was adopted. If you know anything about the CBO scoring process, you would know that. But that requires someone interested in the full analysis and not just those pieces cherry picked to support a pre-disposed opinion.

And deficit neutral has nothing to with what any individual will pay...it refers to the impact on the federal budget.

added:
White House talking points and lies?

Have you forgotten the "death panels" and the Medicare scare tactics, the "government rationing", the industry "studies" that fudged the costs to their benefit and all those endless partisan opinion columns with an agenda that misrepresented the facts and that you flooded the discussion with.... not to mention the sudden tsunami of inane pictures you "contributed" to the discussion recently (I was actually embarrassed for you with that childish outburst until I realized that you would never man up and admit it was an over-reaction.)

Cherry picking again?

[TheMercenary]

Originally Posted by Redux

The latest CBO letter you posted was in regard to ONE component, ONE specific level of coverage (bronze) to be offered through the Exchange (which you think is a fantasy) in response to a request from ONE senator.

That is why it is a factual bit of information that needs to be added to the debate as the American Public is then able to see what the real costs to them will be. The "Bronze" level is the lowest level of coverage, the coverage that most Americans will be exposed to. And by their own admission the costs are going to go through the roof. If you don't think that nearly $20,000 for family insurance is not a significant increase...

It supplements.....not replaces or updates. It doesnt change the overall "score" that CBO provided on the overall Senate bill that was adopted. If you know anything about the CBO scoring process, you would know that. But that requires someone interested in the full analysis and not just those pieces cherry picked to support a pre-disposed opinion.

I am quite familiar with the process. They are nothing more than a math clearing house for what ever information they are fed. They don't and cannot, by their own admission, predict what the actual costs will be in the end.

And deficit neutral has nothing to with what any individual will pay...it refers to the impact on the federal budget.

You are right, which is why for those who are actually going to see a significant increase in their costs could really care less about the fantasy of "deficit neutral". If you are paying significantly more for less care the average citizen is really not concerned with something the Federal Government has so far been unable to achieve in it's history.

Have you forgotten the "death panels" and the Medicare scare tactics, the "government rationing", the industry "studies" that fudged the costs to their benefit and all those endless partisan opinion columns with an agenda that misrepresented the facts and that you flooded the discussion with.... not to mention the sudden tsunami of inane pictures you "contributed" to the discussion recently

Your opinion. The opinion peices I contributed were merely against your parties line. That does not make them "partisan", other than they disagreed with your White House talking points. If you look at the majority of opinion pieces they are from subject matter experts, not a partisan mouth piece of the Demoncratic party.

[Shawnee123]

Volt-air? Was that there feller the guy who invented elektricity? Cause man, your being to smart for me.

[classicman]

Hey Dux . . .

Whats the deal with this interpretation...

This is essentially health-insurance reform as little applies to the health-care delivery system and its costs. Here is the status of major provisions of the bills, mostly as they apply to employer plans provided to employees and retirees:

An issue that I think plays a major role in the end user/payor costs.

* The Senate’s Christmas bill dropped Medicare buy-in for pre-age-65 retirees; dropped the public-option plan and approved multistate “health exchange” private plans to ensure everyone has coverage available to them, to be overseen by the Office of Personnel Management.

* Due date for implementation: House bill 2013, Senate bill 2014.

* Overall cost for both bills is estimated at $900 billion over 10 years, but estimates are unreliable due to back loading of benefits in the early years while still collecting taxes.

* National (House bill) and state (Senate bill) “health exchanges” are created as insurance pools for individuals and small groups.

* Medicare Advantage plan phases out over three years (House).

* Medicare “doughnut hole” phases out by 2019 (House).

*

Hospitals are held accountable for preventable readmissions.

Does it say how? Won't they just pass this cost on somehow?
*

Employers will be required to “pay or play,” i.e., keep their current health plans or pay 8 percent of payroll (House) or $750 times every employee of 30 hours per week or more (Senate). Companies where $750 is a bargain will likely drop their private plans and take the state-managed “private” plan, setting the stage for a single-payer program later.

This seems really confusing. Isn't $750 a bargain for every company? They quote the average cost of a family plan to be something like $12,000. I must be missing something here, but what?

* A grandfather clause for five years under the House bill and unlimited by the Senate for employer health plans in effect on the day of enactment.

* Litigation against state health exchange plans would be subject to state laws (House bill) while historic Employee Retirement Income Security Act (ERISA) would continue national standards under the Senate bill.

* Work-place “wellness” is encouraged under the Senate plan which permits giving employee discounts up to 30 percent tax free for meeting plan goals.
* A long-term care program is included, but the details have not yet been thought through.

