The Democrats Want Higher Taxes And Have The Public Option Back On The Table

[boedicca]

The only way to address it is free market forces. Price controls always end up lessening supply.

 

[boedicca]

He's already told us in his own words:

"The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out there. There is going to have to be a very difficult democratic conversation that takes place. The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open."

That's can't be! I thought health care resources existed in infinite abundance.

Anyway, let us know how that statement affects his administration of CMS.

He's already telegraphed his intent.

 

[Greenbeard]

The only way to address it is free market forces. Price controls always end up lessening supply.

Meaning what? Translate that into a specific policy.

He's already telegraphed his intent.

And when that intent (whatever you think it is) manifests itself in CMS policy, let us know. Thanks.

 

[boedicca]

Free market reforms:

- Interstate competition among insurance companies.
- Tort reform to get rid of tort blackmail.
- Tax reform to enable individuals to purchase individual policies with an equivalent tax deduction as businesses receive.
- Education reform which gets rid of restrictions on the the supply of doctors.

For a start.

These would be far more effective than a Big Government One Size Fits All Mandatory Participation Program.

 

[Greenbeard]

Someone else brought up similar proposals in another thread today. If you actually want to discuss those in detail, start another thread specifically on this and we can. There's a lot to be said there.

 

[boedicca]

We went through all of them during the ObamaCare discussions. They are the ones the GOP delegates put forth during the phony bipartisan summit hosted by Obama. The Dems ignored them and proceeded with the mess we now have.

 

[Greenbeard]

So you're not open to discussing them in another thread?

 

[mudwhistle]

Pretty soon you won't be...because the fine for not having coverage is much lower then the costs. Soon companies will be dropping coverage for their employees in favor of just paying the fines.

That would be a nice outcome but it's unlikely since the preference for employer-based coverage is strengthened under this law (in all the years employer-sponsored coverage has dominated the insurance market, there hasn't been a fine to coerce employers into providing it--they've done it for other reasons).

I suspect you're a plant. How the fuck would you know about the bill?

I've read it. All of them actually, starting with the original House bill, H.R. 3200, in the summer of 2009. In fact, I've also read all of the Republican health care bills in the current Congress, too.

It wouldn't make much sense to take an interest in the subject and follow the public debate if I didn't want to become familiar with what was being debated. Am I unique in thinking like that?

It's extremely hard to find a copy of the current form of the Health Care bill much less understand it.

No, it isn't. Every bill introduced in Congress is available on THOMAS, the Library of Congress's site. Under "Search Bill Summary & Status" search by bill number. H.R. 3590 is the root bill, H.R. 4872 is the much smaller reconciliation bill that amended it. Or, if you want more of a community feel as you're reading it, read it on Open Congress. Or on Gov Track.

If you prefer comprehensive summaries instead of the actual text of the law, there are about a hundred places you can go:

NASMD's summary
Kaiser's summary
Summary from some law firm
Section-by-section walk-through from the Senate Dem Policy Committee

In addition, THOMAS will show you the official summary of the law compiled by the Congressional Research Service when you search for it and OpenCongress provides its own section-by-section summaries.

I'm pretty sure at no point in American history has information been so readily available from the comfort of your living room. Please start making use of it.

Unless you were involved in the drafting and rewriting of this monstrosity it's very difficult to understand....even though I have some legal background.

No, I didn't design it but I'm confident I have a pretty good handle on it.

Please explain to me how companies dropping their group plans for employees is a good thing? I can't wait to hear this BS.



By the way; It's kind of hard to make use of it unless they post it first. But by the time they post it..it's already law or they wait so late that you only have a few hours to read it before it's voted on. Reading it after the fact is counterproductive for the debate and not what they said would happen...not to mention highly suspect. Also, Harry Reid and company are as we speak adding new provisions to it...and many of those are subject to change without prior notice. I've read parts of it and read a few of the summaries of what it contains.

