Read this Q&A from Ezra Klein about HCR, PLEASE!

[grytpype]

Those of you who think HCR without the public option is a corporate giveaway that won't help you... time to re-open your mind again and stop the hysteria.

http://voices.washingtonpost.com/ezra-klein/2009/12/chat_transcript_reconciliation.html

Excerpts:

Palookaville, Pa.: I'm a moderate who has supported health care reform from the beginning. I am now very concerned that the current state of the bill delivers all the uninsured into the arms of a very content insurance industry, while not only failing to rein in costs but failing to in any way address the fundamental causes of the current crisis. Liberals, with whom I was in agreement until this past week's development, now accuse me of being emotional and irrational because I don't want to create an even greater burden for the poor, which I believe the bill, in its current form, does. Please tell me, is it not reasonable to be worried that this bill exacerbates the current crisis? What would you see as reasonable opposition from those who want reform, but don't want it to be a boon to insurance companies?

Ezra Klein: I don't believe it is. I want to be very clear on this: I think this bill will do more to help the poor and underserved than anything since the Great Society. I think it will do more to control costs, and create an infrastructure to control costs and a politics able to control costs, than anything we've ever done, full stop.

I'm not alone in this. Writers like Jon Cohn. Advocates like the Center for Budget and Policy Priorities and Families USA. Senators like Jay Rockefeller. Among the people who have really been in the trenches on this for years, there's near unanimity that losing this bill will be, and will come to be understood, as one of the most tragic and unnecessary failures in recent legislative history.

...


Lexington, Ky.: If there is no public option, what is the primary mechanism in the bill that will promote competition, thus presumably driving rates down? If insurers continue to be exempt from anti-trust rules and there is no public option, do you believe there will be a significant increase in real competition?

Ezra Klein: The public option contained in the House bill, which is a public option that Dean and others would accept, would not have controlled costs. CBO estimates, in fact, that its premiums would be slightly higher than comparable private plans (though they also said the public option would have delivered slightly better services).

I don't know another way to say this than to say it clearly: The idea that the exchange-limited, non-Medicare public option was the central cost control mechanism in this bill was never credible. It was good policy, and I would have liked to see it in the bill. But the effort to secure it by pretending that it was somehow transformative ended up misinforming a lot of people about the nature of both the option and the larger bill.

...

Potomac, Md.: Ezra, thanks for explaining everything so clearly. I understand that insurance companies can't exclude people for pre-existing conditions, but can they charge higher premiums, which could have the effect of excluding them?

Ezra Klein: Nope.

...

Morris, Minn.: Hey Ezra,

I keep seeing complaints about the mandate is a problem in the absence of a public option because there will be no competition -- is there a strong argument that the exchanges won't work (to produce competition)?

Ezra Klein: Not an argument that is somehow solved by the inclusion of the weak public option. Also, the new attack on the mandate is really disturbing: There's an almost ironclad argument that the bill itself, much less the exchanges, won't work in the absence of the mandate, as I argued in yesterday's post 'the importance of the individual mandate.'

...

Columbia, S.C.: Hello Ezra, I've read your post on the individual mandate and understand the desire to cover an additional 30 million Americans. I agree that we need HCR and those folks should be covered. However, the problem I see with this mandate is the lack of any sort of cost controls on insurance companies, other than our hope that they will cooperate. What's your take on this?

Ezra Klein: I don't know what cost controls people want exactly. If insurance is not affordable under the mandate, the mandate will be revoked or stronger cost controls will be added. But here's one cost control in the bill: if an insurer jacks up his rates, he can be decertified from the exchange. That is to say, an insurer who raises prices beyond what's reasonable would lose access to the market. That's a stronger cost control than anything we have now. So too is the excise tax, which slaps on a 40 percent tax if insurers let their costs rise above a certain level, and that level grows more slowly than cost increases do.

This is what cost control looks like. And it's better than anything we currently have.

[mdmc]

1. I like Ezra Pound enough

who is Klein? a blogger or somethin

[Demoiselle]

10. Well I looked him up...sort of...

He writes for the Washington Post, which these days, doesn't impress me, frankly.
He has also edited/contributed to the American Prospect, which impresses me a little more.
How old he is, what his life experience/education is, I couldn't find. At least not through the Washington Post site.

