Why I'm Probably Going to Jail

Time will tell ... (0.00 / 0)

"For a package that will make things worse rather than better. For a situation that will cause even more people to become uninsured than lack coverage now." I really think that this statement is pessimism at its extreme and really far from the truth. But time will tell if I mistaken on this.

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by: nouvelle_ange @ Thu Dec 10, 2009 at 09:39:35 AM CST

Nouvelle_Ange (0.00 / 0)

I would hope that you are right and I am wrong. So here's my question to you: in what way does the Senate bill improve anything?

Medicare for those 55-64 won't be subsidized: at fair market price, it will be no more affordable than high priced plans from insurers of last resort. What is the point of unaffordable insurance?

It doesn't look like there will be a Medicaid expansion. Even if it DOES expand from 133% to 150%, how will it improve on the Massachusetts model? There, people have mandatory coverage and an ability to get the low cost plan, but because costs were not controlled AND the pool of primary care providers was not expanded, the people with the new "coverage" cannot find doctors nor hospitals to treat them. Is it "insurance" if no one accepts it?

The "basic plan" in the Senate plan requires that people pay between 30 and 40% of their costs AFTER insurance pays its part. How will this prevent additional bankruptcies due to heart attacks, cancer, and other high-priced illnesses?

There is a trigger - who will write that? There's a trigger in the Medicare drug plan, and even though the threshold has been passed, big Pharma has prevented its implementation. What would be different here?

Honest, nouvelle_ange -- find me SOMETHING to cling to in the current legislation. ANYTHING. I'd love to have some hope, but I've read it, I've read everything I can find about the compromise, and I just can't find it.  

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by: DocJess @ Thu Dec 10, 2009 at 11:49:35 AM CST

[ Parent ]

do we know if the mandatory clause is going to hold without a public option? (0.00 / 0)

seems like they should be part of the same package

mandating unaffordable health insurance for folks who cant afford it seems about as reasonable as outlawing sickness....

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by: UplandPoet @ Thu Dec 10, 2009 at 12:11:46 PM CST

[ Parent ]

Mandates (0.00 / 0)

The mandates stay, based on everything I've read. HOWEVER, those are only the individual mandates, not those for employers buying insurance, nor for ERISA-covered self-insured corporations.

That's the trigger deal -- 4 years of mandates to SEE if the insurance companies will present policies that are affordable. In the interim, taxes, fines, and no public option of any actual worth. The Medicare part for those 55-64 would kick in in 2011, but unsubsidized.

Remember, there is an election in 2010, so we could end up with an end to the triggers and any future public option, while keeping the taxes and fines.....

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by: DocJess @ Thu Dec 10, 2009 at 12:28:35 PM CST

[ Parent ]

somehow, i doubt the taxes and fines will stay if the public (0.00 / 0)

is screaming, but now is certainly the best to time to scream!

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by: UplandPoet @ Thu Dec 10, 2009 at 13:20:44 PM CST

[ Parent ]

Hope (0.00 / 0)

DocJess,

As you probably suspected already, I have not read the gazillion pages of the bill. But my hope is based on the 3 factors below:

1. Senator Kennedy played a HUGE role in getting Obama elected. I think this was the main reason why Obama staked his political reputation on healthcare reform this year, just when most moderates would have preferred for him to focus on just Economy, Economy, Economy. I do not believe that Obama would stab Kennedy in the back by signing a bill that makes the situation worse.

2. I believe Obama is a very logical person, who thinks through things. As of today, I cannot find a reasonable theory for why he would reward the healthcare insurance sector and punish the voters in the process for no gain to the voters at all. I would have to think of him as very much suicidal, which I do not think is the case.

3. Obama is a writer and a former law professor. As such, unlike me he has probably combed through the entire bill and any amendments that have a chance of passing. So, when it is time for him to sign, I believe that he will know exactly what it is he is signing (which I cannot say about some of the other presidents).

So, I still maintain that I will wait and see what he finally signs. Then wait a few more years to see the real life impact. In the meantime, my hope remains.

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by: nouvelle_ange @ Thu Dec 10, 2009 at 13:59:21 PM CST

[ Parent ]

Nouvelle_Ange (0.00 / 0)

1. If Ted Kennedy knew what was in this bill, it would kill him. He, for decades, has fought for "Medicare E" - health insurance for all. He said a number of times during his illness that it was not right that by virtue of the money he had he could afford the very best standard of care, and others could not.

