People seem to be forgetting that this whole thing will be lubed with subsidies. So the 55-64 set might be shocked by the amount they have to pay for a premium in 2011, but starting in 2013 they'll be subsidized. The public option wouldn't start until 2013 anyway. The overall cost of treatment, though, should be cheaper than anything they could get in a public option because Medicare rates are way cheaper that the PO would have been able to attain (the strong PO tried to peg close to Medicare and failed). Meanwhile, four years from now, the uninsured under 55 will be able to go into these exchange things without the burden of sicker old folks in their risk pool. And hopefully, if the Medicare additions give positive reviews of their new plan, even younger people will want to buy in.
It seems to me the pincer strategy of attaining single-payer, wherein Medicaid and Medicare converge and eventually swallow everybody, is still a safer bet (and yeah, I know it hasn't happened in 40 years) than this "oil spot" plan in which we expand the PO to the boundaries of Medicare and Medicaid and load it full of consumers jumping off the private insurer ship. Because at the end of that plan, we'll have to ratchet reimbursement rates down to Medicare level, and the providers will throw a shit fit--just see how they reacted to this moderate expansion of Medicare.
@BearDownCBears: I disagree that a public option would have a ratcheting down of reimbursement rates. If that happened, doctors and hospitals would refuse to participate and drop out. There are already many doctors who refuse to participate in Medicare. But since the public option is an option, it means people have the choice to pick other insurance plans. If providers aren't in the network, people won't choose the public option. The public option will have to provide better service or the same service at a lower price than insurance companies. Its basic economic theory. And in the case of the public option, lower prices can occur because of reduced administrative costs due to the fact that there aren't shareholders expecting a profit and CEOs expecting millions of dollars.
@Lymed: I'm talking about the magical endgame, wherein a enormous portion of market is covered by either Medicaid, Medicare or the PO. I thought the conceit of this conversation was that the PO is a stalking horse to single payer. By consolidating those programs, we would have a bruising buyer that would force providers to lower costs or go out of business. I just think that that particular step of consolidation will be particularly difficult for the reasons you just gave: providers want to get paid at market prices, not Medicare prices. If we're being offered the chance to expand the Medicare pool while we can, won't it make that endgame easier? The CBO has said that the PO will likely be more expensive than your average plan anyway. And I agree with Timothy Noah that it won't cut costs.
While I was writing this I realized that yours is a coverage issue, that you're worried that putting more people on the Medicare payroll might restrict services because doctors won't treat them. Point taken. But Jesus, man, we can't stay terrified of providers forever. That's where the money is.
@BearDownCBears: I never conceited that point. There are people who fear a PO will lead to a single payer and there are people who want the PO to lead to single payer. But that isn't going to happen without another big legislative process like we have now, if it ever will happen.
I was pointing out a coverage issue if there was a public option and if the public option ratcheted down provider reimbursements. I was saying it isn't going to happen because providers would leave the network and then people would choose not to have a public option.
On a different note, I think we need to completely rework provider compensation and move away from fee for service. We need a system that, at the end of the day, actually compensates primary care doctors more. Because we need good primary care doctors. There are other providers who are getting overcompensated because they get paid more for bad care resulting in complications.
@Lymed: God a compensation bill would be awesome. I have no clue how we would go about it though, what with the finger-pointing at society's healers and whatnot. Talk about another big legislative process--we might as well attack the clergy.
Americans (and politicians) seem to be forgetting that this entire issue began not as "health insurance' reform but "health CARE" reform. According to various statistics, around 48 million Americans are totally without health insurance. 24% of all Americans who are carrying coverage are woefully underinsured. The teabaggers would like for us to forget this fact and focus solely on the issue of government participation in the process, but let's not take our eye off the real issue: people are suffering. When Remote Area Medical (a traveling group of physicians, dentists, and veterinarians who normally practice in rural, under served areas) came to LA to provide free medical care this summer, thousands of people showed up (some hitching hundreds of miles). Many hadn't been seen by a physician in years and showed signs of advanced physical deterioration. When RAM has to rent out a stadium to provide enough space to care for all the people who need their services, the system is in need of repair.
This is what I don't understand about the hate for the public option.
