Barbara Boxer's list of things in the Health Care bill is good as far as it goes

[lunatica]

She sent me an email. A portion of it follows. The one item on the list that I hadn't heard of before and which allays one of my worst fears is the one that reads...(the bill) Require insurance companies to spend at least 85% of their income on patient care, not executive pay or profits

(snip from the email) I'm committed to staying as long as it takes and doing everything I can to get
health care reform passed through the Senate this year, because hard-working
American families deserve it.

Unfortunately, right-wing senators are doing everything in their power to derail
reform and bring the Senate to a grinding halt. Their obstructionist tactics mean
that we'll be working day and night right up through Christmas Eve.

There are so many good things in this bill, even though I surely wanted it to be
better. But, at the end of the day, this is still a very good bill -- and the most
significant reform of America's broken health care system since Medicare was enacted
in 1965.

Among other things, the bill would:

* Extend health insurance coverage to 31 million more Americans, including 14
million lower-income, working people through Medicaid
* Prohibit insurance company discrimination based on gender or pre-existing
condition -- and make sure you can't lose your insurance when you get sick
* End the upward, unsustainable increases in insurance premiums
* Increase funding for community health centers in 10,000 communities across the
country, enhancing primary care for more than 25 million people who have
traditionally been uninsured or underinsured
* Close the prescription drug "doughnut hole" for seniors
* Require insurance companies to spend at least 85% of their income on patient
care, not executive pay or profits
* Cut the federal deficit by $132 billion, according to the Congressional Budget
Office

We can't let this opportunity pass us by. That's why I'm going to keep fighting for
the very best health care reform bill we can get -- while defending women's
reproductive health -- and then work as hard as I can to get it passed and signed
into law....

edited to correct an error

[lunatica]

1. Some good news is unwelcome here?

[libertypirate]

2. How is it morally justified to help only some people

when you could help them all. People who justify the suffering of others should not record a win.

We should not be compromising with people who kill us for profit.

[lunatica]

9. I'm confident Barbara Boxer will work very hard to get everyone covered sooner than later

Here is her record on how she voted on Health Care issues and here's a site that has hundreds more of her votes on all the other issues. She is a woman's rights and child wellfare Progressive advocate and dependable. We are extremely lucky to have her as a Senator. She has always fought for better healthcare and she will continue to do it.

http://www.ontheissues.org/Senate/Barbara_Boxer.htm#Welfare_+_Poverty

* Voted YES on regulating tobacco as a drug. (Jun 2009)
* Voted YES on expanding the Children's Health Insurance Program. (Jan 2009)
* Voted YES on overriding veto on expansion of Medicare. (Jul 2008)
* Voted NO on means-testing to determine Medicare Part D premium. (Mar 2008)
* Voted NO on allowing tribal Indians to opt out of federal healthcare. (Feb 2008)
* Voted YES on adding 2 to 4 million children to SCHIP eligibility. (Nov 2007)
* Voted YES on requiring negotiated Rx prices for Medicare part D. (Apr 2007)
* Voted NO on limiting medical liability lawsuits to $250,000. (May 2006)
* Voted YES on expanding enrollment period for Medicare Part D. (Feb 2006)
* Voted YES on increasing Medicaid rebate for producing generics. (Nov 2005)
* Voted YES on negotiating bulk purchases for Medicare prescription drug. (Mar 2005)
* Voted YES on $40 billion per year for limited Medicare prescription drug benefit. (Jun 2003)
* Voted YES on allowing reimportation of Rx drugs from Canada. (Jul 2002)
* Voted YES on allowing patients to sue HMOs & collect punitive damages. (Jun 2001)
* Voted NO on funding GOP version of Medicare prescription drug benefit. (Apr 2001)
* Voted NO on limiting self-employment health deduction. (Jul 1999)
* Voted YES on increasing tobacco restrictions. (Jun 1998)
* Voted NO on Medicare means-testing. (Jun 1997)
* Voted YES on blocking medical savings acounts. (Apr 1996)
* Let states make bulk Rx purchases, and other innovations. (May 2003)
* Increase funding to combat the global HIV/AIDS epidemic. (Mar 2003)
* Rated 100% by APHA, indicating a pro-public health record. (Dec 2003)
* Improve services for people with autism & their families. (Apr 2007)
* Establish a national childhood cancer database. (Mar 2007)
* Preserve access to Medicaid & SCHIP during economic downturn. (Apr 2008)
* Expand the National Health Service Corps. (Mar 2009)

