HEALTHCARE THREAD

rootless cosmopolitans

^^^code for jews iirc

My apologies if anyone was offended. I meant that only as a generic term for young, mainly single, people who move jobs a lot and live in cities.

Irish Travellers gonna be pissed!

haha just kidding o. nate

just been reading some fascist history is all

then you deal with what you owe to hospitals the way I do: call them and say you have no money and let them figure it out. That is better than owing them $200k.

But healthcare shouldn't be about about paying for cancer treatment or other outliers - if you can't afford health insurance there are options for cancer treatment (shitty ones, but options) that aren't that different from the above poverty plea - without having the government foot the tab for insurance that doesn't help you out the other 99.9% of your life. I feel this way about private insurance too - there's zero reason for me to pay $150-250/month for a plan with no co-pays and a deductible that's around 20% of my income.

The subsidization would be reasonable if we were paying for plans with affordable unlimited GP visits, specialists and excellent prescription coverage and reasonable deductibles for hospitalization, but that's not the case.

i def appreciate the persepctive akm

thanks. I realize some people might write my opinions off on this because I and my family are very personally impacted by the implications of this bill. But I think my perspective is valid, and maybe more valid than the opinions of lots of otherwise healthy, insured people who stand to lose very little with this bill's passage. It actually pisses off, I should be congratulated for not killing all of you and every Republican I see. J/K. But I got an email from Jane Hamsher this morning that sounded so much like Sarah Palin/Teabagger horseshit that I unsubscribed from ever getting their updates and lost absolutely all respect for Firedoglake (not like I had that much to begin with because the name is so dumb).

if anyone stands to lose out, at least in the short-term, it's probably young, urban, rootless cosmopolitans

How about the young, urban and recently unemployed? I got let go in September and have been having a hell of a time trying to find a job. While I do, UI covers my rent and car insurance/power/phone bills. I hope the job market gets better in 2k10 because I don't want to end up having to pay an extra $700 when tax time comes around and still not be able to go to the doctor when I get sick.

you wont

i will steal it from him

milo you sound like youre arguing against insurance in general, not this healthcare plan!

Will the money get deducted from my tax refund?

This healthcare plan is for-profit insurance, so yeah, they're kind of intertwined. For-profit insurance provides shitty care for too high a price on the low end - and now we're going to give them billions of dollars for more of the same.

Will the money get deducted from my tax refund?

I got a letter from Obama this morning Adam I guess I have to cover you until you get work

you better be pounding that pavement man I am not made of money

Thank you for that advice I hadn't thought of looking for a job before!

lol

way to fucking go you goddamn idiots. your 'compromises' turned the country against your bill

The Quinnipiac survey also indicates that while a majority of Americans oppose the health care plan, they back two options that were cut from the Senate bill. According to the poll, 56 percent support the option of getting coverage through a government health insurance plan, with 38 percent opposing the public option. And nearly two-thirds like the proposal to allow people as young as 55 to buy into the government run Medicare program, with three in ten opposed.

I understand being upset -- apparently, REAL reform will be impossible until we get a progressive party in power when i'm about 95 -- but really, preferring 'nothing' to this? I've yet to hear the rationale.

I reiterate: I have yet to hear a decent explanation of how this is not just a huge giveaway/gov't subsidy for insurance companies

like, I don't get where the cost controls are. it just transfers the burden of paying for private insurance from employers directly to the taxpayers

the cost controls on healthcare spending? or on insurance premiums?

the former. the latter are covered by this legislation, no...?

http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande

Some words on cost control from Atul Gawande. Also, corn.

so his argument is that these small pilot programs will guide the healthcare industry towards best practices, thereby reducing costs? I am deeply skeptical.

well theyre connected so its sort of silly to separate them. but yes measures intended to control healthcare spending growth are all over the bill, alongside provisions to control the cost of premiums. (ill spare you the atul gawande article since i assume youve read it but in case you havent its here: http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande.) its hard to say what exactly will end up in the bill that gets signed by obama since a bunch of senators & congresspeople are still trying to add/strengthen portions, plus (as gawande points out) there are dozens of pilot programs and odds & ends all in the bill... its kind of a kitchen-sink approach.

but specifically: the medicare advisory board, which is huge, seems likely to make it into the final version w/ the amendment that lieberman and rockefeller are working on the strengthen it. the similar new HHS dept which is created entirely to test reforms will help a lot. bundled payments, while voluntary right now, are a big deal. hospital reports will now help govern medicare payments (i.e. the more effective a hospital is, the better its payments are. there are medicare-based incentives for doctors to join 'accountable care organizations' that help w/ 'comprehensive' care.

to be fair none of these reforms are guaranteed to lower healthcare costs or even stop the bad growth... but im not sure that theres anything out there short of comprehensive systematic reform that would have guaranteed results. theres a lot out there on this--ron brownstein did a v. long post about this as i recall. ezra klein has some stuff too i believe.

sorry thats in response to

the former. the latter are covered by this legislation, no...?

― larry craig memorial gloryhole (Shakey Mo Collier), Tuesday, December 22, 2009 11:55 AM (20 minutes ago) Bookmark Suggest Ban Permalink

from, God help me, the Brooks column:

The second reason to oppose this bill is that, according to the chief actuary for Medicare, it will cause national health care spending to increase faster. Health care spending is already zooming past 17 percent of G.D.P. to 22 percent and beyond. If these pressures mount even faster, health care will squeeze out everything else, especially on the state level. We’ll shovel more money into insurance companies and you can kiss goodbye programs like expanded preschool that would have a bigger social impact....

