The Unified Theory of Health Care Reform: A Wyden Plan with a Public Option and a Payroll Tax Cut?
Rich Rodgers
[Editor's note: This weekend, we're thrilled to tell you that Rich Rodgers has joined our regular cast of contributors. He's a former aide to Portland City Commissioner Erik Sten and previously worked in the Oregon State Senate and at Metro.]
Before the Supremes take over the news, here's my attempt at a health care roundup.
Senator Max Baucus (D-MT) chairs the Senate Finance Committee, and so he is pretty darn powerful on the subject of health care reform. He released this in November 2008, essentially a set of principles to guide health care reform. Among other things, Baucus would require everyone to have health insurance, including the 50 million uninsured currently, and would provide some mechanisms to help people who cannot afford it.
A summary of President Obama's plan is here, which includes some specifics, as well as a set of principles. Key features include a stronger hand in bulk purchasing of prescription drugs, a requirement of insurance companies to cover pre-existing conditions, and a new public insurance plan to introduce competition in the marketplace.
Ron Wyden (D-OR) has the Healthy Americans Act, which includes a very specific approach for how to pay for universal health care coverage, and it gets rid of the employer-provided health care system that currently serves around 170 million people.
All of these plans would pay 100% of the premiums for people under the poverty line, with declining support up to 400% of the poverty line. Each of the plans contains measures to control costs and emphasize high quality, proactive care. There's a whole bunch of other important stuff in there, computers and things.
You might know that Senator Wyden is under fire for two reasons. First, his plan would remove the tax exemption for employer provided benefits, replacing it with a standard deduction at a fixed amount. This has the effect of making people pay taxes on their health care plans if they cost more than the deduction allows.
Secondly, Wyden is being pushed to agree to include a public plan among the new menu of offerings. President Obama and many others view a public plan as an essential way to keep insurance companies honest. As reported here at BlueOregon by Carla Axtman, Wyden's office has said that the Senator is open to a public option, provided the bill meets the Senator's test for real reform.
A lot of heated rhetoric is being thrown around, but perhaps we can read between the lines?
It's not absurd to postulate that what Wyden's office is saying is that the core funding mechanism of the Wyden plan has to be in the bill to get his support. This funding mechanism is a major accomplishment on its own. It gets us out of an incredibly messy and expensive employer-provided health care system while providing a bridge for funding from those employers in the form of 'the single largest pay raise that America has ever seen'. According to this report, employer contributions to health care coverage totaled $440 billion in 2005. Under Wyden's plan, those employer contributions would be converted into a raise for employees, who would then purchase insurance on their own.
It may be that Wyden's Republican co-sponsors don't like the public option. If, for example, a public option was created that had lower administrative costs and limited reimbursement rates and ended up costing 20-30% less, insurance companies could lose lots of business. Some doctors and hospitals will worry that a public plan will not pay them enough, just as Medicare and Medicaid reimbursements run at 60-80% of the private plans today. But surely nearly everyone agrees that we need some effective backstop to control health care costs from a system-wide perspective?
It would seem that there would be broad support for a synthesis of the Obama, Wyden & Baucus proposals. There doesn't appear to be anything mutually exclusive about the plans. It should be possible to devise a plan for universal coverage using a menu of plans that provide benefits as good or better than what Congress gets, with the Wyden financing mechanism that moves us away from the mess of employer-provided health care.
Last night, House leaders announced a proposal to pay for half of the costs of health reform over the next decade with a tax surcharge on the wealthiest Americans--1% for couples at $350K, 2% at $500K, and 3% for a $1 million or more. This would bring in around $550 billion over ten years. It's unclear how much support this proposal will have, but the idea of using the income tax to fund health care is the right one.
