Calling KR & CricAddict!

[Ram]

So, whats this new Obama Healthcare plan guys? Pros and Cons? Any of you care to give a quick 6-7 line explanation?

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Some brief thoughts Here are some brief thoughts from me. First, no bill is on the floor yet; so, we don't really know what form it is going to take. What I like: (1) President Obama is finally addressing the issue of bringing healthcare COSTS down via tort reform, and not just government subsidizing healthcare for everyone. It may be grandstanding on his part as he is addressing the AMA, but it is a move in the right direction. (2) Insurance companies have agreed to cut their admin. costs by 100s of billions (maybe up to a trillion) over the next decade. (3) VP Biden said yesterday that there is no way employers will be taxed on healthcare benefits to pay for government-sponsored healthcare. That is a good move. (4) Increased focus (at least in rhetoric) on preventative care: Enuff said. What I don't like: (1) The insistence on a government-run insurance provider. Medicare - fail. Medicaid - fail. Big private HMOs - fail. Gov't = humongous HMO = epic fail. The solution is to ditch the HMO system and even the playing field for small private insurers to compete in an open market. (2) Mandating that everyone have health insurance: If a person chooses not to have health insurance, it is a risk he/she takes. It is estimated that 20 million of the 45 million uninsured choose to have no insurance even if they can afford it. Dude, this is America - everyone should have a chance to screw up. We don't need a nanny state. (3) Mandating coverage of preexisting conditions: I know KR will rip me, but I think this is an utopian idea that cannot be implemented. People will invariably cheat their way into the system - i.e., not buy insurance until they are diagnosed with something big. And insurance companies will jack up everybody's premium to ridiculous levels to subsidize people with preexisting conditions. And by the way, even now, group insurers cannot deny coverage based on preexisting conditions. They can have an exclusion period, but not deny coverage outright. It is when you are an *individual* (not part of a group) looking for coverage for pre-existing conditions that there is a problem. Here's a good article about pre-existing conditions: http://www.cnn.com/2009/HEALTH/05/14/preexisting.condition.insurance/ (4) No clarity on "who is going to pay for this?": Government-subsidized healthcare will cost trillions. The country is living off borrowed funds already. Who will pay for this now? (5) No talk of giving tax benefits to encourage people to save for health emergencies (health savings accounts). So, there you go! Addendum: http://www.gazette.com/opinion/care-56595-health-obama.html If you're really interested in this issue and have the time, read the above link. Raises many interesting points.

[fineleg]

Nice summary, Cricaddict :thumbs_up: Lack of coverage for preexisting conditions is a big problem for many. They have to do something to address this. Not easy to solve, I agree.

[Ram]

Thanks CA. Will respond to your post in greater detail once I went through all your links.

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Thanks CA. Will respond to your post in greater detail once I went through all your links.

Here is more: http://www.wellpoint.com/pdf/Premium%20Cost%20Drivers.pdf If you can get through the entire pdf, you will be amazed at how ignorant we are, and how the media/government have controlled the debate. And more: http://www.cnn.com/2009/HEALTH/06/18/ep.health.reform.basics/index.html This CNN summary is well-balanced, except that they are using flawed data when they say this at the end: For example, the United States ranks ... 180th infant mortality (meaning 179 countries have higher infant mortality rates such as Angola and Turkey and 43 countries have lower infant mortality rates such as France and Sweden .

[kumble_rocks]

Didn't see this thread before, but looks like cricaddict has already responded. I find it ironic that proponents of a fake war ( which include most republicans) are somehow worried about burgeoning healthcare costs . Here is some food for thought , had we not waged this war , we would be saving 2 trillion dollars and counting , enough to provide universal health care for the next 10 years at least. And pre-existing condition is not an utopian idea that cannot be implemented. If People will invariably cheat their way into the system - i.e., not buy insurance until they are diagnosed with something big, then republicans should support the government mandate for individual insurance , which surprisingly they don't . And what is happening now anyways? We have uninsured ending up in emergency and they have to be treated as per the law. And guess what, their costs are being passed on to us as hikes in insurance premium. I agree with republicans on the tort reform . This will eliminate unnecessary duplicate tests and bring down the costs and curtail the ridiculous pay back the trial lawyers receive in the name of justice.

[Ram]

But guys, if insurance companies have to accept people with pre-existing conditions, then, wouldnt that sky-rocket premiums for the rest of the crowd, because the insurance companies have to shell out 100s of 1000s of dollars for this new group of people who bought insurance ONLY because they got diagnozed with something big?