He sounds very knowledgeable. But then, who doesn't about this mare's nest of legislation? And he looks about 30 years old which means I could be his mother.
So I'm ultimately not all that impressed, (So sue me, I'm a cranky old New Deal Democrat. )
Ezra has better manners than Joe Klein, though.

[liberalpragmatist]

12. He's 25

nt

[mdmc]

14. God Bless the New Deal Democrats

cranky and otherwise..

[mdmc]

2. If my co-pays go down, then I owe him a coke

if they go up then I was correct - this bill sucks..

(And who is this guy and how would he know what is in the bill?)

[Larkspur]

3. Klein also supported the Iraq War

He's part of the Democratic Beltway elite whose duty is to put down the Peasant's Rebellions.

[Hello_Kitty]

4. If insurance cos. are still allowed to be monopolistic these "cost controls" are worthless

If they gang up and convince the gov't that raising premiums X percent is "reasonable" so it shall be.

[wryter2000]

5. WTF?

Potomac, Md.: Ezra, thanks for explaining everything so clearly. I understand that insurance companies can't exclude people for pre-existing conditions, but can they charge higher premiums, which could have the effect of excluding them?

Ezra Klein: Nope.

What in hell kind of answer is "nope"? What's to stop them?

[SpartanDem]

11. What stops them? The bill makes it illegal

[Milo_Bloom]

16. Where?

There are no cost controls.

Sure, we'll give you insurance... for 10x the rate of those without this condition. You have now been excluded, without being excluded.

For example, you are likely excluded from owning a Bentley, not because they wouldn't sell you one, but because you can't afford it.

Same result.. different path.

[SpartanDem]

21. Read the bill

These sections deal with banning pre exsisting conditions

SEC. 2702. GUARANTEED AVAILABILITY OF COVERAGE.

`(a) Guaranteed Issuance of Coverage in the Individual and Group Market- Subject to subsections (b) through (e), each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual in the State that applies for such coverage.
`(b) Enrollment-
`(1) RESTRICTION- A health insurance issuer described in subsection (a) may restrict enrollment in coverage described in such subsection to open or special enrollment periods.
`(2) ESTABLISHMENT- A health insurance issuer described in subsection (a) shall, in accordance with the regulations promulgated under paragraph (3), establish special enrollment periods for qualifying events (under section 603 of the Employee Retirement Income Security Act of 1974).
`(3) REGULATIONS- The Secretary shall promulgate regulations with respect to enrollment periods under paragraphs (1) and (2).


2705. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS AND BENEFICIARIES BASED ON HEALTH STATUS.

`(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
`(1) Health status.
`(2) Medical condition (including both physical and mental illnesses).
`(3) Claims experience.
`(4) Receipt of health care.
`(5) Medical history.
`(6) Genetic information.
`(7) Evidence of insurability (including conditions arising out of acts of domestic violence).
`(8) Disability.
`(9) Any other health status-related factor determined appropriate by the Secretary.


As for charging 10x for pre exsisisting condtions that would be outlawed too


SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

`(a) Prohibiting Discriminatory Premium Rates-
`(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
`(A) such rate shall vary with respect to the particular plan or coverage involved only by-
`(i) whether such plan or coverage covers an individual or family;
`(ii) rating area, as established in accordance with paragraph (2);
`(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
`(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
`(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).
`(2) RATING AREA-
`(A) IN GENERAL- Each State shall establish 1 or more rating areas within that State for purposes of applying the requirements of this title.
`(B) SECRETARIAL REVIEW- The Secretary shall review the rating areas established by each State under subparagraph (A) to ensure the adequacy of such areas for purposes of carrying out the requirements of this title. If the Secretary determines a State's rating areas are not adequate, or that a State does not establish such areas, the Secretary may establish rating areas for that State.
`(3) PERMISSIBLE AGE BANDS- The Secretary, in consultation with the National Association of Insurance Commissioners, shall define the permissible age bands for rating purposes under paragraph (1)(A)(iii).
`(4) APPLICATION OF VARIATIONS BASED ON AGE OR TOBACCO USE- With respect to family coverage under a group health plan or health insurance coverage, the rating variations permitted under clauses (iii) and (iv) of paragraph (1)(A) shall be applied based on the portion of the premium that is attributable to each family member covered under the plan or coverage

[Milo_Bloom]

23. *SIGH*

Yes, READ THE BILL!

