Chart Of New Health Care Law

[ltullos]

Re: Chart Of New Health Care Law

yes, we should clearly have waited for the gop to endorse a single payer system.

/s

+1 ;_tu

[Woodsman]

Re: Chart Of New Health Care Law

Spot on. 1+ and all that. Obama and the Democrats killed the public option and the Heritage Foundation and Romney created the individual mandate.

[dcarrigg]

Re: Chart Of New Health Care Law

Don't forget buying insurance across state lines to give the consumer choices and not the menu of a particular home state's special interest lobbies. The GOP wanted a market oriented system rather than the crazy bureaucratic monstrosity we see unfolding.

Don't get me wrong, something must be done. Some single payer systems seem to work, some are disasters. Now we penalize doctors, reward government bureaucrats, and throw huge profits at drug companies, some hospitals, and insurance companies.

As Shakesphere said: a pox on both your houses. We need to replace both of the oligarchic parties with an independent, anti fire one.

I suggest we have enough varied backgrounds, raw brain power, and respect for rational, documented discussion to maybe formulate some ideas that really help the common man, and grow the economy.

I was never sure how that "across state borders" thing was going to work, and this law wouldn't have accomplished it from the way I look at it. The Federal Government has some supremacy over the states, but the states have some sovereignty too. Telling states by Federal law that they have no right to regulate the insurance carriers within their borders is not something I am sure would be held up in court. And I'm pretty sure that states' AGs would sue over that right.

That being said, I think you're right. Sometimes I think Larry Lessig is onto something with the represent.us idea. Any plan has to be long term and thought out. But sometimes I also think he tries too hard to be an outsider. I have often wondered about the possibility of setting up an American Middle Class Association. Something akin to AAA but for FIRE protection. Charge membership dues. Offer free, skilled, and impartial advice and attorney/accountant service on FIRE matters to members (hell, there are enough jobless JD grads out there now looking to do good, this service shouldn't be too hard to set up). And take half of all of the membership dues and put them towards creating a real lobby for the middle class with real weight behind it - the kind that writes its own laws and hands them out to be introduced - and the kind with a real membership that trusts it and reads what it puts out. And just like FIRE, the donations can easily be bi-partisan. All you have to do is put forth a pro-middle class agenda, which usually precludes special gifts to the FIRE gods.

As it is, the AARP is pretty effective at what it does. Something for the working and not retired among us to at least make them take notice would not hurt. And given the system we're in now, if you have no money, you have no speech. I don't care if 10,000,000,000 people sign an internet petition. Unless they're bundling donations and threatening to fund challengers and drafting legislation, they're not in the game. Truth is, you may need both. But to me it's odd that America's largest constituency doesn't have a lobby group. And I think the lack of this group puts the middle class at a real disadvantage come sausage-making time.

[vt]

Re: Chart Of New Health Care Law

Interesting and workable ideas.

I suspect the overwhelming majority, if not everyone on this forum, wants to see the middle class prosper, and less the fortunate have a safety net to provide basic living standards.Any difference of opinion is based on the best way to accomplish this.

Some feel government does this best, and certainly some government programs are necessary. I actually worked with the anti poverty programs briefly in the 70's, living on poverty wages and living in a poor community. I have seen what government programs can and cannot accomplish.

Some view private industry as the best way to grow the middle class, and take people out of poverty. Governments cannot pay for services without a strong and growing tax base, and private industry cannot grow with excessive regulation and red tape.

There are problems in that corruption and favored interest prevent the poor and middle class from being helped in a fair manner. One of the principal tenants of Itulip is to accomplish a strong and growing middle class by proper ethics in the public and private sectors. We need to expand these discussions and find ways aid those entities that help achieve these goals.

Special interests, aided and abetted by politicians at both ends of the political spectrum have veered away from the noble goals of the American experience. The people need to correct this through the democratic process.

[c1ue]

Re: Chart Of New Health Care Law

Some single payer systems seem to work, some are disasters.

I'm curious - which are the single payer disaster examples?

[vt]

Re: Chart Of New Health Care Law

Two American friends who are married to Brits say the NHS is not nearly as good as what they had through American employers.

http://reformmedicaid.org/2011/06/me...ccess-failure/

http://www.reuters.com/article/2012/...82Q12V20120327

With the Obamacare rollout and federal and state budget constraints, I fear this can get worse.