If revenue neutrality was the goal, a reduction or elimination of the 2.9% Medicare taxes paid by employers and employees would, in combination with the Wyden plan, help US businesses with international competition. Medicare revenues are currently around $300 billion a year, more than the proposed surcharge would generate, but there is a lot to be said for removing the costs of health care from the cost of doing business. This is especially true for manufacturing, which is very badly hurt right now. All together, for example, Ford estimates that health care costs add $1500 to a price of a car. The income tax is a better vehicle than payroll for raising health care revenues.
The components are there for a real revolution in health care: The Wyden funding mechanism, a public option with strong cost controls, and a shift in the costs of financing health care from payroll to the income tax. Universal health care with cost containment, plus a dramatically more competitive American economy. It's within reach.
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Jul 11, '09
This, from Bill Moyers Journal, is the smoking gun in the debate about reform of health care:
"Looking back over his long career, (Wendell) Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year. Under these conditions, Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations.""
If the primary, and perhaps the only, concern insurance companies have is corporate profits they shouldn't be anywhere near a national health care policy. They have demonstrated a willingness to sacrifice the lives of policy holders for corporate profits, so why would we want them involved in the future?
Jul 11, '09
Here's a UTube video of Potter's interview with Bill Moyers.
http://www.youtube.com/watch?v=Mv1FwOCNoZ8&eurl=http%3A%2F%2Fwww.dailykos.com%2Fstory%2F2009%2F7%2F11%2F752306%2F-Former-CIGNA-executive-says-Michael-Moore-was-right-all-along-%255BUPDATE%255D-&feature=player_embedded
Jul 11, '09
Thank you for this very thoughtful column. I have thought that some comments here at BO needlessly dumped on Ron Wyden because he didn't hold a press conference in DC and say "OK, you win, I will dump the Healthy Americans Act and join the throng saying unless we have a public option nothing else matters including details of implementation".
We got a mailing the other day from Wyden for Senate saying "When big money starts attacking Ron Wyden's health care plan...". Inside there is a list of bullet points, including this one "Allow states to enact a "public option" just like the Oregon Health Fund Board recommended to the Oregon Legislature in November 2008".
Now I realize that Digby of California and other non-Oregonians wouldn't know about such a mailer. Probably lots of people who have been peer pressuring Ron don't know that some of us "get our back up" if we get a sense that the message from some people is "conform to what we support and forget you ever knew anyone who doesn't conform because they are not worth knowing".
A quarter century ago, Ron Wyden and I were both delegates to the Democratic National Convention. More than a decade ago, I registered NAV for several years because I was tired of the peer pressure of "all good Democrats support....and you should forget you were ever friends with anyone who doesn't conform to the program".
I remember who tried to pressure me even after I registered NAV, and who respected my right to hold an opinion not everyone agreed with. Ron Wyden was in the latter category.
So I am willing to give him the benefit of the doubt on this issue. I wonder how many people who criticize Ron Wyden have ever seen him discuss Healthy Americans Act in a town hall of ordinary citizens (surely not Digby or other out of state commentators).
I wonder how many in DC who criticize Ron have ever held town hall meetings of ordinary citizens and taken questions on their proposal the way I saw Ron explain and take questions at our local town hall meeting. Reportedly, Baucus sends staffers to town hall meetings in Montana rather than going himself. And how popular is Grassley with ordinary Iowans if there is a monopoly insurance company which does most of the insurance in Iowa?
Grassley's seat is up for re-election in 2010 and he is 77. Apparently he says he is running for re-election, but who knows. And there are other issues besides Single Payer. A web search of Grassley and re-election came up with this from an Iowa site:
http://iowaindependent.com/17241/braley-hopeful-health-reform-will-be-in-plain-english
I like this unified theory, and I like the column. So refreshing after all the stuff about how we must all force Wyden to conform because Public Option is the Holy Grail.
If public option is the only thing passed--no controls on medical costs, on everyone being covered regardless of pre-existing conditions, on teamwork so that medical professionals actually all discuss a patient they are treating and know their whole medical situation, as well as prevention programs-- I don't see how that is a great victory.