* Under the Senate plan, a 40 percent tax would apply to the excess of health-insurance premiums above $8,500 single and $23,000 married.

* High earners, under the House bill, would be subject to a 5.4 percent surtax above $500,000 single and $1 million married.

* Both bills have new taxes on medical devices, insurers, drugs, etc., all of which are likely to be passed to the public.

Well that sucks. . .

* Taxes under the House bill treat domestic partners as married. The Senate bill does not.

* Flexible spending accounts would be limited to $2,500 and indexed to the consumer price index rather than the medical cost index.

Again, all these points apply essentially to employer-sponsored plans for employees and do not address other issues such as access to and delivery of services. The Senate bill is almost certain to be the basis for a final bill as the Senate has already shown it cannot muster the votes for many of the House bill’s provisions.

Link

I don't know if this is spun or not, so I'm just throwing it out there for discussion.

Oh an after attempting to read some of this bill, I strongly suggest anyone with any problems relating to insomnia to try reading it.

Originally Posted by classicman

Hey Dux . . .

Whats the deal with this interpretation...

An interesting interpretation by the Chamber of Commerce, which is spending $millions, along with the insurance industry to oppose the bill.

But I would agree that more of the reforms are "insurance" reforms (particularly impacting small business, ie members of the Chamber of Commerce) but there are signficant provisions that focus on containing costs in the delivery system.

An issue that I think plays a major role in the end user/payor costs.

Does it say how? Won't they just pass this cost on somehow?

Yep it says how it will pay for the $900 billion cost...over 10 years.

In the House, its primarily from the 5.4 % surcharge on high income earners (over $500 K0 that will raise an estimated $500 billion over ten years...and the cuts in payments to Medicare Advantage providers who have been ripping off the system for years and getting an average of 15% over Medicare guidelines, but lettting addtional companies "bid" to offer the same services at a lower rate....expected savings about $150 billion.

That brings the revenue up to $650 bill out of the $900. The rest is less predicatable...including the taxes on medical devices, etc...but with tax credits to famlies up to 4 times the poverty level (about $88K...so many middle class families wont pay that tax)....and the least predictable of the remaining revenue is in the out years and from "savings" from greater efficiencies and technologies.....iffy.

The Senate takes a different approach with the tax on high end insurance plans, but it appears that will be modified to raise the level at which plans are taxed t0 the benefit of many middle class workers and add a 1% FICA tax on income over $200K.

Some have a problem with the top 1-2% of taxpayers bearing a large portion of the costs in new taxes. I dont have a problem with that at all.

This seems really confusing. Isn't $750 a bargain for every company? They quote the average cost of a family plan to be something like $12,000. I must be missing something here, but what?

What is accomplishes is to enable companies that are marginal in size (to big for the small pool and to small for cheaper policies provided through big companies) to end their own employer-plan and enter a plan with a larger pool of other small businesses....a bunch of companies pooling together can offer cheaper insurance that a single small/medium company alone....simply by having a greater number of people included, spreading the risk.

Oh an after attempting to read some of this bill, I strongly suggest anyone with any problems relating to insomnia to try reading it.

You have to be a policy wonk to really want to read the bill, but there are good section-by-section summaries.

My Voltaire reference..."the perfect is the enemy of the good"

Who doesnt want a perfect bill that provides both comprehensive insurance reform and reform of the delivery system...all w/o costs to taxpayers?

I'll take what I think is a good bill and build on that...because the political reality is that the perfect bill aint gonna happen......or "a half of loaf is better than none."

Will it work as envisioned? Probably not completely. No legislation this comprehensive plays out completely as planned...never has and never will. But IMO, it is a reasonable approach, with most costs covered, and a good chance that it will accomplish many of the goals.

Others disagree and neither side should be claiming they can predict the future. I dont think i have ever suggested it is a great bill (I have always said IMO, it is as good as I think it can be given the politics) or that it will be 100% successful and everyone will be happy and healthy. And, I have tried to explain it as I understand it.

And, IMO, it is bullshit for others to be screaming "failed" even before it is given a chance to succeed....or claiming that the "propaganda" or talking points are all on one side of the discussion here. That is dishonest to the point of being blatantly and purposefully ignorant (not referring to you).

Only time will tell.

Or..we can punt and put it off again as we have for the last 80+ years since Teddy Roosevelt first called for comprehensive health care reform for all Americans.

[TheMercenary]

Originally Posted by Redux

An interesting interpretation by the Chamber of Commerce, which is spending $millions, along with the insurance industry to oppose the bill.

Bullshit. The insurance companies are about to get a windfall profit and they know it, and you know it, but you refuse to say so. As I said before millions of dollars to the insurance industry is like pissing in the Great Lakes to that industry.