They can ban you for any number of reasons (including credit worthiness), they just can't say it is for the pre-existing condition anymore.

And yes, they can still raise your rates to rediculous levels to weed out those with pre-existing conditions, since there are 0 cost controls.

[SpartanDem]

24. "must accept every employer and individual in the State that applies for such coverage"

It is there in black and white in my first response.

[Milo_Bloom]

25. Again, READ THE BILL.

Where are the cost controls? Accepting someone and someone being able to afford it are two different things.

There is no requirement to accept those unable to pay.

Also caps pretty much weed out those with preexisting conditions as they quickly reach their caps, but why worry about the loopholes.

What corporation ever took advantage of loopholes?

It is amazing to me the people willing to try and defend this joke of legislation by failing to read the whole bill and only quoting the parts that say what they want it to say.

[SpartanDem]

27. I'd say being forced pay 90% of premiums in care is major cost control

alsowith customers able to leave their insurer without the fear being rejected at another company will pressure them to hold down prices.

[Milo_Bloom]

29. What "other" company?

Or don't you realize that the anti-monopoly provisions don't exist anymore?

And really? 90% is going to control costs? So obscene profit and overhead costs are going to "control" costs?

Let's forget how easy it is to get around this with all the loopholes built into the bill or very simple accounting tricks.


0 Cost controls.

0 Competition.


Looks like it is time to kill the bill.

[SpartanDem]

32. When most insurers only pay out 75%

I'd say making that pay 90% or have to refund their customer is major cost control. They will have to lower overhead and can only keep so much money before they're forced to return it. Second even without the anti trust you act like that everybody only has one choice.

[Milo_Bloom]

33. LMAO!

Yeah, because health insurance companies with higher profits than casinos are allowed makes total sense. We better get down on our knees and thank the politicians for their generosity in letting the company only gouge us so much.

Let's forget the fact that costs can easily be inflated and job titles adjusted so that nothing actually changes.. but hey, corporations have always played so fair in the past, of course they will continue to do so in the future.

No overhead will be lowered. No money will be returned.

0 Cost controls.

0 Competition.

The bill must be killed.

[dana_b]

20. exactly what I was thinking

:wtf:

[damntexdem]

6. More lies from Klein.

Kill the bill!

[Name removed]

8. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Milo_Bloom]

17. Try using an argument not so easily debunked.

[grytpype]

7. Who are the l******* who are voting this down?

[liberalpragmatist]

13. Yeah, this site is being taken over by drones

At least the DKos frontpagers are giving reasoned arguments (even if I think some of their arguments are flawed).

Here we're just getting teabagger-esque chants, slogans and assertions.

[FrenchieCat]

31. Everything is unrecced automatically.

Bunch of lockstepping baggers right here on DU are doing the honors.

"Seriously, they're all over DU shouting 'KILL THE BILL!' ... it's the funniest thing! I guess we can take next week off."
WASHINGTON - DECEMBER 17: Sen. Jon Kyl (R-AZ) confers with Sen. Lindsey Graham (R-SC) during a news conference by Republican Senators


(courtesy of Clio the Leo)

[optimator]

9. how much does the white house pay him?

and why should anyone give a fuck what he says?
He sounds like a fucking retard on everything he has ever written.

[flpoljunkie]

18. Klein's not the retard here. The Senate public option was a pale imitation of a robust pubic option

as well as the House's passed version of the public option. We need to work on stricter regulation of insurance companies and the 3:1 ration in the Senate bill for age. The House's ration of 2:1 is preferable, but not ideal. I think those who smoke ought to pay more. Smoking will kill you and causes huge health care expenses in the process. This is something people can control, unlike age.