[kumble_rocks]

But guys' date=' if insurance companies have to accept people with pre-existing conditions, then, wouldnt that sky-rocket premiums for the rest of the crowd, because the insurance companies have to shell out 100s of 1000s of dollars for this new group of people who bought insurance ONLY because they got diagnozed with something big?[/quote'] It's not that easy MM. The problem with the American system is that we have become slaves to employee provided group plan . The insurance companies rely on employee provided group plans to spread the costs among the employees because most will not be suffering from serious ailment but still pay premium and this will offset the few sick individuals in that group. That's why , a patient with cancer will have still have coverage through his employer and the insurance companies pay for his/her cost. But good forbade you lose your job , you are covered by COBRA for only 18 months after which no insurance company will cover you.And if you are too sick or unable to find a new job , you are toast . I find it ironic that republicans in the house and senate who are against universal health care conveniently benefit from government plan for themselves. Otherwise Dick Cheney would be bankrupt by now. And who will cover cancer patients like Giuliani or McCain . They are using the same socialized medicine blanket coverage provided by Government for their pre-existing conditions. So if Obama proposes extending the same plan to everybody , why should the republicans cry foul ? And btw , what happens to the uninsured now ? If they end up in emergency , the hospital will treat them by law and that costs will be translated as higher insurance premium for one and all.

[fineleg]

But good forbade you lose your job ' date=' you are covered by COBRA for only 18 months after which no insurance company will cover you.And if you are too sick or unable to find a new job , you are toast ..[/quote'] There are many Americans in their 50s who are in such situation in this economy. The current medical system offers nothing much for them. And with medical costs stratospheric, they cannot afford care.

[kumble_rocks]

There are many Americans in their 50s who are in such situation in this economy. The current medical system offers nothing much for them. And with medical costs stratospheric' date=' they cannot afford care.[/quote'] Agreed . Keep in mind that house democrats wanted to pass extension of COBRA along with the stimulus bill early this year. The gist of the extension bill was that anybody who is 55 years or older or if one has worked in a firm for more than 10 years can continue to extend COBRA until medicare kicks in ( 65 years) or until they find a new job which provides insurance. As usual the senate republicans with the tacit support of business group killed this addendum . Also, keep in mind COBRA is not cheap . Clearly goes to show that the insurance lobby has no intention of covering the sick and the needy . They are answerable only to their equity holders. Can we trust a private insurance company or the government for our health is a million dollar question . I choose the latter .....

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Can we trust a private insurance company or the government for our health is a million dollar question . I choose the latter .....

Why would you? Medicare and Medicaid will run out of money before you know it. A really eye-opening, but very long article on health care. A must-read and must-understand. People, do not believe everything that the government tells you: http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf An excerpt (about Medicare and Medicaid):

In 1965, two massive government health care programs were launched—Medicare and its late entrant, Medicaid. This federal intrusion into the health care system has distorted the entire market ever since and yet politicians keep calling for expanding these “excellent” programs to cover all Americans, “Medicare for all” as Senator Ted Kennedy (D-MA) likes to call it. Medicare, the primary insurance program for Americans over the age of 65, is funded entirely by the federal government, i.e. taxpayers. In fiscal year 2007, Medicare spent $427 billion accounting for 16 percent of the federal budget. This year, Medicare will spend more than it collects from payroll taxes and by 2017, it will spend $884 billion. It will take a payroll tax of 6.4 percent just to keep the program afloat.11 Myth One 17 Wasting away We’ve already seen how Medicare passes much of its costs off to private payers. But it also wastes an enormous amount of money. Studies show that Medicare officials waste as much as $1 out of every $3 the program spends.12 That’s hardly a system worth expanding. Medicaid, the insurance program for poor Americans, is administered at the state level and receives about 50 to 70 percent of its funding from the federal government. It, too, is a model of inefficiency. And there’s an enormous amount of fraud. The total federal state cost of Medicaid in 2007 was $338 billion and is projected to be $717 billion in 2017.13 In New York State alone, a retired chief fraud investigator estimates that as much as 40 percent of the state’s Medicaid claims are fraudulent. This costs the state about $18 billion a year.14 Examples of fraud abound. In 2003, for example, Dr. Dolly Rosen billed Medicaid for 991 procedures each day, costing taxpayers more than $1 million.15 Both Medicare and Medicaid also impose price controls by setting low reimbursement rates to doctors and hospitals. This has caused an enormous amount of hardship, as an increasing number of doctors are refusing to see patients if the government is footing the bill. Nearly one in three seniors in search of a new doctor is struggling to do so, according to the Medicare Payment Advisory Commission.16 “When I moved down here, I thought the only difficulty would be in finding good ones,” reported a newly enrolled Medicare patient about finding a doctor in Raleigh, N.C. “but it turned out that I would call a place and say, ‘I have Med--’ and they wouldn’t even let me finish.”17 18 / The Top Ten Myths of American Health Care: A Citizen’s Guide The government may efficiently control the costs at which doctors are reimbursed. This does not, however, account for the pain and suffering people endure waiting for care or the value of their time spent searching for a doctor. The government sets the fees paid to doctors according to a schedule of codes for 8,000 procedures. The cost is $60 billion.18 According to a recent report from the Center for the Study of Health System Change, just about half of all doctors said they had stopped seeing or limited the number of new Medicaid patients.