Remember......"We have to pass it before we can see what's in it". Remember that? What that means is until it goes into effect nobody can really tell what it's gonna do. That's Nancy Pelosi's own words. Because of this I seriously doubt you really have an accurate grasp on what it will do...because you have to understand 100% of it to know for sure what it will do. You have to know every single exception in coverage, every single facet of the 2500 plus pages. Even if you have a photographic memory you'll never really completely understand it.

The problem with this bill and every bill they write is that it is too complex...intentionally. Entries that don't belong in a Health Care bill have been hidden in it. Exclusionary language is all over the place. People that were told they would be covered really aren't because of loopholes all over the bill. One of them is children that live with their parents to age 26 were advertised to have been covered immediately upon signing but instead aren't until the program kicks in somewhere down the road. Insurance companies are taking full advantage of this loophole. Loopholes maybe the writers didn't even know were in there. How can these incompetents be trusted with something this complex?

Then there is the corruption element you refuse to take into account. That is the kicker. I trust nothing these people do....and nether should you. If you trust them you're only setting yourself and the rest of us up for a serious ass-reaming. They've done it before and they'll do it again. Trust me.

 

[The Rabbi]

Pretty soon you won't be...because the fine for not having coverage is much lower then the costs. Soon companies will be dropping coverage for their employees in favor of just paying the fines.

That would be a nice outcome but it's unlikely since the preference for employer-based coverage is strengthened under this law (in all the years employer-sponsored coverage has dominated the insurance market, there hasn't been a fine to coerce employers into providing it--they've done it for other reasons).

It would not be a nice outcome. It would be disaster.
The preference is not strengthened. It is weakened by the existence of cheaper alternatives. As health insurance costs have gone up companies have looked harder and harder at ways to control those costs. The ultimate way is to drop it completely. Normally that would leave employees out in the cold. But with Obamacare insurance companies must issue coverage and it must be affordable. So companies really don't lose much by opting out. The fine is simply a matter of math as to which is cheaper.
I predict it will not be long before a Fortune 500 company announces they are the first to drop coverage.

 

[The Rabbi]

He's already told us in his own words:

"The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out there. There is going to have to be a very difficult democratic conversation that takes place. The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open."

That's can't be! I thought health care resources existed in infinite abundance.

Anyway, let us know how that statement affects his administration of CMS.

They do, with proper incentives. Just like every other commodity exists in virtual abundance, at the right price. But control the price, you control the supply as well.
It will affect policy by dictating rationing of health care, complete with panels that will decide what is acceptable protocol for different patients and what isn't. This is what Britain has already done. They have already declared that people have basically 18 months of life if they are chronically ill.
Do we want that here as well? No, I don't think so.

 

[Meister]

Pretty soon you won't be...because the fine for not having coverage is much lower then the costs. Soon companies will be dropping coverage for their employees in favor of just paying the fines.

That would be a nice outcome but it's unlikely since the preference for employer-based coverage is strengthened under this law (in all the years employer-sponsored coverage has dominated the insurance market, there hasn't been a fine to coerce employers into providing it--they've done it for other reasons).



I've read it. All of them actually, starting with the original House bill, H.R. 3200, in the summer of 2009. In fact, I've also read all of the Republican health care bills in the current Congress, too.

It wouldn't make much sense to take an interest in the subject and follow the public debate if I didn't want to become familiar with what was being debated. Am I unique in thinking like that?



No, it isn't. Every bill introduced in Congress is available on THOMAS, the Library of Congress's site. Under "Search Bill Summary & Status" search by bill number. H.R. 3590 is the root bill, H.R. 4872 is the much smaller reconciliation bill that amended it. Or, if you want more of a community feel as you're reading it, read it on Open Congress. Or on Gov Track.

