This HCR Bill: 45,000,000 Get Single-Payer Vermont Health Care

[shraby]

THIS IS IMPORTANT.
I'm bringing this over from DailyKos..Pelosi, Reid, Sanders, Cardin have pulled one over on the Republicans!!

Great Diary there.
<http://www.dailykos.com/story/2009/12/22/818060/-This-HCR-Bill:-45,000,000-Get-Single-Payer-Vermont-Health-Care>

45,000,000 get single-payer care =vs.= 3,000,000 P.O. tickets ??? -- Cummon folks.

Ted Kennedy's existing CHC program expands along lines developed by Bernie Sanders and Ben Cardin.

The single best thing to happen for America's working poor since food stamps:

-- 14,000 nationwide Community Health Clinics

-- Expand CHC capabilities to match VHA

-- 45,000,000 people served

-- $$$$$ to attract 20,000 primary care physicians, nurses, etc.

-- Drugs at VHA prices

-- Dental care

-- Patient billing scaled to income

<http://www.dailykos.com/story/2009/12/22/818060/-This-HCR-Bill:-45,000,000-Get-Single-Payer-Vermont-Health-Care>

[tmyers09]

1. SHHHH

Nobody tell Joe Lieberman...

[andyrowe]

5. hahaha

nice.

[aquart]

9. Seriously, is it absolutely too late to derail it?

[coti]

31. No, it's not.

Shhhh.

[mzmolly]

24. Absolutely! We'll hear much more about hidden

public options in the future I presume? :hi:

"Harry Reid concealed Sanders-Cardin till the last hour, then popped it into the Senate HCR Bill." Go Harry!!! :toast:

[mmonk]

34. Yes, he needs to be distracted from that.

[Shagbark Hickory]

2. What about the middle class?

[Oregone]

3. No worries. Theyll be lower class soon enough

[shraby]

4. Go read the whole piece.

I figured a long time ago that something was up the way everything kept changing from day to day and week to week. That maybe it was to keep the GOP off balance so they couldn't focus their bitching on any singular point and hammer it to death. Just maybe I was right?

[tridim]

16. Dare I say..

Political Chess?

Our leaders are brilliant, they played the GOP beautifully. :)

[NYC_SKP]

6. Recommended! nt

[debbierlus]

7. You know what? This might be THE way to really develop a model that truly can be expanded

I need to think about this more, but this is the first explanation I have read that has shown me something SUSTAINABLE with the option of real growth and a development model for expanding coverage based on the centers models.

It doesn't justify the passage of any of the crap that was placed in the bill, but this is the only thing that I see that is tangible to expound in a positive and again, sustainable way.

I have always deeply respected Sanders and he is the ONLY Senator whom I trust with getting ANY type of honest assessment about the bill. Bernie appears to be making the calculation that he can work around the system in a whole other way and offer some good basic care right up front.

Nice.

He is the only Senator who fought for any real representation of all the people (a few did force THEIR states to be given extra money at the expense of the rest of the nation.)

I need to read more.

Thanks for posting.

[mzmolly]

27. Good on you debbierlus!

:toast: for remaining open minded, while you advocate for a stonger bill.

[tridim]

8. This is why the GOP is always against Democratic HCR.

Regular people are going to really like it.

Rock on Dems! :bounce:

[sandnsea]

10. Single Payer Vermont Care??

What are you trying to say.

[eridani]

11. Great. But it does NOT have to be tied to a mandatory insurance fuckover n/t

[tridim]

12. Everyone read the KOS diary. This idea is brilliant.

IMO it's much better than the public option.

It's the perfect foundation for a true single-payer system.

[dysfunctional press]

13. after reading the piece, i have a couple of quick question about it...

maybe i missed it...but- who are the 45 million people that will get it?
is it one of the options that will be available to everyone through the insurance exchange?
when would it take effect/be available(beyond vermont)?

[shraby]

15. I didn't go to Sanders website, maybe he explains it

better.

[dysfunctional press]

30. okay- after reading some more- this IS NOT 'single-payer' by any sane definition...

your subject line is what had me confused.

[Bobbie Jo]

14. K&R

Thanks for posting this, I've been catching bits and pieces of this one.

[FLAprogressive]

17. Hyperbole Alert!

from a comment....

Hyperbole Alert (9+ / 0-)

The clinics are great (I get my medical care from two of them in Vermont).

But Vermont has a Medicaid buy-in up to 300% of poverty line for children (Dr. Dynasaur), up to 185% of poverty for adults (VHAP), and a public option with no income limits and sliding scale up to I think 400% of poverty (Catamount Health, which also limits out-of-pocket to $1000 annually). It also has a strong regulatory system in place that polices the two private companies that operate in the state.

Sorry, I'm happy Bernie got this as his pound of flesh, but this bill does not get the U.S. anywhere near the Vermont system.

by pletzs on Tue Dec 22, 2009 at 03:07:56 PM PST

[drm604]

18. I'm confused.

Who can use these clinics?

Does this somehow cover people who need things like hospitalization or chemotherapy?

Are there income requirements? Can a middle class family still go bankrupt due to a health crisis?

Vermont has single payer? How was I not aware of that?

[FLAprogressive]

19. This DKos diary misleads but that's no surprise

2 month wait to see a doc at Rural Health Here (1+ / 0-)

And they MAY NOT TAKE THE CASE.

14,000,000,000 to build 10,000 new centers? NOt likely that is 140,000 per Center. That is NOT enough to do much more than put the Walls up if they build that many.

And get 20,000 new primary care physicians? That is more likely to cost 200-400 Billion, a little more than 14B. It is great but the numbers JUST DO NOT WARRANT that degree of celebration.

The Mandate is still in.