[lapfog_1]

27. I think we all agree that Barbara Boxer has been an outstanding

Senator. In fact, on this very board, I have posted numerous times (before the primary season now two years ago) that I thought she would make a great Presidential Candidate. She would have been my first choice had she decided to run.

That's all well and good.

However, if she is trying to convince you (and us) that MLR provision in the bill will "reign in" insurance company profits, then either she is misleading you or she doesn't know herself. It won't. It only establishes a profit MARGIN. Not a profit amount. If there is a fixed margin, and you want it to also be a fixed amount, you must control costs. And this bill does not.

[sandnsea]

18. I guess we shouldn't have passed Medicare, Medicaid or SCHIP then

Disruptor.

[libertypirate]

28. You act like we are living in the past!

People are being killed and financially destroyed by the corporate monsters at the table.

Do you find it disrupting to think? Or does thinking disrupt your regularly scheduled programming?

The failure of these Democrats will destroy someones life, that is the reality you wish to ignore.

I don't want corporations in charge of what they obviously don't value; the lives of my family being top of that list.

[lapfog_1]

3. Funny that. I think that is one of the VERY WORST aspects of this bill

It converts insurance companies from their current "control costs by any means, even if we are bastards, so we can increase profits" to Cost Plus contractors totally dependent on tax dollars.

Mandates are taxes. Subsidies are tax dollars. Their entire revenue stream is now tax dollars.

MLRs (the 85% of revenue must be spent on medical services part) convert them to Cost plus contractors.

The only way for them to increase profits in the new (post 2014) environment is to increase medical costs. Which they will. Probably with wild abandon.

I've posted about this now numerous times, and NOBODY has refuted my argument yet.

It works this way. They know how the system is rigged (read the bill), they are greedy corporatists (any disagreement?), they have some very smart people working there (probably smarter than in our government). They LOVE this bill. They will hold doctors conferences and go to hospital administrators and extol the virtues of MORE TESTS and MORE treatments. Why? Because they make $15 dollars of CEO salary and bonuses and stock dividends (profits!!!) for every $100 of test performed and treatments ordered. Think about it. As the base medical costs rise (best practices, ya know), they can raise premiums... and therefore their own profits.

What about competition? Won't one company see an opportunity to lower costs and gain more customers?

NOPE. These companies are the ONLY INDUSTRY in the US to be granted exemption from anti-trust laws (with the exception of major league sports). With this bill, they KEEP that status. They are an unregulated monopoly. They can call each other up and have a conversation about HOW MUCH to charge for what plan. And they DO. Anybody else (even the big oil - which likely does this, but in secret) were to do this, there company would be broken up (AT&T, STANDARD OIL, etc) and the officers placed in jail for collusion.


And, you might ask her, how in the heck does passing this bill "defend women's reproductive health"?

[walldude]

7. Yup... gotta read between the lines.

How is forcing 31 million people to buy the same crappy insurance that caused us to start a reform bill in the first place reform?

[lunatica]

16. Gee, I don't recall saying the bill is wonderful or perfect

Some DUers read words that aren't there. It's like they can read everyone's mind so much better than the person who has the mind.

[lapfog_1]

19. You're right.

What you said was

"The one item on the list that I hadn't heard of before and which allays one of my worst fears is the one that reads...(the bill) Require insurance companies to spend at least 85% of their income on patient care, not executive pay or profits"

And I and now a few others have pointed out that this isn't something that should "allay fears" but rather a provision that should alarm people.