Uninsured non-citizens The 45.7 million “Americans” include large numbers of non-citizens who replied to the Census Bureau survey. In fact, the Census Bureau’s breakout shows that more than 10 million of the people considered uninsured by the U.S. government aren’t U.S. citizens at all. Some political commentators have estimated that the number is as high as one in four.11 It is certainly unfortunate that these individuals have no health insurance (although they can still get free treatment in U.S. emergency rooms), but even a fully nationalized health care system would be unlikely to provide health insurance for them. Yet the press—the Boston Globe, USA Today, New York Times, and virtually every other major U.S. newspaper—continues to cite this statistic even though it includes a high percentage of non-U.S. citizens. (I must confess, it’s such a common statistic that I even reference it multiple times throughout this book.) Myth Three 37 Nevertheless, almost 25 percent of those 45.7 million aren’t Americans, but merely residents of the United States. Low-income uninsured However eye-opening, the above arguments don’t counter the fact that many citizens of the United States want health care but can’t afford it. Doesn’t something need to be done to ensure that poor and lower-income Americans have decent access to affordable, high-quality health care? In fact, the United States government already offers many in this very group a big hand up. As many as 14 million of the 45.7 million uninsured— poor and low-income Americans—are fully eligible for generous government assistance programs like Medicare, Medicaid, and SCHIP.12 The problem is, they’re just not enrolling in these programs. “You may think that a poor single mom with three children living in South Central Los Angeles is among the uninsured, but in fact, she is eligible for Medicaid, as are her children. . . . Because Medicaid and children’s health programs allow patients to be signed up literally in the [emergency room], these individuals could be covered; they just choose not to do the paperwork,” writes Dr. David Gratzer.13 As it turns out, a 2008 study by the Georgetown University Health Policy Institute shows that a whopping 70 percent of uninsured children are eligible for either Medicaid, SCHIP, or both programs.14 In justifying his national health care plan, Barack Obama often complains that “nearly eight million children” lack health insurance.15 What he doesn’t tell you is that six million of those children are currently uninsured for no reason other than the fact that they have not been enrolled in available programs. 38 / The Top Ten Myths of American Health Care: A Citizen’s Guide Meanwhile, according to the Urban Institute roughly 27 percent of non-elderly Americans who are eligible for Medicaid simply choose not to have it.

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It's not that easy MM. The problem with the American system is that we have become slaves to employee provided group plan . The insurance companies rely on employee provided group plans to spread the costs among the employees because most will not be suffering from serious ailment but still pay premium and this will offset the few sick individuals in that group.

Agreed. Scrap that. To heck with the big HMOs. Let people buy their own customized coverage. There are several private co-ops that offer better plans already.

That's why , a patient with cancer will have still have coverage through his employer and the insurance companies pay for his/her cost. But good forbade you lose your job , you are covered by COBRA for only 18 months after which no insurance company will cover you.And if you are too sick or unable to find a new job , you are toast .

That is not entirely true. You can find catastrophic plans; after an exclusion period of no more than 180 days (or is it 90?), they will cover you. What about Medicaid until you can find a job?

I find it ironic that republicans in the house and senate who are against universal health care conveniently benefit from government plan for themselves. Otherwise Dick Cheney would be bankrupt by now. And who will cover cancer patients like Giuliani or McCain . They are using the same socialized medicine blanket coverage provided by Government for their pre-existing conditions. So if Obama proposes extending the same plan to everybody , why should the republicans cry foul ?