If you prefer comprehensive summaries instead of the actual text of the law, there are about a hundred places you can go:

NASMD's summary
Kaiser's summary
Summary from some law firm
Section-by-section walk-through from the Senate Dem Policy Committee

In addition, THOMAS will show you the official summary of the law compiled by the Congressional Research Service when you search for it and OpenCongress provides its own section-by-section summaries.

I'm pretty sure at no point in American history has information been so readily available from the comfort of your living room. Please start making use of it.

Unless you were involved in the drafting and rewriting of this monstrosity it's very difficult to understand....even though I have some legal background.

No, I didn't design it but I'm confident I have a pretty good handle on it.

Please explain to me how companies dropping their group plans for employees is a good thing? I can't wait to hear this BS.



By the way; It's kind of hard to make use of it unless they post it first. But by the time they post it..it's already law or they wait so late that you only have a few hours to read it before it's voted on. Reading it after the fact is counterproductive for the debate and not what they said would happen...not to mention highly suspect. Also, Harry Reid and company are as we speak adding new provisions to it...and many of those are subject to change without prior notice. I've read parts of it and read a few of the summaries of what it contains.

Remember......"We have to pass it before we can see what's in it". Remember that? What that means is until it goes into effect nobody can really tell what it's gonna do. That's Nancy Pelosi's own words. Because of this I seriously doubt you really have an accurate grasp on what it will do...because you have to understand 100% of it to know for sure what it will do. You have to know every single exception in coverage, every single facet of the 2500 plus pages. Even if you have a photographic memory you'll never really completely understand it.

The problem with this bill and every bill they write is that it is too complex...intentionally. Entries that don't belong in a Health Care bill have been hidden in it. Exclusionary language is all over the place. People that were told they would be covered really aren't because of loopholes all over the bill. One of them is children that live with their parents to age 26 were advertised to have been covered immediately upon signing but instead aren't until the program kicks in somewhere down the road. Insurance companies are taking full advantage of this loophole. Loopholes maybe the writers didn't even know were in there. How can these incompetents be trusted with something this complex?

Then there is the corruption element you refuse to take into account. That is the kicker. I trust nothing these people do....and nether should you. If you trust them you're only setting yourself and the rest of us up for a serious ass-reaming. They've done it before and they'll do it again. Trust me.

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

 

[rightwinger]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

 

[mudwhistle]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

He usually leaves when I or anyone else presents something he cannot or won't answer.

And the "FACTS" aren't as straight forward as he claims they are.

We've already established that regardless of what's in the bill...the Democrats have proved to be untrustworthy. He cannot argue that. How are we supposed to assume that they'll ever fulfill their end of the bargain. The bargain is we give them our money and they spend it wisely as Greenbeard claims they have laid out in the bill. Not to mention the fact that he gave himself away when he said it was satisfactory that companies would rather pay fines then cover their employees. That was very telling.

Only a Progressive thinks that extorting money from Corporations while forcing workers in private group plans into public plans is a GOOD THING.

 

[The Rabbi]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

Bwahahahaa!!!!!!!!!!!!!!!

 

[Meister]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

Yes he has facts, but why won't he answer the obvious flaws?
Like I said....he seems to be a tool from the dems. I noticed you wouldn't refute that, leftwinger.

 

[boedicca]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

He's been kicking his own ass as the facts he has been presenting undermine his own case when properly illuminated.

 

[Greenbeard]

Please explain to me how companies dropping their group plans for employees is a good thing? I can't wait to hear this BS.

You're a conservative who hasn't read any Milton Friedman? I'd recommend starting with Capitalism and Freedom, it's pretty seminal.

Employer-sponsorship of health insurance is distortionary. It only came about through an accident of history, World War II-era policies that the public demanded be enshrined in law after the war ended. As it happens now, people like me are stuck in a given plan because our employer doesn't offer any choice (people with larger employers may have more choice but still not the full menu of options that will be available in the exchanges). Decision-making about that particular choice isn't done by me or my co-workers, it's done at the top of the organizational chart. That severely hampers my ability to shop for something I like. And by "severely hampers," I mean "virtually eliminates." Which is why it's so distortionary.