But I would agree that more of the reforms are "insurance" reforms (particularly impacting small business, ie members of the Chamber of Commerce) but there are signficant provisions that focus on containing costs in the delivery system.

Neither of the Bills do much to contain the costs of Healthcare with the exception of a few very narrow areas. There are no cost containments on what the insurance companies are going to cost those who currently have insurance in the form of co-pays and premiums.

Yep it says how it will pay for the $900 billion cost...over 10 years.

To bad there is absolutely no way that you or the whores who are making deals to pass this bill can ensure that is going to happen.

[quote]....expected savings about $150 billion.[/quotet]But you can't ensure that is going to happen. Now as we get down to the wire there is a lot of discussion about how much more expensive it is going to really be. But we will never know until it comes out of the SECRET and NON-transparent talks. Another lie from the Dems and Obama.

The rest is less predicatable........iffy.

The first honest statement you have made about what this is really going to cost the Taxpayers.

Some have a problem with the top 1-2% of taxpayers bearing a large portion of the costs in new taxes. I dont have a problem with that at all.

Of course you don't. It serves the greater plan of wealth redistribution by the Socialist Demoncrats.

What is accomplishes is to enable companies that are marginal in size (to big for the small pool and to small for cheaper policies provided through big companies) to end their own employer-plan and enter a plan with a larger pool of other small businesses....a bunch of companies pooling together can offer cheaper insurance that a single small/medium company alone....simply by having a greater number of people included, spreading the risk.

There is no promise that marginal sized companies are going to be able to enter the insurance exchanges.

My Voltaire reference..."the perfect is the enemy of the good"

Who doesnt want a perfect bill that provides both comprehensive insurance reform and reform of the delivery system...all w/o costs to taxpayers?

I'll take what I think is a good bill and build on that...because the political reality is that the perfect bill aint gonna happen......or "a half of loaf is better than none."

Which is a very dangerous view of how your guys want to deal with the taxpayers money.

Will it work as envisioned? Probably not completely. No legislation this comprehensive plays out completely as planned...never has and never will.

No shit!?!?!

And, IMO, it is bullshit for others to be screaming "failed" even before it is given a chance to succeed....or claiming that the "propaganda" or talking points are all on one side of the discussion here. That is dishonest to the point of being blatantly and purposefully ignorant (not referring to you).

Oh, sort of like the millions of jobs that are have been made by the last bailout and the lies Pelosi, Obama, and Reid made to the American public?

[TheMercenary]

Some damm good questions:

The Honorable Barack Obama

President of the United States

The White House

1600 Pennsylvania Ave, NW

Washington, D.C. 20500



Dear Mr. President,

I read with great interest press reports indicating that Administration officials and Democrat congressional leaders have struck a deal related to the so-called “Cadillac” tax on high cost health plans. Numerous press reports indicate that health insurance plans covering state and local government employees and plans for employees in collective bargaining agreements would be exempt from the tax until 2018, while individuals employed in the private sector that are not covered by union contracts would pay the tax as early as 2013 -- even if they have the exact same insurance coverage.



While the reported deal is bad enough for working Americans, I am concerned that the deal that was negotiated behind closed doors may also have been designed to benefit federal government officials and employees at the expense of other Americans. Specifically, I request that the Administration provide answers to the following questions prior to announcing any final agreement on a health care bill:



1. Will the health care plans offered to Members of Congress and Administration officials, including Cabinet officers, White House staff, and political appointees, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

2. Will the health care plans offered to federal employees, including over 382,000 employees making in excess of $100,000 a year, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

I regret that I am forced to send this letter. I do not believe it would be necessary if you and your Administration had televised the health care negotiations on C-SPAN, as you committed to during the campaign.



Sincerely,



Eric Cantor

http://www.politico.com/livepulse/01...tes_Obama.html

[TheMercenary]

Well imagine this:

Payments to states emerges as major obstacle to healthcare reform

By Jared Allen and Jeffrey Young - 01/15/10 06:46 PM ET

Some House Democrats believe their states would get shortchanged in the overhaul of the nation’s healthcare system and the funding issue is fast becoming a major hurdle to getting a bill signed into law.


How much of a burden states would have to shoulder for a proposed Medicaid expansion is the latest friction point between the House and the Senate, and is threatening to blow a hole in the measure’s price tag.

“There’s a lot of angst right now from members from states like New York and California over this,” a senior Democratic aide said. “And there’s a growing concern that these states are getting the short end of the stick. And that’s particularly frustrating because it was members from these states that carried this bill to the point we’re at now.”


Lawmakers from these states and others are disgruntled because states that already offer more generous Medicaid coverage would be offered less additional assistance than states with relatively smaller programs.


