WH: Putting It All in Perspective

[ProSense]

Putting It All in Perspective

Posted by Dan Pfeiffer on January 05, 2010

With Congress now needing only to combine ideas from the House and Senate versions of health insurance reform into one final bill to send the President, there is an unavoidable temptation among the media to focus on the five percent of differences between the two versions, instead of the remarkable 95 percent the bills have in common. But, even as difficult work does remain, it is important not to lose perspective of how far we have come and how close we are to the enacting health reform.

The reality is that the two versions of reform legislation are vastly similar – built upon a shared foundation that will provide stability and security for Americans with insurance, affordable options for those without, and lower costs for families, businesses, and the government.

Both the House and Senate versions of health insurance reform rest upon the following building blocks:

• Insurance reforms to protect consumers from insurance company worst-practices – like denying coverage based on pre-existing conditions, capping total coverage, and dropping or watering down coverage when you get sick and need it most
  
  
• Consumer protections that will restrict how much of your premium dollars insurance companies can spend on marketing, profits, salaries.
  
  
• Creation of a health exchange to increase consumer choice and guarantee coverage
  
  
• A commitment to expanding health coverage
  
  
• Affordable health options, with subsidies for working families and a hardship waiver
  
  
• Tax credits to help small businesses afford coverage
  
  
• Improvements in the health status of our population by investing in prevention and chronic disease management
  
  
• Making preventive care completely free – with no copayments or deductibles
  
  
• Lowering the cost of health care for our seniors
  
  
• Improving the quality and extending the life of Medicare
  
  
• Strengthening our primary care workforce
  
  
• Reforming the delivery system
  
  
• Ensuring that reform is not only fully paid for, but actually significantly reduces the federal deficit.

So as you follow the health reform debate in the media, don't fall prey to the cynicism and pessimism of a lot of the chattering class and remember that we are on the precipice of a historic accomplishment that will make a real difference in the lives of American families.

[impik]

1. Let the Rec/Unrec war begin (because *this* is what important here).

Thank for the post, ProSense. I'm sorry for what you're gonna have to suffer in this thread.

[T Wolf]

2. Oooooh. I guess all our work is done, now that our governing elite have fixed medical care

with such a great plan.

All is good. Happy days are here again. All praise the Democrats.

And in a year or two, when we see how little has actually improved and Obama has to "work with" a more repuke Congress, we can sit back and pat ourselves on the back for a job well done.

Save this imaginary list of gains and see what really happens.

[ProSense]

3. No, the work is only beginning. n/t

[saracat]

5. Lets hope they aren't as improved as the banking with the 70% interest rates and new processing fees

Since there is not aspect contained that will cotrol rising premiums and we are now "forced" to pay mandates, I can't see this as progress or improvement.

[damonm]

8. Au Contraire...

Both bills contain language where insurers have to justify their rates in order to be included in the exchange. Exclusion from the exchange will carry with it the stigma of an unnecessarily higher price - so insurers have a competitive incentive to keep prices reasonable, which emphatically does NOT exist as of right now.
This, coupled with the fact that, under provisions in both bills, insurers have to be transparent about how much of your premium is spent on actual care vs. marketing, salaries, bonuses, etc., and I can't see this as anything BUT improvement.

Is it as much improvement as I wanted? No.

But it's the first big step.

[saracat]

13. Really? That spells competition to you?Just as the insurers have already found a way around jacking

up the rates for PE conditions, there is a very easy way around this too. Justification will be really easy an as for the "stigma"? Don't make me laugh.This will be the same as the "stigma" of coutoure clothing.Gimme a break.And there is no enforment in any of this and the insuresrs are basically self policing.We are still "letting the freemarket decide" and we know how well that works. Sheesh.But we are all entitled to our opinions. I respectfully disagree.

[zipplewrath]

4. Regulatory approach

It's a regulatory approach to managing the health insurance industry. It should do everything for health care that banking regulations did for the banking industry. I'm sure it will be very successful in producing a large lobbying infrastructure in DC to support campaigns of the future.