Call me any name you want, I think Ron is being an experienced politician, not an evil impediment to health care reform.
Are you folks who are pressuring Wyden really trying to say he is more of an impediment than Baucus and Grassley?
Jul 11, '09
As a manager of not-for-profits for 25 years, I'm sick of insurance rates going up a MINIMUM of 15% a year, more often 25%, with fewer benefits. Only year they didn't go up was when I forced the staff to go on an HMO. Wages have not kept up with inflation for the simple fact that any raises we could have offered have gone to "health insurance." The Republicans are fools and lying if they try to give us any free market rhetoric on this. The employees have never gotten to choose their product, so free market does not apply here. And none of this system really focuses on good HEALTH, except perhaps Kaiser where doctors can be doctors rather than bidnesscreeps. The whole system is F'D.
10:20 p.m.
Jul 11, '09
It is not true that the Wyden funding mechanism "employer contributions would be converted into a raise for employees."
Such conversion is purely voluntary. There are limited incentives to do so in the first two years the Wyden Plan is in effect. An employer could convert all, some or none of then current health benefit contributions to wages.
<hr/>Short version: Employers are not required to convert any of their savings from decreased health insurance benefit contributions to wages. If the Wyden Plan went into effect during a low unemployment, strong corporate revenue labor market there would be relatively stronger pressures to convert, but in a high unemployment, weak corporate revenue market such incentives would be correspondingly weaker. However, employers cannot discriminate among classes of employees in degree of conversion, so if they converted a high proportion of health benefits to salary for middle or upper management or particularly valued classes of skilled workers they would have to convert the same proportion of all other employees' health benefits.
<hr/>Greater detail:
Under the Wyden Plan, employers are required to contribute substantially to a pool of money that would cover part of the subsidies for premiums for the Healthy Americans Private Insurance plans (HAPI plans, not to be confused with Happy Meals™) that would be created by the law.
Under the Wyden Plan, employers with 50 or fewer employees would pay from 2% to 10% of the national "average HAPI Plan premium" (AHPP) per employee, on a sliding scale according to quintiles of revenue -- i.e. the employers in the bottom 20% of revenue would pay 2%, in the top 20% of revenue 10% & scaled in between. Employers with 51 to 200 could pay as much as 15% of AHPP if they were in the top revenue quintile and had 200 employees or as little as 2.1% if they had 51 employees and were in the bottom 20% of revenue. Employers with over 200 employees = "large employers" would pay between 17% and 25% of "average HAPI Plan premium," again scaled by quintile of revenue.
To net out even nominally, employers currently paying health benefits would subtract the amount to be paid for their required contribution to the HAPI plan premium pool from the amount they were currently paying as a health insurance benefit. Assuming for the sake of simplicity that to start with average HAPI plan premiums were similar to average group plan premiums, for a high revenue large employer paying 100% of premiums that would be about 75% of "average HAPI plan premium," but if the employer contribution were 60%, the wage/salary increase would be 35% of AHHP, and if the contribution were 40%, the increase would be 15% of AHHP.
The net even percentages would be higher for lower revenue employers, and higher across the board if HAPI plan premiums were lower than current premiums to start. But in no case unless the employer wished to net negative would it be 100% of current benefits.
Lower revenue employers, who presumably are those struggling most with rising insurance prices, would have an incentive to keep more of the saved revenue, especially if they were losing money or close to the edge. Likewise employees would be in a worse position to bargain by threatening to change jobs in a high unemployment economy. Thus the Wyden plan looked more attractive in the false boom bubble economy of a few years ago than it does now in these terms.
Meanwhile the newly converted wages would be taxable. There is a complex interrelationship between subsidies for premiums base on a ratio relating income to 100% of poverty up to 400%, and size of health expense tax deduction -- generally as subsidies decline, tax deduction rises, up to 0% subsidy and highest (apparently generous) tax deduction at 400% of poverty, with the deduction then declining again above $62,500 for individuals or $125,000 couples modified adjusted gross incomes (which includes Social Security income for these purposes).