People that make a little less than 50K for a family of three will still be paying 600 dollars a month for insurance which covers only 70% of costs, and can require 2K out of pocket before it pays ANYTHING.

To Goldman Sachs in according to their desires, From us in accordance with the IRS.

by Bluehawk on Tue Dec 22, 2009 at 07:15:22 PM PST

< Parent >

Hyperbole Alert (9+ / 0-)

---


The clinics are great (I get my medical care from two of them in Vermont).

But Vermont has a Medicaid buy-in up to 300% of poverty line for children (Dr. Dynasaur), up to 185% of poverty for adults (VHAP), and a public option with no income limits and sliding scale up to I think 400% of poverty (Catamount Health, which also limits out-of-pocket to $1000 annually). It also has a strong regulatory system in place that polices the two private companies that operate in the state.

Sorry, I'm happy Bernie got this as his pound of flesh, but this bill does not get the U.S. anywhere near the Vermont system.

by pletzs on Tue Dec 22, 2009 at 03:07:56 PM PST

----

CHCs are not "Single Payer" (4+ / 0-)

Community health centers are a great thing, but you're misleading a lot of people by equating them to a "single payer" system of care.

If the clinics were free to patients and funded by progressive taxation, then they would something like a "single payer" system.

[drm604]

22. I agree that the DKos piece is misleading,

but I think you got your math wrong. 14,000,000,000 divided by 10,000 is 1,400,000, not 140,000. Your overall point still stands.

[FLAprogressive]

25. guess my post was kind of misleading too -- forgot to mention that those were individual comments...

[FLAprogressive]

26. ...but I think we can agree that community health clinics are not a comprehensive single payer plan

[regnaD kciN]

33. Not the only math he got wrong...

People that make a little less than 50K for a family of three will still be paying 600 dollars a month for insurance which covers only 70% of costs, and can require 2K out of pocket before it pays ANYTHING.

That's pretty much wrong on all counts.

First of all, subsidies for people up to 400% of federal poverty level will guarantee that the most such a family would have to pay for insurance is 9.8% of income (government subsidies would pay for the rest). 9.8% of $50,000 income is $408.33/month, not $600/month.

But it's even more off than that. The 9.8% figure is for those in the 300%-400% of poverty level category. In fact, 300% of poverty level for a family of three is slightly over $54,000, so a family "that make a little less than 50K" would actually be under 300% of poverty level, and would have to pay a smaller percentage of their income for premiums (I'm not sure of the exact percentage for that particular income level, but I know it would be less than 9.8%).

Furthermore, the notion that such insurance "can require 2K out of pocket before it pays ANYTHING" is pure nonsense. In fact, basic health procedures are covered under the rules of the bill. The only way you'd have to pay $2K up front would be if your first visit upon obtaining insurance would be for a massive coronary, taken straight to the emergency room and then into surgery for a quadruple bypass. Unless you have a catastrophic illness, there's no way you are going to have to pay much out-of-pocket, let alone all up-front before insurance begins covering anything.

By contrast, incidentally, look at the fate of the same hypothetical family under the current system. Those premiums would definitely be above $600/month (probably well over it -- in most places, family premiums top $1,000/month), and would come with no government subsidies to make them more affordable. There will be at least as many co-pays as there would be under the new HCR bill, plus, most likely, a larger deductible, and one that might have to be paid up-front. There won't be an annual cap on out-of-pocket expenses like there is under the HCR bill; in fact, there are probably going to be annual and lifetime caps on benefits, so that bypass might mean that you'll wind up owing tens of thousands, and never be able to collect for any other illnesses. Of course, that probably won't matter, because your insurance company would be able to drop you after your bout of coronary disease, and no other company would likely cover you, because of your costly pre-existing condition.

Somehow, that hypothetical family seems to be doing a lot better under the HCR bill than before, don't they?

But "what about the mandates???" I hear you cry. First of all, this is a hypothetical case of someone who purchases insurance, not one who chooses to go without. But, if your family leans in that direction, here's another point: under the Senate bill, if the post-subsidy portion of premiums comes to more than 8% of income, that person or family is exempt from the mandate. In this particular case, it means that, if the cheapest monthly premium they could find is more than $333.33, they could just say "no thanks" to insurance and not have to pay a dime in penalties. (If their premiums were under that, and they still decided not to get coverage because of the principle of the matter -- possibly emulating Keith Olberman? -- the penalty they would have to pay would work out to...$124/month. Not exactly something that would have much chance of breaking anyone's bank, to be honest, although I can't see why a family with a $50K income -- above the median household income, by the way -- would prefer paying $124/month in penalties rather than $333/month to have insurance coverage.)

[BR_Parkway]

35. If you took some of the open retail/strip mall space that is all over

right now, 1,400,000 would do a whole lot of equiping and fitting out a clinic. Not to mention the boost in local economies with construction jobs

[Hekate]

20. KnR

[FLAprogressive]

21. More proof that this is misleading.

Calling this 1x-payer for 45m is absurd (4+ / 0-)

Recommended by:
AndyT, michidan, vets74, healthy

DOn't get me wrong, this is good, but you are claiming that 45,000,000 people will get coverage equivalent to a single payer system for a total cost of $14bn over 5 years. That works out to $64/year. That is completely absurd.

[dysfunctional press]

28. may i ask you a question...? (besides that one)

what is the (4+ /0-) all about...? (in other posts on this thread you also use (9+ /0-) and (1+ /0-) )

:shrug:

[slipslidingaway]

29. So the original poster agrees with a comment that calls part of

their diary absurd.

[Juche]

23. Thanks for posting that

Primary care funded by the government is a big accomplishment and something to be proud of.

[Hannah Bell]

32. Vermont only has about 650,000 people. Who are these 45 million?