Well ... they are government employees. So, the government gives them insurance.

And btw , what happens to the uninsured now ? If they end up in emergency , the hospital will treat them by law and that costs will be translated as higher insurance premium for one and all.

Exactly. Make care affordable. Make insurance affordable. Give tax breaks to people who want to buy insurance. Take the government out.

[kumble_rocks]

Agreed. Scrap that. To heck with the big HMOs. Let people buy their own customized coverage. There are several private co-ops that offer better plans already.

Good luck finding insurance that covers pre-existing condition.

That is not entirely true. You can find catastrophic plans; after an exclusion period of no more than 180 days (or is it 90?), they will cover you. What about Medicaid until you can find a job?

Post me a link of a insurance that covers chemotherapy on the open market. So let's see , you want to a patient suffering from let's say lung cancer to wait till medicare kicks in at 65 years. What if he or she caught the cancer when they were in the 20's and are not in a position to work anymore.Bottom line is , you are being intellectually dishonest here. You think an insurance company will cover somebody with failing kidneys with some catastrophic plan which has high premium. No way Jose !

Well ... they are government employees. So, the government gives them insurance.

Doesn't the irony here escape you ? You don't mind lawmakers conveniently writing themselves a government plan which precludes pre-existing conditions and covers them for life but have huge problem if Obama suggests extending that plan to average joe. Do you seriously think that private insurance will cover Cheney ( heart lung patient), Giulani (cancer ) and other sick republicans who are opposed to universal health care.

Exactly. Make care affordable. Make insurance affordable. Give tax breaks to people who want to buy insurance. Take the government out.

Agree care should be more affordable . Tax break is useless with it's blanket of upto 5000 USD . With due respect , what kind of rubbish solution is that ? You want to give 1000 USD tax break to somebody who can potentially incur 1 Million dollar medical bill simply because they were denied insurance ? Bottom line is , insurance companies DO NOT want to cover the sick. They are answerable to shareholders , not to the needy and suffering. And why should they , if I am an underwriter , I would never cover the sick and the needy. Not good for business.

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Agree care should be more affordable . Tax break is useless with it's blanket of upto 5000 USD . With due respect , what kind of rubbish solution is that ? You want to give 1000 USD tax break to somebody who can potentially incur 1 Million dollar medical bill simply because they were denied insurance ?

I'll try to write a thoughtful response to the rest of your post later, but just a clarification. The annual $ 5000 credit is not for medical care, but to help people pay their premiums. To encourage people to buy insurance. Could one not buy a decent individual policy for $ 400+ a month?

[kumble_rocks]

I'll try to write a thoughtful response to the rest of your post later' date=' but just a clarification. The annual $ 5000 credit is not for medical care, but to help people pay their premiums. To encourage people to buy insurance. Could one not buy a decent individual policy for $ 400+ a month?[/quote'] The crux of the matter is cherry picking by insurance company , whom to cover , whom to not cover. I know colleague of mine who is a independent SAP consultant got his medical insurance denied simply because he is suffering from diabetes . Now, he is forced to look for a job so that he will fall under group umbrella. So much for encouraging entrepreneurship by republicans ...

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The crux of the matter is cherry picking by insurance company ' date=' whom to cover , whom to not cover. I know colleague of mine who is a independent SAP consultant got his medical insurance denied simply because he is suffering from diabetes . Now, he is forced to look for a job so that he will fall under group umbrella. So much for encouraging entrepreneurship by republicans ...[/quote'] It'll get worse with the government controlling what to cover, when to cover, how much cover etc.

[kumble_rocks]

It'll get worse with the government controlling what to cover' date=' when to cover, how much cover etc.[/quote'] Sure ,for few rich folks like yourself !:--D