10:33 p.m.
Jul 11, '09
Further issues with the Wyden Plan:
It is based on the "standard" version of the BC/BS Federal plan as of January 2009 in defining benefits. Previous version was based on "standard" 2007. That Federal plan may well be worse now than it was in 2007 in terms of deductibles and co-pays; it certainly has gotten much more expensive according a friend who gets it. I will need to look into the deductible & co-pay issue.
The subsidies cover premiums but not deductibles and co-pays ("shared responsibility payments"). The bill specifically contemplates high deductible plans paired with "healthcare savings accounts." In cases of protracted expensive treatments co-pays themselves can be hugely burdensome financially.
Abortion services are not included. HAPI plans are required to provide supplementary insurance at additional cost for abortion services, except that HAPI plans may be provided by religiously affiliated insurance organizations and such organizations are exempt from providing even supplementary abortion services coverage, and there is no requirement that at least one of a state's HAPI plans provide even such additional cost supplementary coverage.
<hr/>The Wyden Plan also involves an individual mandate, under which penalties can be waived in cases of hardship, though only at the discretion of the state -- so families could be faced with a Hobson's choice of unaffordable premiums, even with subsidies, or penalties of the same amount plus 15% if the state won't waive.
The plan also includes apparently strong minimum criteria for benefits, which however could be waived upon state application and approval from the supervising agency -- so that the actual strength of minimum benefits depends entirely on the willingness of that agency to maintain that strength, and could be modified by political-ideological change in administration, and could vary widely from state to state.
This raises the spectre of the Wyden Plan facing the same fate as the Massachusetts plan -- failure to control costs & insurance prices, high level of "hardship waivers" on the individual mandate because of unaffordability even with subsidies, meaning "coverage" is not universal, and continuing hollowing out of benefits received for the price for those who are "covered."
Alternatively it could also lead to situations in which states influenced by "blame the poor" ideologies could both enforce punitive insurance requirements and permit "affordable" lemon insurance plans that fail actually to provide needed care in many instances.
10:39 p.m.
Jul 11, '09
LT,
Regarding "big money" -- Ron Wyden has received, to date, in the 2005-2010 senatorial election cycle, contributions either to his campaign funds or to his "leadership PAC" (i.e. money with which elected officials buy influence with other elected officials by donations) $395,000 from health insurers, pharmaceutical companies, hospitals, doctors, or lobbying organizations representing those interests, according to the Center for Responsive Politics. In the previous cycle, when he was not yet on the Senate Finance Committee which has jurisdiction over aspects of health care funding and reform, he received nothing like that amount from those interests. And the election is still over a year away.
Jul 11, '09
In watching the Moyer's show last night, I got the impression from Potter that the insurance companies drove up prices to then offer the cheaper high deductible plans. I have been on a high ded. plan for several years and as a result my insurance hasn't paid a single dime for my health care. I have covered 100% of my medical costs plus paid them a tidy sum. I would assume that many others are in similar situations.
Jul 11, '09
I wonder how many in DC who criticize Ron have ever held town hall meetings of ordinary citizens and taken questions on their proposal the way I saw Ron explain and take questions at our local town hall meeting
I'd love to except his office won't release dates of town hall meetings. I've called three times asking when the next meeting is West of the Cascades and get bupkis! When are they, Ron?
2:39 a.m.
Jul 12, '09
"BO needlessly dumped on Ron Wyden because he didn't hold a press conference in DC and say "OK, you win, I will dump the Healthy Americans Act and join the throng saying unless we have a public option nothing else matters including details of implementation"."
Rev up the false dichotomy machine!
No one said "nothing else matters;" rather that it is a necessary (but insufficient) part of any reform solution. And that's not why I personally am criticizing him for not dumping the HAA; it's because a) it's flawed in some fundamental ways and b) it has the same chance as single payer for passage--none. And I'm extremely concerned that he can't even do the absolute minimum and commit to voting for cloture on the majority bill.