And I, and now a few others, have provided you with thoughtful analysis of the provision that you think should allay fears and you resent our analysis, and, more to the point, don't have an argument that refutes that analysis.

Please, just read the bill and think about it. Tell me why the insurance corporations will not have an incentive to raise costs (or at least encourage the practice of raising costs by the providers)?

If I'm wrong about this, and there is something in the bill that I missed or am mistaken about, I'd like to know.

[lunatica]

21. You're assuming I want to refute your analysis

You're still assuming a hell of a lot. It's called jumping to bizaare conclusions while elaborating on an on about how thoughtful your arguments are. Perhaps your analysis is something that I welcome. Do you require that I kiss your ass in grovelling gratitude for spilling your profundities into my empty little brain?

:sarcasm:

[lapfog_1]

26. No, I require a bit of civility in our discussion.

In another post in this same thread you admitted that you can't read and understand the bill because of the "technical language" that it contains. OK, fine.

But then don't jump on me by claiming that my conclusions are "bizarre". How would you possibly know?

Again, I am trying to provide you with an alternate view of the provision you thinks should alleviate our fears because it restricts the insurance companies' profits. And I was just trying to point out... it doesn't. And provide you with reasoning as to why it doesn't.

But hey, if your mind is made up... Far be it for me to waste time trying to give you other points of view to think about.

[lunatica]

10. Your prescience astounds me

You must have crystal balls to gaze into.

And if you want to ask her anything do it yourself.

[lapfog_1]

14. No, I have eyes that can read and a brain that thinks...

Here, you can read it yourself.

http://democrats.senate.gov/reform/managers-amendment.pdf

It only takes about 3 hours. Not that bad really.

I listened to about an hour and a half on C-SPAN when the repukes forced the clerk(s) to read it out loud the other morning.

Sorry if you feel I've insulted you somehow, that's not my intent.

I'm happy to debate my analysis of the bill with anyone here. If it was a better bill, or even one that was a step in the right direction, I wouldn't be opposed to it. I'd still be disappointed in the compromises made with Lieberman and Nelson. And I can't believe that my HERO ( she was my Senator for years when I lived in CA, she would have made a GREAT President), is saying the supporting of this bill (with the Nelson language that effectively eliminates insurance coverage for abortions) is somehow DEFENDING reproductive services for women.

It's my belief the the party knows that this is piece of crap, but they feel they must get a bill to the President and the President feels that signing a bill, any bill, is better politically than failure. So they are circling the wagons. Ok, that's fine. But don't tell me that this is "defending reproductive services for women" because that's just not true.

[laughingliberal]

23. I'm with you 100%. If you can read and you have the smallest inkling how the insurance companies

have played us up to now, you can see it does nothing to change their worst abuses and hands over a nice, new crop of victims to them. Hell, I don't even buy the deal about no denials for preexisting conditions. What do they get? A paltry fine? Yeah. That'll stop 'em. And when they've all paid a fine for turning a person down, that person has no public option to which they can turn.

[debbierlus]

32. It is disgusting. Stop pissing our collective leg and telling us its raining

[laughingliberal]

20. I'm not disputing a thing. Anyone who thinks the insurance companies spent

over $600 million lobbying for this beast just to have to clean up their act...heck, I've got some swamp land....cheap

[pscot]

4. This bill can be improved

over the next few years, but only if we hold on to the numbers we have in the Senate. If Democrats can hold their ground in the mid-term elections, this reform bill can be made to work, and the most egregious problems can be weeded out. If the bill goes down, the NOPers will gain strength and confidence. It would be a big mistake to let that happen.

[walldude]

11. Why do people keep saying that? We have a majority

How is anything going to be different in two years? If we hold the same numbers why would that make it more likely that they will do something then?

You watch, the bill will be changed before it's voted on, and it won't be for the better. And judging from the way anyone who has spoken out against this bill has been treated, it certainly looks to me like they don't give a rats ass whether anyone likes the bill or not. That is not the attitude of people who will be willing to do more later. It's the attitude of people who think their shit doesn't stink.