I have a good friend that was hired by major corporations to offer health insurance to contract employees in the midwest and southwest about 8 years ago. They lived in lower cost areas and were getting paid $20 an hour plus the company provided and extra few dollars and hour for benefits to help pay health costs. The monthly costs were very reasonable for all but the uninsurable. Only a very few signed up; the rest wanted it for free. My friend even found private physicians in these communities who would take uninsured patients and only charge them for the cost of what we would pay for a copay for a basic appointment, as long as the doctor didn't have to do insurance paperwork.

This makes you wonder how signing up uninsured under Obamacare will work if it's not free, which it won't be.

[DSpencer]

Re: Chart Of New Health Care Law

The Federal Government has some supremacy over the states, but the states have some sovereignty too. Telling states by Federal law that they have no right to regulate the insurance carriers within their borders is not something I am sure would be held up in court. And I'm pretty sure that states' AGs would sue over that right.

So what you're saying is that the Supreme Court upheld the Federal Governments ability to:

Force residents of every state to buy health insurance
Specifically define the limits of acceptable health insurance policies
Tell the states to set up health insurance exchanges and do it for them if they refuse

...but the courts wouldn't uphold the Federal Government's ability to stop the states from forbidding people from buying out of state insurance?

[dcarrigg]

Re: Chart Of New Health Care Law

So what you're saying is that the Supreme Court upheld the Federal Governments ability to:

Force residents of every state to buy health insurance
Specifically define the limits of acceptable health insurance policies
Tell the states to set up health insurance exchanges and do it for them if they refuse

...but the courts wouldn't uphold the Federal Government's ability to stop the states from forbidding people from buying out of state insurance?

Pretty much. Crazy, huh?

[dcarrigg]

Re: Chart Of New Health Care Law

This makes you wonder how signing up uninsured under Obamacare will work if it's not free, which it won't be.

I think it will work just how it worked in Massachusetts. About 98% of people on the tax rolls will eventually be insured. 2% will not and will pay the poor bastard tax. Another 2-4% or so of the population will not be on the tax rolls, stay somewhat transient, and never be part of the stats.

People will pay the tax at first, for a couple of years until they get their act together and finally buy it. Then it will become the new normal. It will decrease buying power some. But it's pretty easy to buy this stuff on the MA health connector. Easier than it ever was before. And it's easier to judge price and benefit competition. And employers and tax credits end up offsetting a chunk of it.

I still don't think the mandate is the good way to go. But Romney actually rolled out a plan in Mass that is going now and people in general really don't complain much about it. The biggest complaints come from the cost side, and up here people are pretty well stuck on the idea that single-payer's the proven way to fix that.

The federal plan is substantially similar to the Mass plan. I think you'll find in three or four years, when it's all in place for a little while and Obama is gone, people will be used to it and not it mind so much.

Mass is now on to debating bigger things. So is Vermont. States are like little crucibles. It's good to let them experiment a little bit and see how things go.

[BadJuju]

Re: Chart Of New Health Care Law

Two American friends who are married to Brits say the NHS is not nearly as good as what they had through American employers.

But you have to have a job and it has to be a job that offers health insurance. Also, you may still have to pay entirely out of pocket for the health insurance. Not so useful, then.

[DSpencer]

Re: Chart Of New Health Care Law

Pretty much. Crazy, huh?

My cynical side thinks its crazy to ever expect the courts to reign in the power of the Federal Government. We've been pretty much screwed since Wickard v. Filburn. I absolutely cannot fathom the Supreme Court deciding that Congress can't regulate insurance in a way that guarantees intrastate access. Apparently, you see that as likely.

I would love for you to share a Supreme Court precedent that suggests I am wrong.

[vt]

Re: Chart Of New Health Care Law

The GOP was pushing interstate access to health insurance as a major part of their health care proposal when Obamacare was going through the legislative process. I can't imagine they would do so unless they thought they could override state regulations in this area.

[c1ue]

Re: Chart Of New Health Care Law

Two American friends who are married to Brits say the NHS is not nearly as good as what they had through American employers.

http://reformmedicaid.org/2011/06/me...ccess-failure/

http://www.reuters.com/article/2012/...82Q12V20120327

With the Obamacare rollout and federal and state budget constraints, I fear this can get worse.

So let me summarize your point:

The insurance policies offered by 2 fully employed individuals (note: are these IT? Finance? Day Labor? Technical? Sales Clerks?) is better than the NHS which is available to all Britons and even foreigners.