Look at PUBLIC education. You can choose to send your children to a public school (for a small fee), or, if you don't feel like the public school is adequate for your children and you can afford to send them elsewhere, you can personally opt out of the public option and send them to a PRIVATE school.
Is that socialist of us? Because then I would expect all the people hating on the public option for being socialist have their children in private school, even if it does cost my yearly salary to do so.
Why isn't the public option framed in these terms? I feel like a lot more people would understand it.
@morninggloria: It's interesting though, as a lot of the right is made up of "everyday American folk" like Palin likes to appeal too who are probably struggling the MOST paying for healthcare and don't have a choice but to put their kids in public schools.
You'd think people would be REJOICING about this but political nonsense just gets in the way. I just don't get it... no matter what party is pushing it, if a bill would change my life for the better, I'd be clamoring to support it. It's this blind support that is so infuriating to me.
@Le Kangourou de Kataroo: I think a big part of how modern politicians trick the people of America is that they have convinced the lower class & lower middle class that they are in fact solidly middle class-- or even upper middle class! This is the promise of consumerism & credit. You might even have a hot tub...out back of your heavily mortgaged home, that you bought on credit you are still paying off.
People hate paying taxes, & are convinced that tax hikes on the wealthy mean tax hikes on THEM. It is hard to explain that paying a little now means paying a lot less down the road; the Republicans prey pretty heavily on that.
@mordicai: Agreed, and would like to add that the American Dream is mostly delusion. People oppose laws that would penalize the rich because they honestly believe that someday they will be wealthy, fabulously wealthy, if they just pull hard enough on their own bootstraps.
@morninggloria: Right; any minute now they'll get their break & have their inherited wealth from their long decades (centuries!) of exploitation pay off. Wait, people, what?
I'm fortunate to have a secure job with very, very good health insurance. Consequently, I haven't paid much attention to the Health Care debate. Can any Jezzies recommend a web site with a neutral, non-politicized, non-insurance-company'd summary of this issue? Thanks in advance for any reply.
@zoethebitch: Look at the Kaiser Family Foundation website (www.kff.org). They have a great comparison tool. They have no current connection with Kaiser Permanent and Kaiser Industries. While they were started by the same person, Henry Kaiser, they truly are independent.
@zoethebitch: Thank you for taking interest. Though you have a secure job with good insurance, it's in everyone's best interest to get involved in better reform. We all have a loved one that may get sick, loose their job and insurance. Also, others without insurance or bad insurance plans drives the medical costs up for the rest of us, among many other things.
@Lymed: I had never heard of the Kaiser Family Foundation before. Explored their web site and found this page titled, "Explaining the Basics of Health Reform": [www.kff.org]
Just what I was looking for. Thanks.
From the article....Boehner & Co are planning on trying to block raising the debt limit.
"It will be an opportunity for us to point out the excessive spending that's going on in this Congress," said House Minority Leader John A. Boehner (Ohio).
It was raised several times--7, if I'm not mistaken--in the Bush admin to finance Iraq (among other things)! They're acting like this is something new.
Edited by pantsless economist...access RESTORED at 12/11/09 10:16 AM
pantsless economist...access RESTORED was starred
pantsless economist...access RESTORED was unstarred
@pantsless economist...access RESTORED: Let us not forget for a single fucking minute, that the cost of the Iraq war was NEVER included in the annual federal budget. Not. Once. Every single dollar that went to that war came from 'emergency spending bills". Where the fuck were the teabaggers, with their feverish righteous indignation THEN?!?
I will never get over the level of irony in the fact that the people whining the loudest about government "invading their bodies" with government-run healthcare are often the same people who want government to invade women's bodies by taking away reproductive rights.
I hope this is Pelosi setting up a situation where she can say the Senate proposal isn't a better idea than a public option.
I'm listening to Diane Rehm right now. The buy-in to Medicare is only for people who are uninsured. So what happens to people who insured on the individual market but have to pay more for worse insurance?
@Lymed: 60% of the bankruptcies in this country are medical. The majority of those are from working people that have insurance when they get sick. So this bill does little to help that.