[jenmito]

6. K&R. By that list, it's obvious to see that Obama is out to help big corporations

and industries. :sarcasm:

[cornermouse]

7. A list of WH lies

It doesn't stand up when you look into underlying documentation which indicates, for example, that they think the way to preserve medicare is to make a 20% cut in payments to providers resulting in fewer providers keeping their doors open and the remaining providers considering whether they will agree to continue to take medicare patients at all. By the way, how many businesses do you know who can afford to take a 20% cut in profits?...

Anyway, when people get a new monthly bill for insurance or, in my case, higher bill due to the mandatory aspect, they aren't going to be grateful to the democratic party. They're going to get mad at the democratic party.

[secondwind]

9. the so-called 20% "cut" is the cutting of waste and fraud. Don't think for a moment

that providers everywhere don't PAD their bills.........

[Peacetrain]

10. Remind me never to ask you to join my team.. damn son, you are in the tank 24/7

[ProSense]

11. So these are lies based on

your wishful thinking:

Anyway, when people get a new monthly bill for insurance or, in my case, higher bill due to the mandatory aspect, they aren't going to be grateful to the democratic party.

[cornermouse]

17. Do you prefer the fact that people who supposedly benefit

from this will be paying 3 times more than what I pay now?

[bornskeptic]

18. The 20% cut is not going to happen.

It is not part of the Senate healthcare reform bill. It is a scheduled cut based on the formula for computing provider reimbursements which was instituted years ago. It was scheduled to take effect on Januarry 1, but last month a bill was signed postponing it until the end of February. The hope is that a permanent fix can be put in, but that will be postponed until the final form of the healthcare bill is known. There is no way that Congress will ever let those cuts actually happen. If nothing else they will postpone them for another year, as they've been doing every year for several years..

http://atlanticfinancial.wordpress.com/2009/12/22/medicare-2010-fee-21-2-percent-cut-stopped-for-60-days-senate-poised-to-pass-healthcare-reform/

[uponit7771]

12. But did Obama save Bambi?!?! No?!?! Well....you know

[HousePainter]

14. Checklist on the WH PR release

So glad to see a propaganda billboard straight from the WH Communications Office being posted on this non-commercial site.

But let's take the arguments one by one :

Insurance reforms : like the ability to charge high-risk patients or those in certain higher risk age groups up to 3 times the premiums of the lowest risk population.

Consumer protection - how much of your premium can go to marketing, profits and salaries- Check with Wendell Potter (former Cigna employee) on this item- he's explained quite clearly how the Industry is already planning to game those numbers. Or talk to any actor who took "points" (a percentage of the gross after expenses) instead of salary back in the 70s and 80s to get a sense of how "creative accounting" works.

Creating health exchanges : State exchanges not a national exchange - is an explanation really necessary to point out the weakness of that framework ?

A commitment to expanding health coverage - throw that in the same bin that "transparency", fierce advocacy of LGBT issues,
the end of lobbyists setting the DC agenda and real financial regulation reform are rotting in.

Affordable health options with subsidies for working families etc. - in other words our tax dollars being used to help our less fortunate citizens get insurance - with an immediate (at least) 12-18% (see:consumer protection) siphoned off the top by the private insurers who are the only game in town- mandates with penalties if you don't buy in - with policies that will carry co-pays that make a mockery of the whole corporate give-away masquerading as progress to boot.

Ensuring that reform is completely paid for - The excise tax on so called "Cadillac" plans which will quickly(within six or 7 years) be yet another tax burden on the backs of most of the middle class. Don't be lazy- do the math.

[ProSense]

15. So many false arguments

Insurance reforms : like the ability to charge high-risk patients or those in certain higher risk age groups up to 3 times the premiums of the lowest risk population.

Currently, it's up to 11 times, and not unusual in other countries.

Consumer protection - how much of your premium can go to marketing, profits and salaries- Check with Wendell Potter (former Cigna employee) on this item- he's explained quite clearly how the Industry is already planning to game those numbers. Or talk to any actor who took "points" (a percentage of the gross after expenses) instead of salary back in the 70s and 80s to get a sense of how "creative accounting" works.

MLR goes up about 15 percentage points.

Creating health exchanges : State exchanges not a national exchange - is an explanation really necessary to point out the weakness of that framework ?