I also note there is no mention of ages. Are these young? (20-34) Middle aged? (35 to 54)? Old and preMedicare? (55-64) Medicare? (65+) This matters a great deal as well.

I have a good friend that was hired by major corporations to offer health insurance to contract employees in the midwest and southwest about 8 years ago. They lived in lower cost areas and were getting paid $20 an hour plus the company provided and extra few dollars and hour for benefits to help pay health costs. The monthly costs were very reasonable for all but the uninsurable. Only a very few signed up; the rest wanted it for free. My friend even found private physicians in these communities who would take uninsured patients and only charge them for the cost of what we would pay for a copay for a basic appointment, as long as the doctor didn't have to do insurance paperwork.

This makes you wonder how signing up uninsured under Obamacare will work if it's not free, which it won't be.

Perhaps you can add the detail of what you consider 'reasonable'. Someone who makes $20 an hour takes home something in the order of $2400; a $200 per month health insurance plan is a non-trivial part of this.

I think it will work just how it worked in Massachusetts. About 98% of people on the tax rolls will eventually be insured. 2% will not and will pay the poor bastard tax. Another 2-4% or so of the population will not be on the tax rolls, stay somewhat transient, and never be part of the stats.

People will pay the tax at first, for a couple of years until they get their act together and finally buy it. Then it will become the new normal. It will decrease buying power some. But it's pretty easy to buy this stuff on the MA health connector. Easier than it ever was before. And it's easier to judge price and benefit competition. And employers and tax credits end up offsetting a chunk of it.

I still don't think the mandate is the good way to go. But Romney actually rolled out a plan in Mass that is going now and people in general really don't complain much about it. The biggest complaints come from the cost side, and up here people are pretty well stuck on the idea that single-payer's the proven way to fix that.

The federal plan is substantially similar to the Mass plan. I think you'll find in three or four years, when it's all in place for a little while and Obama is gone, people will be used to it and not it mind so much.

Mass is now on to debating bigger things. So is Vermont. States are like little crucibles. It's good to let them experiment a little bit and see how things go.

The report which I suspect you are referring to also noted that 25% of all adults claimed they had significant financial hardship in 2010 - which led to reduced health care spending among other things.

As I've noted repeatedly - reforming the actuarial insurance portion of the health care problem isn't going to help with the much more fundamental problem of cost escalation.

From my perspective, ObamaCare and its purported Massachusetts forebearer does just enough to stop real reform, and not enough to actually address the problem.

[lektrode]

Re: Chart Of New Health Care Law

Originally Posted by DSpencer So what you're saying is that the Supreme Court upheld the Federal Governments ability to:

Force residents of every state to buy health insurance
Specifically define the limits of acceptable health insurance policies
Tell the states to set up health insurance exchanges and do it for them if they refuse

...but the courts wouldn't uphold the Federal Government's ability to stop the states from forbidding people from buying out of state insurance?

Pretty much. Crazy, huh?

so much for 'state sovereignty', eh?

and some are wondering why some of us are getting bent outa shape about this issue (amongst others, mostly due to a failure of the legislative process - in the beltway esp - to make decisions, the 'sensitive' issues in particular - and then leave it to the courts, thus ROBBING The Rest of US of our CONSTITUTIONAL RIGHTS to set policy/make/chg law thru use of the ballot box - course that just gets back to the lamestream media's agenda, to selectively 'inform' - which causes the UN-INFORMED to throw their 'consent' into the winds of the 'cause du jour' - and i'll leave that rant for another time ;)

but crazy isnt term i'd use (and since i'm not all that edumacated, i cant come up with a better one at the moment, so....)

this is what it really gets back to - and to me is Exhibit A, or the prima facie of the nature of The Problem

.....People will pay the tax at first, for a couple of years until they get their act together and finally buy it.

yeah, IF they dont have some sort of accident, that wipes em out financially first - then they'll end up wards of the state, anyway!
(since its really quite simple, for those of us who've worked our asses off, paid thru the nose for 'insurance' all these years and THEN, when they/we actually need some return on all that 'investment' ??? - get told their co-pay for a CTscan is 1500bux?

why this is VERY enlightening - but is a little unclear on just what those numbers represent - is that the 'net cost' to the patient/ rate-payer (victim) or is that the PRICE of said service?