[Milo_Bloom]

15. His Analysis is completely flawed

Does he not understand the simple meaining of the word "reasonable" and how it is used in this context?

THERE ARE 0 COST CONTROLS IN THIS BILL. Using "reasonable" as a guide is an old trick done by corporations to give themselves no accountability. As long as they move in concert, which they will, all costs remain "reasonable".

[Joe Chi Minh]

19. Lexington, Ky.: If there is no public option, what is the primary mechanism

in the bill that will promote competition, thus presumably driving rates down? If insurers continue to be exempt from anti-trust rules and there is no public option, do you believe there will be a significant increase in real competition?

Ezra Klein: The public option contained in the House bill, which is a public option that Dean and others would accept, would not have controlled costs. CBO estimates, in fact, that its premiums would be slightly higher than comparable private plans (though they also said the public option would have delivered slightly better services).

I don't know another way to say this than to say it clearly: The idea that the exchange-limited, non-Medicare public option was the central cost control mechanism in this bill was never credible. It was good policy, and I would have liked to see it in the bill. But the effort to secure it by pretending that it was somehow transformative ended up misinforming a lot of people about the nature of both the option and the larger bill.

Is it my imagination, or did Klein completely fail to address Lexington KY's question? Just answer the question, Mr Klein. Merely claiming the public option was inferior to the one under discussion, while implying that you're having immense difficulty putting it more plainly(!), as if it's the readers fault is a sick joke in itself.

Ezra Klein: 'If insurance is not affordable under the mandate, the mandate will be revoked or stronger cost controls will be added. But here's one cost control in the bill: if an insurer jacks up his rates, he can be decertified from the exchange. That is to say, an insurer who raises prices beyond what's reasonable would lose access to the market. That's a stronger cost control than anything we have now. So too is the excise tax, which slaps on a 40 percent tax if insurers let their costs rise above a certain level, and that level grows more slowly than cost increases do.

Kind of running repairs? On what basis, pray, has the public reason to trust that the word, 'reasonable', will be appropriately construed, by whom it will be construed and with what degree of urgency? That last word is of signal importance. Many Americans would not be in a position to tolerate an indeterminate period of 'commissioning', particularly since it would perforce be required on a permanent basis, since, in the US (and the UK, for that matter), insurance companies have historically been, when not wholly derelict, i.e. in the case of poor claimants, unlikely to be able to afford the kind of legal representation to take the behemoths on, and win. A specially-designated category, I understand, with its own cute, special little denomination in insurance jargon.

It all begs the question: what is the rationale underlying the Administration's tenderness and delicacy when it comes to imposing rigorous rules on the insurance companies from the start; thereby obviating all that nonsense about commissioning/running repairs.

Neoliberalism has been absolutely exposed as insanity, and/or criminal fraud, and yet still this persistent need to treat Big Business with kid gloves, as 'the goose that lays the golden eggs', instead of respecting Adam Smith's precepts, to the effect that its principals should be treated as untrustworthy and seditious in relation to the public good, and absolutely necessitating very purposeful controls on the part of government.

[impik]

22. Don't even try, dude. Logic and reason are gone and they're never coming back to this place

[Clio the Leo]

26. kick for the late night crew NT

[mcablue]

28. Ezra is predictable

Let me guess, without reading the post: He's making excuses in favor of the bill. Isn't he?

[FrenchieCat]

30. The difference is that his writing is reasoned, logical and factual.....

which is more than I can say about your crap that I've been reading since you joined last month.

[HughMoran]

34. Let me guess without reading your post

You're still against it.

wasn't that fun.

:eyes:

[Cha]

35. You're the one who is way too predictable.

[ThePhilosopher04]

36. He never answered the question...

about competition and cost control...only says that an insurer "can be decertified from the exchange" if it jacks up rates, or that if "insurance is not affordable under the mandate, the mandate will be revoked or stronger cost controls will be added."

There's nothing iron-clad in those statements that gives confidence that cost control can be achieved; and furthermore, who determines what "affordable" means and what "jacked up rates" are under this bill? Seems to me that "affordable" is a matter of perspective, and what percentage or how much do rates have to rise to be considered "jacked up?"