While liberal House Democrats have yielded to the upper chamber on many issues, a growing number of House Democrats – liberals and centrists alike – are beginning to push back hard in opposition to a deal between Senate Majority Leader (D-Nev.) Harry Reid and Sen. Ben Nelson (D-Neb.) that exempted Nebraska from shouldering any of the cost involved in expanding Medicaid services.


Notwithstanding the Nebraska provisions, the Senate bill offers less assistance to states for the Medicaid expansion than the House bill.


But now, with the clock winding down and without an indication that the deal giving Nebraska full reimbursement is off the table, a new coalition of House members is warning that they'll be compelled to stick up for their states, even at the risk of stalling momentum at the eleventh hour.


Rep. Anthony Weiner (D-N.Y.) called it the last potential deal breaker from the perspective of House Democrats.


“It’s not so much a problem that Nebraska got [100 percent Medicare reimbursement],” he said. “We in the House thought everyone should get something like that, that we shouldn’t just expand Medicaid and then just cost shift it to the states. It would obviate everything we’re doing on stimulus and everything else by trying to relieve the burden on the states.”

http://thehill.com/homenews/house/76...-health-reform

1. Will the health care plans offered to Members of Congress and Administration officials, including Cabinet officers, White House staff, and political appointees, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

2. Will the health care plans offered to federal employees, including over 382,000 employees making in excess of $100,000 a year, be exempt from the proposed excise tax in the same manner as those covered under collective bargaining agreements?

1) In the Senate bill, all Members of Congress and congressional staff are required to purchase through through the Exchange:

d) MEMBERS OF CONGRESS IN THE EXCHANGE.

(i) REQUIREMENT. Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are

(I) created under this Act (or an amendment made by this Act); or

(II) offered through an Exchange established under this Act (or an amendment made by this Act).

(ii) DEFINITIONS. In this section:

(I) MEMBER OF CONGRESS. The term Member of Congress means any member of the House of Representatives or the Senate.

(II) CONGRESSIONAL STAFF. The term congressional staff means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

2) Of all the plans available to federal employees in the FEHB program, only one reaches the level of cost at which it would be taxed as a high end plan....And, the reference to federal employees making over $100K has nothing to do with the tax.

[TheMercenary]

Originally Posted by Redux

1) In the Senate bill...

Operative word. But since the scumbags are doing it all in secret we will never know or have the opportunity for public input until the deal is done. November is going to be painful for you guys because there are a lot of really pissed off people out there tired of your lies and backdoor deals.

Originally Posted by TheMercenary

Bullshit. The insurance companies are about to get a windfall profit and they know it, and you know it, but you refuse to say so. As I said before millions of dollars to the insurance industry is like pissing in the Great Lakes to that industry.

Neither of the Bills do much to contain the costs of Healthcare with the exception of a few very narrow areas. There are no cost containments on what the insurance companies are going to cost those who currently have insurance in the form of co-pays and premiums.


To bad there is absolutely no way that you or the whores who are making deals to pass this bill can ensure that is going to happen.

]....expected savings about $150 billion.[/quotet]But you can't ensure that is going to happen. Now as we get down to the wire there is a lot of discussion about how much more expensive it is going to really be. But we will never know until it comes out of the SECRET and NON-transparent talks. Another lie from the Dems and Obama.

The first honest statement you have made about what this is really going to cost the Taxpayers.

Of course you don't. It serves the greater plan of wealth redistribution by the Socialist Demoncrats.

There is no promise that marginal sized companies are going to be able to enter the insurance exchanges.

Which is a very dangerous view of how your guys want to deal with the taxpayers money.

No shit!?!?!

Oh, sort of like the millions of jobs that are have been made by the last bailout and the lies Pelosi, Obama, and Reid made to the American public?

Same old crap.,,,with the "whores" and "wealth redistribution by socialists Democrats" (what, no pics?) , blah blah blah

Any opinion that counters yours is not acceptable.

[TheMercenary]

Originally Posted by Redux

Same old crap.,,,with the "whores" and "wealth redistribution by socialists Democrats" (what, no pics?) , blah blah blah

Any opinion that counters yours is not acceptable.

You can't change the facts no matter how hard you Demoncrats want to spin it.

Originally Posted by TheMercenary

You can't change the facts no matter how hard you Demoncrats want to spin it.

Mrerc spin....good - fair and true and factual

Dux spin....bad - biasd and partisan and bullshit

I know the rules by which you like to play.

[TheMercenary]

Originally Posted by Redux

Mrerc spin....good - fair and true

Dux spin....bad - biasd and partisan

No Dux represents one group. I represent myself and the views of many groups.