@WashingMyHair: The way it tries to address bankruptcies from the uninsured is just going to create other problems. On paper, it sounds great to get rid of annual and lifetime limits on health insurance. But sometimes it isn't because the insurance companies are greedy. Sometimes it is because the employers are not giving enough money to health care. If you have a low wage worker making $9 an hour and the employer only gives $200 a month towards the health premium, do you want the insurance company to offer a $220 plan that is very limited but only has a $20 employee cost so the worker can afford to purchase limited health care rather than no health care? Or do you want to force the insurance company to offer a $400 plan that has no limits but that the employee can't afford?
I guess the insurer could offer a plan that has a $10,000 deductible and a 70% co-insurance rate. That way the low wage worker can afford the insurance. Unfortunately, the worker can't afford to go the doctor so she doesn't take care of her diabetes and has to declare bankruptcy when she ends up in the hospital and has to pay the first $10,000 and 30% of the rest of the charges.
I was talking with my Mom yesterday about the buy in plan and the Senate's trigger option. She thinks that these are all baby steps to eventually having everyone covered by Medicare. I would hope so, but then, my optimism towards the government has been lacking since September 11th. If the buy in and trigger option are massive failures--which they might very well be because the government is broke-ass and the lack of single payer option makes the risk pool woefully small and poor--then we'll never see an expansion of Medicaid, at least not until the Democrats are in power at a time when the government is rolling in money. Which will be when I'm, like, 90.
I also don't understand why people think a government plan is akin to the government invading our bodies. Current practices have private corporations telling us what we can or can't do, all in the name of profit. If there was a government plan, the profit incentive would be much lower and there would be fewer restrictions on how and when money is doled out. So, in short, I'd rather have the government pay me back for expensive procedures than have a private corporation use my body for profit. But I'm preaching to the choir...
@Sandicomm: When Medicare and Medicaid were signed into law, President Johnson was certain they would be expanded to cover all Americans. That was over 40 years ago. I fear allowing people to buy into Medicare could actually destroy any hope of a public plan because people will be shocked and angered by the high cost of purchasing Medicare coverage.
People believe what propaganda tells them to believe.
Well, if congress doesn't phase out the employer tax benefit for health care the Dems better promise to tackle the delivery system in another bill, because costs are gonna keep rising. All of CWA's ideas are revenue-raisers, but they don't bend the cost curve. You have to keep tax revenues ahead of the cost curve, and if costs keep rising, well, do the math.
The bishops were instrumental in getting tough anti-abortion language adopted by the House, forcing Speaker Nancy Pelosi, D-Calif., to accept restrictions that outraged liberals as the price for passing the Democratic health care bill. [...]"
Unless we can tax your ass and treat you like another fucking focus group, PAC, lobbying group, etc. (we should--they've made it clear who they support clear, come hell, highwater, or warmongering, social-service cutting Republicans), GO AWAY.
For the record, I don't give a shit what the church thinks about issues that put them in line with the very liberal, either. Their organization is based on an unprovable, malleable story and is a distraction from rational policymaking. I don't care if their ARE priests or nuns who are consistently "pro-life" and against choice AND the death penalty, I don't fucking religious doctrine swaying policy, period.
This stuff makes me livid. How is there even an entryway for their influence? I don't care if anti-choice Democrats and Republicans agree with them, how are they not sent reeling away from the table of discussion? Aren't there some rules they're breaking here, couldn't the legislators that oppose this amendment tell them (and anyone benefiting from their funding or talking points) where to shove it?
@maude_flanders: I know, I used to think there was a separation of church and state here in the ol' US of A, but it seems like that chasm has narrowed to a slit. Hell, why don't we just have the leaders of each major religious group in the US sit down at a round table and create some policies?
@maude_flanders: It's MIND-BOGGLING. I could literally not care less what Catholic priests think about US legislation. And yet, they somehow have a say? I mean, not to get all Seth Myers, but Really? REALLY?
Guess what, people who believe in religion: YOU DON'T GET A SAY IN MY LEGISLATION. And all you people (yes, on Jezebel) who identify yourselves with any of the religions who are trying to sway this bill yet try to claim that you are against it, maybe now's the time to reconsider your alignment, no?
@TurtleWexlerKickedMe: aligning yourself with a religion doesn't mean you believe in the actions of every other person of the same faith. Just because I'm a Christian doesn't mean I believe in everything that the church/"religious authorities" say.