Defenders say we can’t do real reform because the politics won’t allow it. The truth is the reverse. Unless you get the fundamental incentives right, the politics will be terrible forever and ever.

eh, the report brooks is referencing says that the healthcare reform will increase spending by something like 1%

the last Paul Krugman blog on cost control btw

I like this from Krugman's next-to-last blog:

"the important thing to bear in mind is that this isn’t about (Obama); and, equally important, it isn’t about you. If you’ve fallen out of love with a politician, well, so what? You should just keep working for the things you believe in."

ot fuckin m

Needle exchange ban lifted by Feds, which is something

David Brooks's thing about getting the "incentives" right is basically a libertarian stalking-horse for replacing health insurance with medical spending accounts for all. Not sure what Morbs likes about that idea.

I don't, if that's what he means.

Well, I'm exaggerating a bit, but his big thing is controlling costs, and if you look for specifics on how he proposes to do it, which isn't easy, you'll find that he likes plans that mainly control costs by passing on more of the incremental cost of healthcare to consumers. He's against top-down price controls of the type that some liberals might favor. And expanding coverage is a distant second priority for him, way below controlling costs.

expanding coverage should control costs by itself.

i really like al franken so far

http://www.startribune.com/politics/national/congress/79863887.html?elr=KArksc8P:Pc:UthPacyPE7iUiD3aPc:_Yyc:aUU

BTL comments on that are usual slobbering AH DO NUHHH RECOGNIZE YR AUTHORITEH bullshit. But yay Franken.

So the latest myth to spread like wildfire through the conservasphere is that under the current bill you're going to GO TO JAIL if you don't buy insurance that costs $15,000 for your family.

The articles that parrot this idea all seem to stem from a convoluted misreading/stretching of certain provisions of the bill and the tax code. Basically if you don't buy insurance you're subject to a tax, and the TAX code carries jail time for the most extreme tax evaders (it's pretty rare and this is already the case). The problem is that it's really fucking difficult to explain to people without legal experience why no one is actually going to face jail time for not buying insurance. Further, the problem is that while there appear to be thousands of websites/blogs/articles making the jail claim, it took diligent searching to find one that dispels the myth (and doesn't even do a very convincing job of it). Those guys are good at information warfare, and honestly I don't think the Democrats have done the best job of either waging their own information warfare or of crafting a bill that doesn't sound scary to a lot of Americans.

yeah I dunno, this is in the bill:

(2) SPECIAL RULES.—Notwithstanding any other provision of law—
‘‘(A) WAIVER OF CRIMINAL PENALTIES.— In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.
‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary shall not—
‘‘(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or
‘‘(ii) levy on any such property with respect to such failure.

which seems to indicate pretty heavily that no one is going to go to jail over this, or even really pay a fine.

Oh, is it? If you have a link to that it would be helpful - much simpler than the kinds of arguments I've been trying to make.

Nevermind, found one.

yeah I found that in a diary on DailyKos, weirdly I haven't seen it out very much, it's a pretty important point though.

It does raise an interesting flipside question - which is whether people will really feel any compulsion to buy insurance if there's no enforcement.

is there really *no* enforcement? i don't know that much about tax though. no liens or prosecution but is there some civil penalty?

expanding coverage should control costs by itself.

― akm, Tuesday, December 22, 2009 4:00 PM (2 days ago) Bookmark

Keyword here is 'should'. Is there anything in this bill that will guarantee premiums will not continue to climb? Cos if not then this kind of thinking is pretty wishful.

The idea of using a tax as an incentive would be nice if people could afford to buy into the private insurance system but just didn't want to. But isn't the reason most people w/o insurance don't have it because they can't afford it?

Bob Herbert via Greenwald:

http://www.salon.com/news/healthcare_reform/index.html?story=/opinion/greenwald/2009/12/29/health_care

Within three years of its implementation, according to the Congressional Budget Office, the ("Cadillac") tax would apply to nearly 20 percent of all workers with employer-provided health coverage in the country, affecting some 31 million people. Within six years, according to Congress’s Joint Committee on Taxation, the tax would reach a fifth of all households earning between $50,000 and $75,000 annually. Those families can hardly be considered very wealthy. . . .

The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans. . . . These lower-value plans would have higher out-of-pocket costs, thus increasing the very things that are so maddening to so many policyholders right now: higher and higher co-payments, soaring deductibles and so forth. . . .

can someone explain why health insurance costs vary so drastically from state to state? and why new york's offerings are so absurd?

it is gonna make more sense financially for me to quit my job and move somewhere else than to purchase (terrible) coverage here, no shit.

i dont know all the reasons but one big one is that insurance laws are mostly governed by states, so depending on how certain regulations work it may make your insurance cost more or less. another is that youve got a different set of people in each state changing the makeup of the insurance pool.

love this guy

was totally unaware of him prior to the '08 election

http://www.cnn.com/2010/HEALTH/01/14/medical.records/index.html?hpt=C2

this is why need EMRs + communication/CCD standards