2. Obama is a man who seeks consensus above all. The idea of "bipartisanship" means more to him than anything else. He said many times that there is no red America, no blue America - only AMERICA, and he wants to be the president of ALL the people.

3. I would bet you my house that he has NOT read the bill. I believe he's been given oral briefings and written summaries. I further believe that those came from Harry Reid, Peter Orzag, the brothers Emanual and their staffs.
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Remember, there is a HUGE difference between the political viability of getting health care passed, and the programs actually implemented.

But I understand your point.  

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by: DocJess @ Fri Dec 11, 2009 at 03:12:30 AM CST

[ Parent ]

Hope #2 (0.00 / 0)

My number 4 reason: where is all the $900 billion going? If there is no one being subsidized, then the cost should be closer to $0, no?

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by: nouvelle_ange @ Thu Dec 10, 2009 at 14:42:33 PM CST

[ Parent ]

well on point 4, thats easy (0.00 / 0)

if we are being sold out, which i tend to agree with you, i dont think we are, but if we are, it goes to the insurance execs who will then turn around and share it with the politicians who gave it them....

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by: UplandPoet @ Thu Dec 10, 2009 at 15:05:10 PM CST

[ Parent ]

Good one! (0.00 / 0)

That's a good one :)

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by: nouvelle_ange @ Thu Dec 10, 2009 at 17:51:23 PM CST

[ Parent ]

This is why insurance should be mandatory (4.00 / 1)

As soon as you say that people can get insurance immediately, no question asked regardless of pre-existing conditions, then healthy people can game the system. They can look at their health expenses over the last year and see that it wasn't that much after all, and decide not to take life insurance, knowing full well that should they experience sudden chest pains they can then sign up for health insurance on the way to the ER and they would be covered. (In fact their emergency care would be covered even if they refused to buy health insurance at that point which is a really a case of letting people free roll the system at everyone else's expense.)

Imagine the fire station only provided service to "subscribers", but anyone could subscribe whenever they wanted. Surely many people would not subscribe to this service until their house was on fire, and then would unsubscribe once the fire was out. Such a system would not pay the expenses of fire control, and similarly a voluntary health insurance system will not pay the expenses of health reform.

What we have to do is make sure that the little guy does not get crushed in the transitions, by underwriting the cost of the plans to the poor.

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by: loeb @ Thu Dec 10, 2009 at 09:40:03 AM CST

i still say declare tomorrow that everone in america is on medicare (0.00 / 0)

no matter the age nor income,

let private insurance sell premiums for a premium!

if you took all the costs of the current system, you would save money and we would have better health care!

how do i know? because most CIVILIZED countries in the world, and quite a few that arent as civilized as we think we are do it, and they ALL have BETTER healthcare for LESS money.

we wouldnt need a public option then.

hmmm, wonder why we don't do it that way? you dont think somebody is making money off of us do you?

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by: UplandPoet @ Thu Dec 10, 2009 at 10:08:12 AM CST

I am in a 'wait and see' mode for the final bill (0.00 / 0)

I cannot find any solid details of what the Senate compromise entails.  I agree with DocJess that, IF the final bill has no robust public option (or some other effective way to keep health insurance premiums affordable) and IF it includes a mandate (both of these would have to be true), then that would justify civil disobedience.  I am not going to accept that from a government that I contribute to and live under.

But let's see what the real bill is.  Then let's figure out how we will combat any features that are unreasonable.  The little leaks from the media are not sufficient to convince me that the worst of all situations will come to pass.

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by: Etucson @ Thu Dec 10, 2009 at 14:10:23 PM CST

The basic problem with Hope.... (0.00 / 0)

Is when we are let down, it is a long road to fall.  If Obama didn't win as the change agent and bring this aura of hope and prosperity to the people voting, there wouldn't be such an aura of disappointment in the Democratic party right now..

It sucks that what brought us up, will and has brought us down.

I like most of us here have gotten almost disgruntled with the party.  They are letting us down for thier own benefit again, and the one person who had promised to save us from that, isn't..  I guess we shouldn't be suprised, a politition making us hear and believe what we want to hear and believe.  And than not following through... Now that is something new (sarcastic).  I had hoped for better, but am not suprised at this disaster.  