And that's why a number of thinkers--of all ideological persuasions--support getting rid of it. See boedicca's post above arguing that the tax exemption on employer-sponsored plans should be extended to all plans. The intent of that policy change is to eliminate the tax preference for employer-provided insurance and thus to ultimately end that system. And when you do that, everyone goes into the same marketplace and everyone gets to choose a plan from the full array of choices available in that marketplace (which, as I said, people like myself can't currently do). That's what "portability" means--decoupling health insurance from job status.

And I'm all for that. I have a soft spot for the Wyden-Bennett bill that would've transitioned everyone into the same marketplace. Wyden himself actually aggressively attempted to get a variation of that proposal placed into the law the ultimately passed--he favored including free choice vouchers in which an employee could, if he so chose, take his employer's contribution to his health insurance and go into the new health insurance exchanges by himself to put it toward any plan he wanted (and not specifically one of his employer's choosing). A weak version of that proposal was ultimately included, but the free choice vouchers are only available to people who are paying between 8 and 9.8 percent of their income on the premiums for their employer-sponsored plan.

The problem is that people want stability--abrupt change is generally not favored. Thus politicians have to promise "if you like your plan you can keep it" and contort themselves into all sorts of odd shapes as they attempt to preserve the existing system. That's part of the reason there's an quasi-employer mandate. But ultimately I hope we can transition away from the employer-based system and more toward one in which everyone exists as an individual making his own choices in the health insurance exchanges. That would be a good thing.

By the way; It's kind of hard to make use of it unless they post it first. But by the time they post it..it's already law or they wait so late that you only have a few hours to read it before it's voted on. Reading it after the fact is counterproductive for the debate and not what they said would happen...not to mention highly suspect.

A few hours to read it? The health care bill that became law is H.R. 3590, released with Reid's manager's amendment on November 19, 2009. It passed the Senate in a vote on Christmas Eve and the House--unaltered--on March 21.

It was accompanied by a relatively short reconciliation bill making certain changes, noted in the section-by-section summary posted above. That bill was publicly available on March 17. It passed the Senate on March 25 and the House later that day.

However, even this is misleading because these are the final products of a process that started evolving in July of 2009. When H.R. 3590 came out, it was a synthesis of the two Senate bills that had been marked up in committee, the Senate Finance Committee's bill and the Senate HELP Committee's bill. The provisions in the final combined bill didn't emerge out of the blue, they were debated extensively in those two committees starting in the summer of 2009. Thus if you'd followed the process from the start, the final bill (which you had over a month to read through before the first Senate vote and four months to read through before it was voted on in the House) would've contained little that was new to you. The same goes for the reconciliation bill, since its contents were revealed before the actual text of the bill was released.

Also, Harry Reid and company are as we speak adding new provisions to it...and many of those are subject to change without prior notice. I've read parts of it and read a few of the summaries of what it contains.

What provisions are being added? Are you talking about the administrative rulemaking process that's going on in the Department of Health and Human Services? Rulemaking is required by the text of the legislation and doesn't have much to do with Congress at this point.

It would not be a nice outcome. It would be disaster.

See above.

The preference is not strengthened. It is weakened by the existence of cheaper alternatives.

I love how "the existence of cheaper alternatives" has a derogatory connotation in your posts. What sort of conservative are you, I wonder?

As health insurance costs have gone up companies have looked harder and harder at ways to control those costs. The ultimate way is to drop it completely. Normally that would leave employees out in the cold. But with Obamacare insurance companies must issue coverage and it must be affordable. So companies really don't lose much by opting out. The fine is simply a matter of math as to which is cheaper.
I predict it will not be long before a Fortune 500 company announces they are the first to drop coverage.