[truedelphi]

31. It is very hard for many people to face the truths

you are pointing out

They do not want to face what this nation has become, or what their Democratic party leaders have become.

I like Boxer very much, but she will not have to live with the provisions of this bill.

The mandates and the fact that the bill has penalties imposed on us to buy a crappy product make this bill unacceptable to me.

[lapfog_1]

15. You think they want to go another 6 month like the last 6 months

anytime soon?

Don't kid yourself. This won't be looked again until well after 2014 (when the majority of the provisions and the state by state exchanges take effect).

[enlightenment]

5. Unfortunately, she didn't discuss the fine print.

The one item on the list that I hadn't heard of before and which allays one of my worst fears is the one that reads...(the bill) Require insurance companies to spend at least 85% of their income on patient care, not executive pay or profits

Sounds good until you notice that because they have only set limits on percentage values, it leaves the door open for the insurance companies to raise rates to make up the difference - the CBO admits that there is nothing there to prevent the increases; she gets away with the 'end unsustainable increases' comment because they've included provisions for 'oversight'. Unfortunately, they haven't indicated what they will do if an insurance company breaks the rules. They also have added a nicely convoluted 'equation' filled with undefined exclusions to arrive at the 85% (it's actually 85% for group policies; i.e., company provided insurance - and 80% for individual insurance offered through the exchanges).

As for the rest, most of it is predicated on how things will presumably play out in the next decade (the donut hole, deficit reduction, community center funding).

You should read through the manager's amendment to the bill - it includes a lot of this stuff (and the wording of the Nelson amendment as well). http://democrats.senate.gov/reform/managers-amendment.pdf

It's really not that long, and it's worth the effort - especially since you have particular concerns. The part you're interested in is covered under section 2718 (starts on page seven of the document).

[lunatica]

12. I don't understand the language in bills

It's way too technical and convoluted. But your explanation is also full of jargon which makes you sound very smart but equally unclear to me. Sorry, but my brain simply doesn't work that way.

But I'm willing to agree that if a corporation can use a loop hole they certainly will. I also believe that Barbara Boxer will work to close those loop holes as she always has.

And I'm not suddenly all enamored of the Democrats and Obama just like I wasn't 'quitting him' or the party yesterday. I see shades of gray in what Barbara says. In the email she states she thinks there's much that needs improvement.

[enlightenment]

29. Your defensiveness is really uncalled for in this case.

You expressed a particular concern and a certain sense of relief that the rates would be capped. I pointed out that the details don't bear out what Boxer wrote in her email - that wasn't even a criticism of her, since all politicians write 'large' rather than addressing the details.

I'm sorry you think my answer was jargon-filled and that you aren't comfortable reading bills. If you're comfortable with what Boxer said, then you don't need anything else I'd think. I obviously misunderstood the nature of your OP; I thought you wanted commentary, but apparently you just wanted to share something that makes you feel better about the bill.

[lunatica]

36. Your attack is uncalled for

And I resent it. I do NOT understand technical jargon and thought I was letting you know. What an ego! Yeah it makes you sound smart but I can't assume you're smart if you can't use simple English to explain anything. You just came across as an intellectual bully who thinks he's so much better than those of us who don't instantly understand fucking jargon.

Forget it if you're so insulted. Don't bother yourself with us obviously inferior intellects. It'll make us both happier.

[enlightenment]

38. Your disingenuousness is more suitable to a child.

Nothing I wrote in my initial response was technical jargon, unless you have difficulty understanding words with more than two syllables.

Your responses to me and to others in this thread have given ample proof that you are uninterested in discussion. If you truly didn't understand what was being said, you would have asked for clarification rather than making snide allusions that the fault lay not with your lack of understanding but with my writing to 'sound smart'.

[lunatica]

39. You're much to defensive

Relax. No one cares.