"nside there is a list of bullet points, including this one "Allow states to enact a "public option" just like the Oregon Health Fund Board recommended to the Oregon Legislature in November 2008"."
Yes, allow at option, in a non-national fashion which cannot take advantage of real bargaining power, and does not take advantage of the ability to keep the companies from rooking individual states like they do now. Many of us know this, because it's what Wyden keeps throwing out there as evidence that he likes the public option, even though he knows it's not what public option advocates are talking about when they say they support one.
"I wonder how many people who criticize Ron Wyden have ever seen him discuss Healthy Americans Act in a town hall of ordinary citizens (surely not Digby or other out of state commentators)."
I've never seen that, no. But his Chief of Staff and another aide did sit with Carla and I for at least an hour, going over his original plan in detail--which is structurally much the same...does that count? (By the way, that was an extraordinary thing for them to do at the time, I thought. Smart, but extraordinary.)
Get your back up all you want. Chris has been far more eloquent on the specific features of HAA; I'll leave that alone. But he's not being criticized by me because a FRPO is the holy grail, other details be damned--it's that a FRPO, short of single payer, needs to be an option for the public, not only to go with cost savings measures and efficiences, but because a FRPO is likely to PRODUCE cost savings and efficiencies. It's both an ends and a means to an end, amazingly.
Jul 12, '09
For all Mr.Wydens hard work on his HAA the plan bothers me a lot. WE are not doing too bad as a family especially in these times( bother me and the wife have jobs), but if you dumped the full cost of a private health insurance premium on us, it would be hard to make the mortgage payment every month. Yes, there is the employer raise thing, but it has been said before this is voluntary and even if then it can be just small percentage of the premium. And is there any mechanism to prevent the Insurance companies from boosting the premium even more so they wont be "hurt" when they have to cover all pre-existing conditions? Im sorry, I like the idea of Single payer, but i would rather have no change than Wydens Plan that would put a huge pressure on our monthly living expenses.
Jul 12, '09
LT. I think there is a enormous concern by voters that somewhere along in the political process of putting together and passing a healthcare reform bill that the republicans, the insurance companies, the pharmaceutical and health care business lobbyists are going to exert enough influence in the process to change the legislation from something that works for the people of this country into something that works for them instead.
After thirty years of watching Democrats in Congress caving in to the republicans and the corporate-big-money-special-interest-groups time and time again I don't have the confidence that they will do the right thing without vigorous citizen input and pressure.
As citizens of Oregon, we don't have influence over Senators from other states. Senators however, do have influence over each other. I want them all to feel the importance of passing legislation that works. Heaven forbid he should be pressured on an issue by we mere voters.
Senator Wyden I'm sure is a good man. However, I want to keep the heat on him, because he is my Senator, to deliver the best legislation possible for the country and not for the lobbyists. Just looking out for my best interests you understand.
And I felt your "Digby of California" remark unnecessarily snide.
Jul 12, '09
Imagine the possibilities if the Wyden plan is adopted. 170 million people who currently enjoy employer provided health care will suddenly be told "here's the cash, now go buy your own coverage". I have no idea how much employers spend on average to provide health insurance. If it is $500 per month per employee, we are talking about well over 1 trillion dollars per year being suddenly paid to the rank and file employees to purchase individual health coverage for themselves. 170 million people attempting to buy an extremely complex financial product, with no experience, and using "windfall" cash from their employer.
Instead of typing this, I should be preparing my first round of infomertials on how you can make millions of dollars at home selling health insurance coverage to saps - err I mean recently empowered consumers. This opportunity will dwarf my prior careers in selling aluminum siding, used cars, herbal erectile disfunction treatment and Nigerian email banking opportunities.
All those rubes, all that money. Mmmmmm.