I agree the moral component of employer-sponsored insurance will be removed, as employees will no longer have bad options in a shitty, largely unregulated individual market as the only alternative to a plan through their employer. You seem to agree, as well, that an employer shouldn't lose any sleep about sending his employees on their own merry way to buy insurance through the exchanges (which I hope you realize is a tacit admission that the individual market is going to be a significantly better place to buy insurance due to reform).

But the financial reasons are still there. Employees now face an individual mandate to have coverage, meaning they'll be demanding coverage as much as (if not more than) ever. The tax preference for health care premium dollars over actual dollars still exists, though it will no longer be limitless thanks to the excise tax on high-cost plans. And ultimately employers are going to be compensating their employees some amount--if some of that is in wages and some is in the form of health benefits, okay. But if an employer decides to terminate coverage, he can't simply delete that part of his employee's compensation package, he'll have to compensate with increased wages (a guy making $40,000 a year with a health package worth $5,000 a year isn't being compensated $40,000 for his position, he's being compensated $45,000--if you want to alter the allocation of the components of his package, that's one thing but lowering his compensation by an amount equal to his health benefit is a different beast entirely). To suggest otherwise is to suggest that all employees are currently greatly overcompensated for the work they do, which is somewhat of an odd market failure.

Just like every other commodity exists in virtual abundance, at the right price. But control the price, you control the supply as well.

That's (the bolded bit) kind of my point. Price rations goods. Price rations health care goods. We do ration now, that statement shouldn't be controversial to anyone who has taken an introductory economics course and recognizes that health care is not an unlimited resource.

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

Yes, The Powers That Be care very much about the opinions of posters on this board. Busted!

Anyway, what is it you want me to respond to? Of course the law has flaws. As I just spent some time saying, I wish it would make an aggressive push to transition away from employer-sponsored coverage. It does some rooting around the edges (i.e. giving employers the options of taking employees into the exchanges), which pacifies me a bit, but I think they missed an opportunity here. But that's the nature of the political process. I was very pleased, however, that the primary funding mechanism they went with turned out to be the excise tax instead of the income tax favored by liberals. The excise tax is a much better policy tool here.

I also think I've made it pretty clear in this thread I think something needs to be done to address provider consolidation and their role in skyrocketing costs. Most of the cost control options in the bill are aimed at the consumer (e.g. the excise tax on high-cost plans, designed in part to put a drag on rising costs) and at improving the delivery system so that it operates more effectively and more efficiently. While I'm fairly confident some of the many delivery system reforms that will be tested under this law will lower costs through quality and efficiency gains, that doesn't necessarily mean prices will go down since in the current system prices don't necessarily reflect costs due to the power of providers. That's a huge weakness that's going to need to be addressed by someone down the line.

He usually leaves when I or anyone else presents something he cannot or won't answer.

I went to see Inception again, apologies. Very enjoyable, I highly recommend it.

We've already established that regardless of what's in the bill...the Democrats have proved to be untrustworthy. He cannot argue that. How are we supposed to assume that they'll ever fulfill their end of the bargain. The bargain is we give them our money and they spend it wisely as Greenbeard claims they have laid out in the bill.

I'm not sure what you're talking about here. The bulk of the money spent here goes to consumers, who use it to choose an insurance plan that's to their liking. These are means-tested premium tax credits that give support to shoppers in the exchanges (i.e. the new individual market).

Not to mention the fact that he gave himself away when he said it was satisfactory that companies would rather pay fines then cover their employees. That was very telling.

I'm discovering that I'm apparently a bit more conservative and pro-competition than some of you. I suppose that is telling.

Only a Progressive thinks that extorting money from Corporations while forcing workers in private group plans into public plans is a GOOD THING.

The exchanges do not contain public plans. I've argued in this thread that they should include one but in the law as it stands now they do not. If your employer drops coverage, you go buy your own individual private plan.

Yes he has facts, but why won't he answer the obvious flaws?