I went back to school to get a job where I can get benefits and not cost a fortune, right now me and my husband are uninsured (I am uninsurable in the market because of an hormonal condition) and my daughter has private insurance.  I just hope that I have good benefits for my family when this disaster goes into effect.  For everyone else.. I truly am sorry.  I pushed for this as a way to help people, not hurt them.  But good intentions are not going to save the millions of hardworking Americans.  

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by: kat @ Thu Dec 10, 2009 at 15:43:24 PM CST

DocJess (4.00 / 1)

And SERIOUSLY what will ya'll call your group that sounds like a democratic version of the republican teabaggers?

In my opinion you are still obsessed with only 'one' issue: Healthcare/Insurance reform.  Our party and Our President is about much more than that!

Sure people have worked hard and many are not going to get everything 'they' want, but that's not a reason to give up and lay on the floor with feet kicking throwing a temper tantrum.

The positive things that 'will' come when the HCR bill is passed outweighs what we would have if the bill were not to pass at all.

Rome wasn't built in a day.

p.s. When will DCW start posting 'in the main articles' some of the POSITIVE things regarding the Senate HC bill that McCaskill, Murkowski, Wiener, etc. have pointed out?

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by: Leah @ Thu Dec 10, 2009 at 16:24:02 PM CST

Leah (0.00 / 0)

First - the idea of steadfastly carrying the party line IS a Republican concept. It is also a fascist concept. It is the Russian newspaper Pravda, it is Fox News reiterating Bushie talking points.

The way that our party maintains its big tent, is that people can tell the truth, protest when the party is wrong, work to elect BETTER Democrats. To follow blindly is not what the party ever was.

And by the way, do you know what our party stands for? Can you quote chapter and verse from the platform? Did you memorize the points upon which Obama ran? If you want to say that the party is many things, and you want to follow them, you better know what they are. Chapter and verse.

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by: DocJess @ Fri Dec 11, 2009 at 03:06:32 AM CST

[ Parent ]

Misc... (0.00 / 0)

Protesting LEGALLY (in my mind) does not equate what you said in your OP. Civil disobedience, risking your life, or refusing to obey the law (if there even ends up being such a law) by refusing to purchase hc insurance is not a civil way to protest.

If dems are going to start to promote 'not purchasing insurance' and end up in jail for civil disobedience then I see no difference in those folks and the crazy right-wing fringe that is working AGAINST our government in a non-civil way.

I find it offensive that you asked for me to quantify my knowledge of the Democratic Party and Obama's running points. In the past I have read the Democratic Party Platform and even if I hadn't I do not need to quote the Dem's platform chapter & verse to know that our party's platform is MORE than just HCR, so I find your statement a bit silly  :)

As far as the points upon which Obama ran I am positive that I know them better than you think since I spent many hours reading Obama's stance on various issues and I watched ALL of his rallies/townhalls/speeches. Also, I'm also very active with the Obameter - I have read all of Obama's campaign promises, I send Bill & Angie updates when I come across them - so if you are going to take the attitude like your friend Tim that I am uninformed then perhaps you and I should shy away from debate in the future.

I do find it ridiculous that you are prematurely talking about 'going to jail' considering the HCR bill isn't even in it's final form as of yet.  The amount of nitpicking and anger over of the HCR bill on DCW has really gotten to be over the top.
Have a great day.

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by: Leah @ Fri Dec 11, 2009 at 16:04:16 PM CST

[ Parent ]

Health care providers as utilities? (0.00 / 0)

I haven't had time to focus closely on the Senate compromise. But I've had time the past days to think a little about broad questions of health care reform. (This is an advantage to having a long walk built into my daily commute. During the walk, I can basically think, even if the rest of my day is insanely busy.)

I've implied it before in several ways, but I'll make it explicit:

Single-payer scares me. It scares me because in this country we haven't been good at keeping the culture wars out of government programs. If we put everyone on government insurance, then I'm afraid it will become a gigantic battleground for every social issue that comes along. Think about the crazy things that come out of state boards of education, and imagine that in medicine. Remember, Medicaid and Medicare can't cover abortions except in cases of race, incest, or danger to the mother, and in some states not even then. Medicare for all would be a setback for the pro-choice movement! And what if some politicians decide to, oh, I don't know, mandate that gays be given information about "cures"? Or that faith healing be covered? For that matter, couldn't you see drug company lobbyists working out ways to favor their companies at the expense of patients?