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Sure ' date='for few rich folks like yourself !:--D[/quote'] Rich? You may want to check out what assistant professors at small colleges make :-)!! Not sure what you mean. Did you mean to write that in response to a previous post where I said "Is it not possible to buy decent insurance for $400+ a month?" If so, here's what I meant: If the gov't gives $5000 tax credit for purchasing health insurance (Ron Paul plan), one can buy a good plan of one's choice for $5000/12 = $400+ a month. Hope that clears it up. Your point re. pre-existing condition - not to patronize you, but I just did a quick search for "individual health plan" "pre-existing condition" and here's one of the links that I got: http://www.medsave.com/health-insurance-articles/Finding-health-insurance-to-cover-pre-exising-medical-conditions.htm Regardless, in the scenario that you present, can' t the person: (a) get on an individual "group plan" like the above after exhausting employer-benefits plus COBRA (that gives *18* months)? After the exclusion period (cannot be > 12 months), you have to be covered. (b) get Medicaid? If a public-option plan passes, you can be sure that: (a) Everyone's employer-provided health benefits will now be taxed to pay for it. Including those making ~ $50K (but we were promised that no one making < $200K would see tax increases. Oh wait, he meant "DIRECT" tax increases, not underhand ones). (b) Employers cannot afford to offer good plans, and may even stop offering health benefits. So, we will all be under the single-payer, crappy, big HMO called "Uncle Sam healthcare Inc." Your point re. McCain and Cheney, I still don't see what you are saying. (a) They are under the government's payroll. They signed up for a health plan. They reap the benefits. I am under my college's payroll. I signed up for a health plan. If I come down with something in the future, they'll pay for it. Not sure I see the problem there. (b) If you think that the Obama-plan is going to provide Average Joe with the same plan as Congressmen, you are badly (and sadly) mistaken. Obama is NOT EXTENDING this plan to everyone. You have fallen for his charming words. The public plan is of much lower quality: http://www.patientpowernow.org/2009/06/22/congress-federal-employees-exempt-insurance-mandates/

Last September Sen. Barack Obama promised that under his health-care proposal “you’ll be able to get the same kind of coverage that members of Congress give themselves.” On Monday, President Obama repeated that promise in a speech to the American Medical Association. It’s not true. The president is barnstorming the nation, urging swift approval of legislation that is taking shape in Congress. This legislation — the Affordable Health Choices Act that’s being drafted by Sen. Edward Kennedy’s staff and the Health, Education, Labor and Pensions Committee — will push Americans into stingy insurance plans with tight, HMO-style controls. It specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).

Just more politispeak from the President.

[kumble_rocks]

I read your response and sadly you seem to go in circles ! I am not even sure if I want to engage you in a debate simply because for me it is much more important than scoring brownie points in a message board. Again , I can list countless cases ,where in an individual insurance has been denied because of chronic life threatening aliment like cancer . Even CBS 60 minutes had a coverage on this issue. Do you honestly think that a cancer patient undergoing chemo will get coverage in the open market. In that program they even talked about how some of them even got rejected by Medicaid . It is estimated that approximately 60 percent of poor Americans are not covered by Medicaid. Even the link you posted clearly says employer based group insurance is the way to go . So , you expect sick chemo patients to look for new jobs simply to be covered. Even I can google and post countless links of sick patients whose insurance got denied because of cherry picking by big Insurance companies. If you think , big insurance companies are looking out for you , you are living in a la la land. And if you feel they provide the best service , why not compete with public plan . Granted social medicine may have it's flaws , but the present system is a big failure. Sad to see your response are becoming increasingly partisan in nature . In his short term , Obama has done much more than what Bush government did in the last eight years to address the health care issue. Just two months in office he was able to sign CHIP that provides mandatory health care for Children. Any way , I will provide detailed response later...

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Sad to see your response are becoming increasingly partisan in nature . In his short term , Obama has done much more than what Bush government did in the last eight years to address the health care issue. Just two months in office he was able to sign CHIP that provides mandatory health care for Children. ..

I take exception to the "partisan" comment. In my initial response to mm, I clearly praised Obama for bringing this issue to the forefront. But it does not change the fact that he is not honest when he first said that everyone will get the coverage that Congressmen get, but now that is off the table. It does not change the fact that he promised he will not tax healthcare benefits, but it is back on the table (did you see Stephanopolous grill Axelrod about this?). If employer-based healthcare is the way to go, why tax it more? Fact is - the system is broken, not because it is a free-market system, but because it is not truly a free-market system. The big HMOs have a huge advantage. The govt will be the biggest of them all. You did not answer this - if the govt gave you a $5000 credit p.a. to buy good insurance, could you buy one? Second, does the law allow insurance company to deny coverage even after the exclusion period? Third, there are plans called "group individual" plans for folks who cannot find employment and have exhausted COBRA. As for Medicaid not covering who it should - you made my point. Involve the government, mess it up.