Jul 12, '09
"It is based on the "standard" version of the BC/BS Federal plan as of January 2009 in defining benefits. Previous version was based on "standard" 2007. That Federal plan may well be worse now than it was in 2007 in terms of deductibles and co-pays; it certainly has gotten much more expensive according a friend who gets it. I will need to look into the deductible & co-pay issue."
This is the plan that I have with the family option. Click here for Non-Postal Employee Rates. The government pays on behalf of each employee/retiree $9167 a year. The employees/retirees pay $4279. That is a total of $13,446 which is more than double what per capita health costs are in countries with systems having much better ratings than the United States according the World Health Organization Report of 2000.
But wait, as they say in television commercials, there's more. For starters there are co-pays and a $700 annual deductible. Then, if a physician charges more than Blue Cross allows you could get stuck for that excess or part of it.
On hearing aids, for example, the plan only pays $1,000. A relative of mine got two from the VA for free that he was told would otherwise have cost him $5,000 a copy. On dental, BC/BS pays only a fraction of the bills. In some cases, nothing. In many cases, the employee has to pay 15% of the plan allowance if he/she is seen by a preferred doctor; 30% if the doctor is classified as "participating." This is unheard of in countries in Western Europe with national health plans.
Because my wife and I have been relatively healthy over the last few years, we would have been ahead if we hadn't paid the premiums we did and just paid the doctors directly. Now, I'm seriously considering dropping out of this system and looking at another plan available on the east side of the Cascade that combines Medicare and personal premiums. We have a couple of friends in this program who have gotten more from it than we have from ours and paid less than we paid.
As for personal attacks on any politician we need to be careful, but if he or she is shilling for insurance corporations or other lobbyists at the expense of people, then as far as I'm concerned it gets personal.
Jul 12, '09
Another thing i read on another blog about the HHA. OK even if the employer paying extra wages for the 1st two years is mandated, what is to prevent a sensible employer from fireing all his staff the next week and hireing them or others again at lower wages..and the poor bloody employee has to figure out how to pay the huge premiums required? This could easily happen in a Right to Work state like Oregon. A bad bad plan for regular middle class folks.
Jul 12, '09
Whatever plan they come up with it need to cover every American equally, including every Congressman, state legislator or union worker to insure the people get the best health care coverage. Everyone, no exemptions or exceptions, I want Mr. Wyden to have the exact same health access I have, nothing better, noting less.
Jul 12, '09
Keep on truckin', Bill Moyers. After the show with the former Cigna exec, he posted this video about an exclusive dinner, hosted by the Washington Post's publisher, Katharine Weymouth to which top White House officials and healthcare lobbyists were invited:
The publisher of THE WASHINGTON POST, Katharine Weymouth — one of the most powerful people in the nation's capital — invited top officials from the White House, the Cabinet and Congress to her home for an intimate, off-the-record dinner to discuss health care reform with some of her reporters and editors covering the story.
But she then invited CEOs and lobbyists from the health care industry to come, too — providing they fork over $25,000 a head, or a quarter of a million if they want to sponsor a whole series of these cozy little get-togethers. And what is the inducement she offers them? Nothing less than — and I'm quoting the invitation verbatim — "An exclusive opportunity to participate in the health care reform debate among the select few who will actually get it done."
The dinner was scuttled after the invitation was leaked to Politico.com (by a lobbyist!). Read about it and watch the video here:
http://videocafe.crooksandliars.com/heather/bill-moyers-weighs-washington-posts-pay-play
I respect Sen. Wyden and do not believe he is in the pocket of the insurance industry. But I would like to see him talk more about his plan and host public forums around the state to answer questions of his constituents and hear from them directly.
Jul 13, '09
Air Jordan shoes 3.5
Jul 13, '09
Rich,
Can you describe the revenue neutral aspect of the payroll tax reduction?