@msridiculous447: If you don't believe in your church's doctrine, why be a member of that church? I ask that earnestly. We've had this discussion on here before (in the early days of Jez, there was a particularly great one, with many sides of the argument representing) and it's still unclear. Why be a member of something if it actively campaigns and lobbies for things you disagree with?
@TurtleWexlerKickedMe: That's what I initially asked myself, and deleted it. I can think of emotional reasons why, but--no offense to those who identify as Catholics here--those reasons are stupid to me. I can only speak for myself, but religion was never comforting, enlightening, or rewarding enough to stay when, at BEST, my priorities could be considered party of my flawed, sinful nature, a fluke to be resolved.
I know what's important to me. I can negotiate morality and the concepts of empathy, personal accountability, and human dignity without another f*cking Gospel that ends with "wailing and gnashing of teeth," another story that seems even more meaningless and irrelevant the third, fourth, fiftieth time I hear it (my respect for some of the priests at my family parish notwithstanding).
The Church opposes policies that would help women and children in desperately poor countries (and here, of course, where we seem both on the cusp of sensible progress and, and then, marching backwards with our eyes wide open) where childbirth is a matter of life or death and family size--in addition to corruption, policies of richer nations, environmental stress, etc.---IS relevant to collective suffering. I think that's fucking criminal--wielding an unknowable God, and the concept of an afterlife, over human progress.
The Church's moral legitimacy as an institution is undermined by the bishops' abuse of power...settling in court, then shuffling abusive priests from parish to parish so they could molest more children. That's unspeakable for a secular, "worldly," predictably flawed seat of power....but from an institution that purportedly calls faithful and non-believers alike to a less violent, more generous, more enlightened version of humanity? An institution that demands special respect because it exists as a beacon and a respite from an immoral world?
The most distasteful thing is that this isn't solely about religious doctrine. I'm guessing half the people who identify as "Christian" in this country and root for dicks like Stupak couldn't give you three Commandments or describe one Gospel that isn't typically trotted out in popular culture. It seems we as a "Christian" nation are Christian to the extent that it allows voters--and worse, policymakers--to be morally or intellectually unaccountable when convenient. It provides a legitimate excuse where others--loyalty to a corporate interest, indefensible busybody chauvinism, whatever--would fall flat, or be more easily unearthed.
I wish I could put the story of Mike Huckabee, Wayne DuMond, and his victims on billboards...that typifies the grotesque, unapologetic arrogance and complacency that religion provides.
Is it a source, or just one mask for assholery that might emerge in another form in the absence of organized religion? I don't know. And I don't care.
I feel so helpless, and so angry. I am am sputtering with rage. Why, why can't the Democrats tell them what we've said here? Doctrine should NOT be a primary source informing policy!! And if this asshole says it isn't, how else can he defend it? Why the FUCK aren't people tearing down his stupid arguments? My tax dollars paid for a three trillion dollar war that sure as fuck offends my conscience, and it will for the next couple of decades while this generation keeps footing the bill. I pay for initiatives spearheaded by religious charities (if not churches themselves).
So what is Stupak's excuse? What other defense is there? You don't like abortion? Don't get one! We already have the Hyde Amendment! If it's no more invasive, why do we need something new?
How can anyone oppose family planning and sex ed unless you support fattening the budgets for social services, TANF, Medicaid, HeadStart, or anything else that children poor to parents who can't afford them, never wanted them, don't know how to care for them, CAN'T care for them because they're on drugs?
What's the matter, what the fuck is wrong with the media that they aren't eviscerating these pieces of shit for weak reasoning or bald-faced lies?!!
What has become clear to me over the last 10 months or so is that part of the problem is that there are no strong Democrat leaders in either house. I was thinking about it the other night and would this Democrat controlled congress have been able to pass the Civil Rights Act of 1964? I really don't think so. We need ball breaking leaders to go in there and be like, if you don't vote for this the party will screw you nine ways from Sunday for the rest of your career. It sounds dirty but I'm convinced that that's how you get shit done in Congress.
@bluebears: I can't agree more. The fact that Joe Lieberman hasn't been stripped of his chairmanship says it all about the balls of the Democratic Party right now.
12/11/09
Public option, not private interests.