Both, but see Hawaii.

A commitment to expanding health coverage - throw that in the same bin that "transparency", fierce advocacy of LGBT issues,
the end of lobbyists setting the DC agenda and real financial regulation reform are rotting in.

That's not a rebuttal. Still, 30 million Americans gain coverage.

Affordable health options with subsidies for working families etc. - in other words our tax dollars being used to help our less fortunate citizens get insurance - with an immediate (at least) 12-18% (see:consumer protection) siphoned off the top by the private insurers who are the only game in town- mandates with penalties if you don't buy in - with policies that will carry co-pays that make a mockery of the whole corporate give-away masquerading as progress to boot.

(emphasis added)

Problem? Currently the insurance companies are siphoning nearly 30 percent.

Ensuring that reform is completely paid for - The excise tax on so called "Cadillac" plans which will quickly(within six or 7 years) be yet another tax burden on the backs of most of the middle class. Don't be lazy- do the math.

Wrong, most insurance plans will never reach that threshold. Also plans for high-risk workers are protected.

[HousePainter]

16. Arguments, arguments

My argument is not that there are no improvements over the status quo in the proposed bill but simply to point out that it is one and a half steps forward , one step back- with many hidden drawbacks- the biggest being that it will push any additional significant HCR off the table through at least the next two election cycles.


Insurance reforms : like the ability to charge high-risk patients or those in certain higher risk age groups up to 3 times the premiums of the lowest risk population.


Currently, it's up to 11 times, and not unusual in other countries.
Which countries would those be?

Consumer protection - how much of your premium can go to marketing, profits and salaries- Check with Wendell Potter (former Cigna employee) on this item- he's explained quite clearly how the Industry is already planning to game those numbers. Or talk to any actor who took "points" (a percentage of the gross after expenses) instead of salary back in the 70s and 80s to get a sense of how "creative accounting" works.

MLR goes up about 15 percentage points.
If you accept the erroneous number of a current MLR of 70%.
Still, on a captive pool of an additional mandated 30 million policies - with no strong cost controls it's a Health Insurance CEOs wet dream.

Creating health exchanges : State exchanges not a national exchange - is an explanation really necessary to point out the weakness of that framework ?

Both, but see Hawaii.
That's like saying - percentage of voters registered Democratic- see New York City-
For both of these cases let's use - Alabama or Mississippi.

A commitment to expanding health coverage - throw that in the same bin that "transparency", fierce advocacy of LGBT issues,
the end of lobbyists setting the DC agenda and real financial regulation reform are rotting in.

That's not a rebuttal. Still, 30 million Americans gain coverage.
True not a rebuttal -simply a comment on the evanescence of political commitments - 30 million gain mandated "coverage" as distinct from "health care" -exactly the problem-

Affordable health options with subsidies for working families etc. - in other words our tax dollars being used to help our less fortunate citizens get insurance - with an immediate (at least) 12-18% (see:consumer protection) siphoned off the top by the private insurers who are the only game in town- mandates with penalties if you don't buy in - with policies that will carry co-pays that make a mockery of the whole corporate give-away masquerading as progress to boot.

(emphasis added)

Problem? Currently the insurance companies are siphoning nearly 30 percent.
30 percent is an incorrect figure (fact check it)
Again -a mandated taxpayer subsidy for private insurers (with an additional 30 million bodies thrown in to sweeten the pot) and that guarantees a minimum of 12-18% "commission" on that subsidy (I use it here as a blanket term for self managed overhead)isn't the sort of deal I would brag about to the middle and working class in this country at this time.


Ensuring that reform is completely paid for - The excise tax on so called "Cadillac" plans which will quickly(within six or 7 years) be yet another tax burden on the backs of most of the middle class. Don't be lazy- do the math.

Wrong, most insurance plans will never reach that threshold. Also plans for high-risk workers are protected.

Actually according to Politifact :"An economist we spoke with said they are commonly offered by state and local governments and universities, the types of jobs that are said to have "great benefits." Estimates we've looked at suggest that, by 2019, the excise tax would affect as many as 25 percent and as few as 17 percent of all tax filers."