I know it works in other countries, but I think the US really is different in some important ways, and I don't trust our politics not to make a mess of things.

On the other hand, it is insane to have markets with only one or two private providers with an antitrust exemption and a legal requirement, as corporations, to maximize profit ("fiduciary responsibility"). The companies literally have to break the law to do what's right for patients--that's crazy and sad.

The way out of this that I liked was to pit the two against each other--the competition of the government option forcing the private providers to treat patients better, while the presence of the private options (with the antitrust exemption removed) decreased the temptation for politicians to wage the culture war through the public side.

But that doesn't look like it's going to happen.

There's another solution, though, although it's not one I like as much, and that's to turn the private providers into utilities. Regulate the heck out of them, and limit their profits, in exchange for antitrust protection and a captive market. I think that's what the Senate compromise is pointing us toward.

The "utility" model is a whole lot better than what we have now, which are just unregulated monopolies with a mandate to take our money and provide as little in return as they can.

Is the utility model better than single payer? [Shrug.] From my perspective, that's pretty close. They're not all that different, actually. In both cases there's a lot of government regulation, and in both cases the profit the insurance provider can make is limited.

If that's where we're headed, then I think it's a big improvement over what we have, but it's also disappointing to me, because we could have done better.

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by: SarahLawrence Scott @ Thu Dec 10, 2009 at 19:45:00 PM CST

Utilities (0.00 / 0)

I live in Pennsylvania, where the electric companies (read: public utilities)were dinged by the courts 11 years ago for gouging on their rates, and not allowed to raise them for 11 years to make up for having the most unreasonable rates in the country.

On January 1st, all the companies will be rising their rates a minimum of 30%, in some cases 60%. They were never required to LOWER their rates, and the increases are well above what inflation would have called for, and above what they have paid for improvements in the interim.

My neighborhood is solidly middle class, and all electric (including heat) and already I know people who will be without electricity by February because they cannot pay the bills.

As to your point about single payer - you're right about the culture wars issue. No doubt. That's a political problem: in terms of provision, the overwhelming majority of people on Medicare in most parts of the country can get medical care at a price they can afford.

I haven't seen anything in the Senate bill about limiting their profits nor regulating "the heck out of them". There is NOTHING in ANY of the bills that says that. In NO BILL does it say "the most you can charge an individual for basic coverage is X dollars." And that's the fundamental problem people are ignoring.

If you say that 90% of every premium dollar must go to patient care (and that's still 2.25 TIMES what non-profits need for administrative costs)it says nothing about how many premium dollars a company can collect from an individual.

Here in PA, you can get "basic" insurance for under $100/month. It caps at $5,000 year. That's what insurance will pay, NOT what an individual pays out of pocket, and many things mandated by the basic plans in the bills require. Therefore, that sort of premium level will disappear if the bill is implemented. If the Massachusetts experience is any guide, base policies for individuals will rise to the $250 - $300/month range STILL for limited coverage and restricted doctors and hospitals. Not affordable to anyone at 151% of poverty. Family rates would be much higher.

At the other end of the spectrum, there is what's known as "the insurer of last resort". In most states, one company is required to take all comers by caveat of the State Insurance Commissioner. We have that here, and those rates can range up to $1800/month for an individual. To be more precise, $1802, which is what my friend who died of ovarian cancer a few months ago paid to the local insurer of last resort. Her policy excluded necessary tests and procedures she needed. As an aside, her SS disability was $1800/month.

With no price controls, the insurance companies will raise the base rates to cover the actuarial determinations of covering the "expensive" patients.  

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by: DocJess @ Fri Dec 11, 2009 at 03:32:27 AM CST

[ Parent ]

All the noise (0.00 / 0)

The compromise bill hasn't been made public, so we don't know what is or isn't in it. I think it's time to sit back and wait to see what is in it, but still reach out to your Congressman/woman to express your position.

I hear all sorts of misinformation from the news media, the politicians, and everyone else on what the public option is/was. That it is robust or watered down. I have no clue what that means. Sorry. I just hope they can pass something that can make health care more affordable and available.

I don't trust many politicians, but haven't seen enough on the "compromise" to say whether it would help Americans with health care.

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by: BoredJunkie @ Fri Dec 11, 2009 at 08:05:01 AM CST