12/11/09
People seem to be forgetting that this whole thing will be lubed with subsidies. So the 55-64 set might be shocked by the amount they have to pay for a premium in 2011, but starting in 2013 they'll be subsidized. The public option wouldn't start until 2013 anyway. The overall cost of treatment, though, should be cheaper than anything they could get in a public option because Medicare rates are way cheaper that the PO would have been able to attain (the strong PO tried to peg close to Medicare and failed). Meanwhile, four years from now, the uninsured under 55 will be able to go into these exchange things without the burden of sicker old folks in their risk pool. And hopefully, if the Medicare additions give positive reviews of their new plan, even younger people will want to buy in.
It seems to me the pincer strategy of attaining single-payer, wherein Medicaid and Medicare converge and eventually swallow everybody, is still a safer bet (and yeah, I know it hasn't happened in 40 years) than this "oil spot" plan in which we expand the PO to the boundaries of Medicare and Medicaid and load it full of consumers jumping off the private insurer ship. Because at the end of that plan, we'll have to ratchet reimbursement rates down to Medicare level, and the providers will throw a shit fit--just see how they reacted to this moderate expansion of Medicare.
12/11/09
12/11/09
[www.slate.com]
While I was writing this I realized that yours is a coverage issue, that you're worried that putting more people on the Medicare payroll might restrict services because doctors won't treat them. Point taken. But Jesus, man, we can't stay terrified of providers forever. That's where the money is.
12/11/09
I was pointing out a coverage issue if there was a public option and if the public option ratcheted down provider reimbursements. I was saying it isn't going to happen because providers would leave the network and then people would choose not to have a public option.
On a different note, I think we need to completely rework provider compensation and move away from fee for service. We need a system that, at the end of the day, actually compensates primary care doctors more. Because we need good primary care doctors. There are other providers who are getting overcompensated because they get paid more for bad care resulting in complications.
12/11/09
12/11/09
12/11/09
Look at PUBLIC education. You can choose to send your children to a public school (for a small fee), or, if you don't feel like the public school is adequate for your children and you can afford to send them elsewhere, you can personally opt out of the public option and send them to a PRIVATE school.
Is that socialist of us? Because then I would expect all the people hating on the public option for being socialist have their children in private school, even if it does cost my yearly salary to do so.
Why isn't the public option framed in these terms? I feel like a lot more people would understand it.
12/11/09
I'm not joking.
12/11/09
12/11/09
You'd think people would be REJOICING about this but political nonsense just gets in the way. I just don't get it... no matter what party is pushing it, if a bill would change my life for the better, I'd be clamoring to support it. It's this blind support that is so infuriating to me.
12/11/09
12/11/09
People hate paying taxes, & are convinced that tax hikes on the wealthy mean tax hikes on THEM. It is hard to explain that paying a little now means paying a lot less down the road; the Republicans prey pretty heavily on that.
12/11/09
12/11/09
Ugh, people.
12/11/09
12/11/09
12/11/09
12/11/09
[www.kff.org]
Just what I was looking for. Thanks.
Love your icon.
12/11/09
And thanks.
12/11/09
"It will be an opportunity for us to point out the excessive spending that's going on in this Congress," said House Minority Leader John A. Boehner (Ohio).
It was raised several times--7, if I'm not mistaken--in the Bush admin to finance Iraq (among other things)! They're acting like this is something new.
12/11/09
12/11/09
[news.yahoo.com]
12/11/09
12/11/09
12/11/09
I hope this is Pelosi setting up a situation where she can say the Senate proposal isn't a better idea than a public option.
I'm listening to Diane Rehm right now. The buy-in to Medicare is only for people who are uninsured. So what happens to people who insured on the individual market but have to pay more for worse insurance?
12/11/09
Thx guys!
12/11/09
I guess the insurer could offer a plan that has a $10,000 deductible and a 70% co-insurance rate. That way the low wage worker can afford the insurance. Unfortunately, the worker can't afford to go the doctor so she doesn't take care of her diabetes and has to declare bankruptcy when she ends up in the hospital and has to pay the first $10,000 and 30% of the rest of the charges.
12/11/09
I also don't understand why people think a government plan is akin to the government invading our bodies. Current practices have private corporations telling us what we can or can't do, all in the name of profit. If there was a government plan, the profit incentive would be much lower and there would be fewer restrictions on how and when money is doled out. So, in short, I'd rather have the government pay me back for expensive procedures than have a private corporation use my body for profit. But I'm preaching to the choir...