What do you want to talk about? If it isn't obvious by now that I'm willing to engage in an actual discussion with you, I don't know how to make that any more clear.

He's been kicking his own ass as the facts he has been presenting undermine his own case when properly illuminated.

Can you elaborate?

 

[rightwinger]

Greenbeard seems to be a planted tool from the dems on this board. He seems to know a lot on the bill...more than most, but does not respond to the obvious flaws that the bill presents.

He has been kicking your ass with facts you can't refute too

Yes he has facts, but why won't he answer the obvious flaws?
Like I said....he seems to be a tool from the dems. I noticed you wouldn't refute that, leftwinger.

Yes people who are educated and make valid logical posts are most definitely dems

 

[clevergirl]

You're a conservative who hasn't read any Milton Friedman? I'd recommend starting with Capitalism and Freedom, it's pretty seminal.

I think we should just jump right into Friedman's position on medical care....and since you are such a fan I am sure you'll concur with not only his analysis, but his conclusion as well

Friedman excerpts from his paper on How to Cure Health Care. The full article is linked at the end.:

"Two simple observations are key to explaining both the high level of spending on medical care and the dissatisfaction with that spending. The first is that most payments to physicians or hospitals or other caregivers for medical care are made not by the patient but by a third party—an insurance company or employer or governmental body. The second is that nobody spends somebody else’s money as wisely or as frugally as he spends his own. These statements apply equally to other OECD countries. They do not by themselves explain why the United States spends so much more than other countries."

"We are headed toward completely socialized medicine—and, if we take indirect tax subsidies into account, we’re already halfway there."

"Third-party payment has required the bureaucratization of medical care and, in the process, has changed the character of the relation between physicians (or other caregivers) and patients. A medical transaction is not simply between a caregiver and a patient; it has to be approved as "covered" by a bureaucrat and the appropriate payment authorized. The patient—the recipient of the medical care—has little or no incentive to be concerned about the cost since it’s somebody else’s money. The caregiver has become, in effect, an employee of the insurance company or, in the case of Medicare and Medicaid, of the government. The patient is no longer the one, and the only one, the caregiver has to serve. An inescapable result is that the interest of the patient is often in direct conflict with the interest of the caregiver’s ultimate employer. That has been manifest in public dissatisfaction with the increasingly impersonal character of medical care."

"In terms of holding down cost, one-payer directly administered government systems, such as exist in Canada and Great Britain, have a real advantage over our mixed system. As the direct purchaser of all or nearly all medical services, they are in a monopoly position in hiring physicians and can hold down their remuneration, so that physicians earn much less in those countries than in the United States. In addition, they can ration care more directly—at the cost of long waiting lists and much dissatisfaction.

In addition, once the whole population is covered, there is little political incentive to increase spending on medical care. Once the bulk of costs have been taken over by government, as they have in most of the other OECD countries, the politician does not have the carrot of increased services with which to attract new voters, so attention turns to holding down costs."

"The high cost and inequitable character of our medical care system are the direct result of our steady movement toward reliance on third-party payment. A cure requires reversing course, reprivatizing medical care by eliminating most third-party payment, and restoring the role of insurance to providing protection against major medical catastrophes.

"The ideal way to do that would be to reverse past actions: repeal the tax exemption of employer-provided medical care; terminate Medicare and Medicaid; deregulate most insurance; and restrict the role of the government, preferably state and local rather than federal, to financing care for the hard cases. However, the vested interests that have grown up around the existing system, and the tyranny of the status quo, clearly make that solution not feasible politically. Yet it is worth stating the ideal as a guide to judging whether proposed incremental changes are in the right direction."



Full article here

 

[boedicca]

He's been kicking his own ass as the facts he has been presenting undermine his own case when properly illuminated.

Can you elaborate?

Your solution to the distortion of employer provided health insurance being a taxpayer funded public option is a pretty good example of how you are kicking your own ass.