Then it will become the new normal. It will decrease buying power some. But it's pretty easy to buy this stuff on the MA health connector. Easier than it ever was before. And it's easier to judge price and benefit competition. And employers and tax credits end up offsetting a chunk of it.

guess i get to be 'the judge' of that, since i'm now shopping for this item - i intend to look very carefully at all the options eye can find and compare it to these 2 states (MA/VT) in particular, to where i'll be purchasing said 'coverage' (ransom, more like) - it should be VERY interesting (and will try report on what eye discover )

I still don't think the mandate is the good way to go. But Romney actually rolled out a plan in Mass that is going now and people in general really don't complain much about it.

esp since any place we've seen 'mandated' anything - car insurance, for instance - the price of it skyrockets (MA vs NH is a purrrfect case in point - and i am painfully aware of other state comparisons too - but you get my point)

and/but with All Due Respect, dc (and there's plenty) - that is quite likely due to the fact that, in general - most people DONT pay for it - somebody else does - vs those of us WHO HAVE BEEN PAYING thru the nose - directly - with OUR OWN MONEY - and now ???
we get to pay not only for our own, but for all the 'qualifiers' to boot!???

and i wont even get into the concept (i'd say 'fact' but i'll leave that to another rant) that in some states, there are only a couple BIG players in the game and in order to get at the BIG subscriber bases (hint: public sector/union) - they offer large discounts to sign em up and then us INDIVIDUALS get to subsidize them too! (as IF it cost em more to cover a single than it costs to cover a group that has 21+ sick days/year, _every_ year, that accumulates...)

why i'm now of the opinion that the prev system is being left fer dead by the big players (as well as the political class, seeing as they exempted themselves) and why its inevitable for single payer to (eventually, after a HUGE runup in costs) will end up appearing to be the Only Way Out.

and i see less and less convincing argument against it - not the least of which is the $750 billion that gets pissed away on anything but 'health' care - without even arguing about 'the profits'

The biggest complaints come from the cost side, and up here people are pretty well stuck on the idea that single-payer's the proven way to fix that.

The federal plan is substantially similar to the Mass plan. I think you'll find in three or four years, when it's all in place for a little while and Obama is gone, people will be used to it and not it mind so much.

Mass is now on to debating bigger things. So is Vermont. States are like little crucibles. It's good to let them experiment a little bit and see how things go.

agreed - but for what people? - since 'most people' dont even see the whole costs - never mind even know what they are - and this is again, The Biggest Problem - case in point:

you may have noted my comments elsewhere about my... uhhhh.... digestive issues - GERD in particular (and tired of poppin the purps) - so yest i attended a free info seminar on the topic - hoping that it was going to be about the TIF proceedure - and tho we got lunch out of the deal (with the purrrfect menu to illustrate/exacerbate the effects of said affliction) - it was on the nissen technique - and here's my point (finally, oh windy one):

asked the doc how much this would cost - or how it compared in price to the TIF - and altho he told me that they both run about same (which is odd, given the TIF is a '2hour outpatient' gig and the other requires full anesthesia, 5or6 incisions and what appears to be an contortionist-inspired re-arrangement of yer innards - being the same that me mother had done, another story) -

bottom line: he had no idea what it costs - and quite likely i immed became an 'un-desireable' candidate merely for asking the price (as in: if ya hafta ask, ya cant afford it...)

so yeah - i'm REAL INTERESTED in comparing everything that MA/VT comes up with to what my current choices are - and muchos mahalos for pointing us to those links, dc

and again - just trying to help prove your point.

i'll shutup now... ;)

[thriftyandboringinohio]

Re: Chart Of New Health Care Law

The GOP was pushing interstate access to health insurance as a major part of their health care proposal when Obamacare was going through the legislative process. I can't imagine they would do so unless they thought they could override state regulations in this area.

The precedent and case study is interstate credit cards, which transformed the industry by a 1978 court case.
Before then, each State had usury laws that set a limit on the maximum interest rate a bank could charge in that state, including credit cards
The court ruling said a bank in a state with a high interest rate limit, or no limit at all, could charge those high rates in any state.
The practical effect was to remove local control of banking for credit cards, and eliminate usury laws.
South Dakota was an early winner, making bank-friendly credit card laws and grabbing the jobs associated with the business.

Same goal and same likely outcome for interstate health insurance. If it can get implemented, the industry will find some state that will remove all restrictions; the insurance companies will do business everywhere under those easy laws; and local state-by-state control of health care insurance will be eliminated for all practical purposes.