12/11/09
People believe what propaganda tells them to believe.
11/20/09
11/20/09
Unless we can tax your ass and treat you like another fucking focus group, PAC, lobbying group, etc. (we should--they've made it clear who they support clear, come hell, highwater, or warmongering, social-service cutting Republicans), GO AWAY.
For the record, I don't give a shit what the church thinks about issues that put them in line with the very liberal, either. Their organization is based on an unprovable, malleable story and is a distraction from rational policymaking. I don't care if their ARE priests or nuns who are consistently "pro-life" and against choice AND the death penalty, I don't fucking religious doctrine swaying policy, period.
This stuff makes me livid. How is there even an entryway for their influence? I don't care if anti-choice Democrats and Republicans agree with them, how are they not sent reeling away from the table of discussion? Aren't there some rules they're breaking here, couldn't the legislators that oppose this amendment tell them (and anyone benefiting from their funding or talking points) where to shove it?
11/20/09
11/20/09
Guess what, people who believe in religion: YOU DON'T GET A SAY IN MY LEGISLATION. And all you people (yes, on Jezebel) who identify yourselves with any of the religions who are trying to sway this bill yet try to claim that you are against it, maybe now's the time to reconsider your alignment, no?
11/20/09
11/20/09
11/21/09
I know what's important to me. I can negotiate morality and the concepts of empathy, personal accountability, and human dignity without another f*cking Gospel that ends with "wailing and gnashing of teeth," another story that seems even more meaningless and irrelevant the third, fourth, fiftieth time I hear it (my respect for some of the priests at my family parish notwithstanding).
The Church opposes policies that would help women and children in desperately poor countries (and here, of course, where we seem both on the cusp of sensible progress and, and then, marching backwards with our eyes wide open) where childbirth is a matter of life or death and family size--in addition to corruption, policies of richer nations, environmental stress, etc.---IS relevant to collective suffering. I think that's fucking criminal--wielding an unknowable God, and the concept of an afterlife, over human progress.
The Church's moral legitimacy as an institution is undermined by the bishops' abuse of power...settling in court, then shuffling abusive priests from parish to parish so they could molest more children. That's unspeakable for a secular, "worldly," predictably flawed seat of power....but from an institution that purportedly calls faithful and non-believers alike to a less violent, more generous, more enlightened version of humanity? An institution that demands special respect because it exists as a beacon and a respite from an immoral world?
The most distasteful thing is that this isn't solely about religious doctrine. I'm guessing half the people who identify as "Christian" in this country and root for dicks like Stupak couldn't give you three Commandments or describe one Gospel that isn't typically trotted out in popular culture. It seems we as a "Christian" nation are Christian to the extent that it allows voters--and worse, policymakers--to be morally or intellectually unaccountable when convenient. It provides a legitimate excuse where others--loyalty to a corporate interest, indefensible busybody chauvinism, whatever--would fall flat, or be more easily unearthed.
I wish I could put the story of Mike Huckabee, Wayne DuMond, and his victims on billboards...that typifies the grotesque, unapologetic arrogance and complacency that religion provides.
Is it a source, or just one mask for assholery that might emerge in another form in the absence of organized religion? I don't know. And I don't care.
I feel so helpless, and so angry. I am am sputtering with rage. Why, why can't the Democrats tell them what we've said here? Doctrine should NOT be a primary source informing policy!! And if this asshole says it isn't, how else can he defend it? Why the FUCK aren't people tearing down his stupid arguments? My tax dollars paid for a three trillion dollar war that sure as fuck offends my conscience, and it will for the next couple of decades while this generation keeps footing the bill. I pay for initiatives spearheaded by religious charities (if not churches themselves).
So what is Stupak's excuse? What other defense is there? You don't like abortion? Don't get one! We already have the Hyde Amendment! If it's no more invasive, why do we need something new?
How can anyone oppose family planning and sex ed unless you support fattening the budgets for social services, TANF, Medicaid, HeadStart, or anything else that children poor to parents who can't afford them, never wanted them, don't know how to care for them, CAN'T care for them because they're on drugs?
What's the matter, what the fuck is wrong with the media that they aren't eviscerating these pieces of shit for weak reasoning or bald-faced lies?!!
#tips
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