[Neecy]

6. Can someone help me with this?

Prohibit insurance company discrimination based on gender or pre-existing
condition -- and make sure you can't lose your insurance when you get sick

I keep hearing about how wonderful the pre-existing condition provision is - but is it also true that they can jack up your rates up to 300% if you do have a pre-existing condition? Also, note that Senator Boxer doesn't mention age discrimination - is it true that your rates will be jacked up depending on your age?

The only thing I'll give her is that the insurance companies could no longer discriminate due to gender. We have our Democratic Congress and a Democratic President doing that all on their own.

[lapfog_1]

22. Yes, it's not 300%, more like 150%

if that is any help.

And then there is the age thing, where it's possible for someone over 50 to be charged up to 4 times as much as someone in the 21 to 30 age group.

What I have yet to figure out, and the bill isn't very clear about, is whether or not someone who is over 50 and has a pre-existing condition (like me, for example) can be changed up to 6 times as much as a healthy person aged 21 to 30.

The 4 X for age, AND an additional 1.5 X for pre-existing.

I don't know the answer to that, and I've read through it twice now.

[laughingliberal]

24. You can't go wrong betting it will be interpreted in whichever way most favors the profits of the

insurance companies. They waaay got their money's worth out of the legislators they bought. I get it the others feel like they must support the president. Hell, they have their jobs to think about, too.

[Neecy]

30. That's why I was hoping for the Medicare buy-in

It's the 55-64 age group that's really going to get soaked with this plan.

Thanks for the info, very useful.

[Tierra_y_Libertad]

8. Barbara has joined the lipstick application squad.

[lunatica]

13. And you've obviously joined the hyperbole squad

I have a different idea of who the pigs are.

[jillan]

17. When they keep saying that healthcare will be extended to 31 mil people, don't they mean

because they are going to mandate them to buy it?

Not trying to be snarky, I honestly don't know.

[lapfog_1]

25. In theory, yes, they are mandating that "30 million"

people that currently don't have insurance (and I keep hearing that the number is really 40 million, because so many people got laid off in the last two years and COBRA has either run out or they can't afford it anymore).

However, any reasonable analysis shows that only about 16 million of those people will actually have the capacity to buy the proffered insurance (even after 2014 when the exchanges are running). They will be able to do so because of subsidies. Almost as many more (15 million) will not be eligible for subsidies, and (because of age) the premiums will still be out of their reach financially.

Axelrod was on the tube this morning saying that the maximum amount that any individual would pay for insurance would be 8 % of their gross income. But this is not correct. A better estimate would be in the 17% range. Of course, that's for an individual plan, a family plan might be significantly higher and the middle class person will still be mandated to buy it, still not qualify for government subsidies, and it will be even more un-affordable.

What they are really saying is... work for a company that has company provided health care OR make over $100,000 a year OR make under $40,000 a year. Otherwise, you are screwed.

[golddigger]

33. Thanks lapfog_1, for your input on this.

:kick: :thumbsup:

[Lindsey]

35. Good post, lunatica. I love the way we here in California always

get emails from our fabulous Senator Boxer letting us know what's going on. I haven't been posting in this forum lately because of the horrific basing of President Obama, but I wanted to thank you for posting some facts.:hi:

[wildflower]

34. I just posted the following question in another thread:

But can insurers deny a claim?

This all sounds good, assuming it's true. Maybe they'll be forced to take me despite my pre-existing condition and even give me an affordable rate, or a subsidy to afford it.

But what happens when I file a claim for a doctor's visit or test? Can they refuse to pay?

I can't seem to find an answer to this question. Because if an insurer won't pay a bill, it doesn't matter that they can't drop me from a plan.

Knowing the answer to this question would ease my mind a great deal.

[lapfog_1]

37. Yes, they can. And if they do, you can appeal

This bill sets up an appeal process for anyone who has a claim denied.

They also have the option to pay a fine instead of fighting the appeal process.

The fine might well be less than the claim.

I expect that this will happen frequently (deny claim, pay a fine, let the government and the providers fight it out).

[wildflower]

40. Thanks

This still worries me, but I'm glad there's something about it in the bill.