Wyden's plan will tax benefits over some amount (not fixed, btw, it is scaled downward for upper incomes to be progressive). Are you saying the payroll tax reduction makes health benefit taxation revenue neutral? Or, are you saying it makes taxing the wealthy revenue neutral?
The clever thing we really need is to keep the Wyden funding mechanism but yet also keep Obama's promise to not raise taxes for those under $250K. Perhaps that is what you are thinking. Unlike some, this is a sincere question for the discussion and not a snide trick.
9:49 a.m.
Jul 13, '09
Peter,
I agree it makes sense to keep the Wyden funding mechanism, move away from employer-funded health care, and honor the President's promise not to raise taxes on anyone making less than $250,000 a year.
While there's something to be said for stability of a payroll tax, the FICA taxes at a combined 15.3% are pretty high, and hit working people and small businesses hard. If we were to move away from employer funded health care, I think it makes sense to move the Medicare piece as well. You might be able to get agreement on shifting some to personal income, and some to capital gains. Ford will sell more cars without the tax in payroll, so it's not a zero sum game. Shareholders will do better, even if it's revenue neutral for the government.
They will have to raise revenue and cut costs to pay for this. Better in my opinion to start looking at Medicare and the public option in the same field of vision, with the same funding mechanisms--ideally something broad based that captures not just income but also capital gains. It's inevitable that the reimbursement rates will be closely compared, so why not the funding source, too?
In a nutshell, the officers, shareholders and owners of the nation's businesses have a personal interest in the health and stability of their employees and their families.
RR
Jul 13, '09
Thanks for your useful info, I think it’s a good topic.
Jul 14, '09
No comments on every American needs to have the same health care option? The power brokers will toss the citizens into a cesspool system while keeping their own goldplated system. I do not trust the medical/industrial machine nor do I trust the politicians. I am especially leary of the rush to the finish line and the lack of details in any plans on the auction block so far.
11:25 a.m.
Jul 14, '09
Under all of the major proposals, the minimum standard for health care plans to be on the approved list is the health care plan provided to the members of Congress. I'm not sure how they propose to compare plans, but I agree with the sentiment.
I'm hoping that the greater emphasis on proactive care & wellness, along with moving away from an employer-based system, will make it easier for people to get the kind of plan they want--plans with different emphases on, say, acupuncture/herbal medicine or sports medicine that complement the things that people do to stay fit and healthy.
Jul 14, '09
Aside from my cynical comment above, I wonder about a "minimum standard" for a qualifying health care plan. If Congress mandates everyone purchase health care, there are going to be a huge number (a majority I suspect) who can not or will not purchase a plan equivalent to what US Govt. employees currently enjoy. Those plans cost around 1000 per month per family - maybe more. In Mass. they currently offer much lower cost plans ($600 per month) which have high deductibles and co pays and don't cover as many things as other plans do, but they do meet the minimum requirement for "coverage" to comply with MA law regarding mandatory coverage. If US mandates coverage, it seems likely that there will be all sorts of bargain basement plans offered which will meet the "letter of the law" but not offer a whole lot in terms of coverage, etc.
Ask yourself this question. If Dick Cheney had not gone into the oil field service / military contracting business but instead had gone into the mandatory coverage medical insurance field, could he have figured out a way to screw the common man while making huge profits from a government program? I think we all know the answer is yes. I assume Dick is retired from the screw-the-public industry, but there are plenty of young Republicans just itching to take his place, and (as I tried to suggest in my post above) I think they are licking their lips over the opportunity to make money from the mandatory coverage industry unless we are protected by a full featured, efficient and affordable public option plan.
Jul 14, '09
If all someone can afford is a bargain basement plan with costly co-pays and limited coverage, are the citizens any better off than they are today? I don't think so, so why the rush to push this through Congress?
It it obvious by all the special interest big businesses in the mix looking out for their bottom lines that the American people are going to get hosed by them. We get higher cost, less coverage and the opportunity to see them laugh all the way to the bank.
Jul 16, '09