Obama

[Cadaverous Pallor]

Originally Posted by Ghoulish Delight

I need to find it again but I recently saw an interesting set of comparative charts. It showed 3 statistics for a bunch of countries. 1) The percentage of the country's total medical spending that is spent by the government 2) The percentage of the country's GDP that total medical spending represented and 3) WHO's ranking of the country's medical care.

In regards to wendy's point, around 50% of total medical spending in this country is already done by the government. So the change being proposed is hardly the 180 degree philosophical shift for this country towards socialism poeple would like us to believe.

So most of the other countries shown had socialized systems where the government represents >80% of spending. The first thing I noticed was, among this list, the US was the ONLY country where total medical spending was >10% of GDP, which seems to rather put lie to the myth that socialized health care = runaway spending. Most were in the 7-8% range, the US is 15%.

Then there were the rankings. The US was something like #23. All but 2 of the countries on the list were ranked higher by WHO, which challenges the common argument that such systems mean worse care.

Just saying.

ETA: Aha, found it. And the US ranking was worse than I remembered, #37 http://thetoiletpaper.com/blog/2009/...ped-countries/

Seeing the graph really hits it home. Much higher percent of our GDP than other nations and much worse results. Perhaps we should try to copy what works.

[Alex]

Originally Posted by scaeagles

I did read on, and yes, I suppose adding a dependent to my existing policy is an exception, but my concern was specifially that a new employee could not be added to the existing employer offered plan. I hve a problem with that as it takes away the ability of the new employee to accept whichever it is they might want. I'm not trying to be difficult. Am I misunderstanding that in your opinion?

No, but that is generally the way grandfathering works. If have an old 5gpf toilet you can keep it but if you want to install a new toilet or do a significant remodel of your bathroom it has to be one that meets current requirements. If you have a public doorway that doesn't meet ADA requirements you (sometimes) can keep it, but if you do any remodeling to the doorway you have to bring it up to speed. If you have a smokestack that has emissions higher than the new standards you can keep it but if you make any changes at the plant you have to bring it up to code.

Why is it so great that the government will allow programs to be grandfathered? The very fact that grandfathering is an issue on existing plans means that the government sees something wrong with them and will not be allowing new similar plans in the future.

That's correct. I don't think it is great to allow grandfathering where not doing so would not create a huge expense (for example, requiring every existing toilet to be replaced immediately rather than in the course of regular replacement).

And when it comes to insurance regulation I believe it is very much not the standard to grandfather existing plans from new regulation. But the grandfathering clause is there because of people complaining that they'd be forced off of insurance that they're satisfied with.

So I'd say the complaints are trying to have cake and eat it too. It is evil of the government to force you into plans meeting new regulations but at the same time the fact that they'll let you keep your current plan if you want is a sign of how evil the new plans are?

That seems to me to be a bit unrealistic and very restrictive. That says you can keep what you have as long as it doesn't change at all (a copay change, whatever). If it changes at all, you can't have it, and have to go with a government approved plan (public or private).

You already have to go with a government approved plan. Insurance is right now a heavily regulated industry. Whatever insurance plan you currently have has been approved by government. If they make a change it has to comply with government approvals. Your government is constantly tweaking what is required for those approvals.

And the grandfathering clause is very restrictive. Such is generally the nature of grandfathering. If it wasn't then new regulations would simply be statement of ideals (especially if completely new entries could opt into the grandfather clause).

===

I need to correct something I've been saying since I misread this section the first time (I'm not really reading the bills in detail now because I don't yet know which of several possibilities will move forward).

The section about grandfathering applies only to individual insurance, not employment based health insurance. So, the bad thing that you've now said is grandfathering is not an issue for you (I'm assuming you get your insurance through employment). Employment based plans would have a 5-year grace period to comply with the new regulations.

So that is pretty standard as every time insurance regulations change now, the insurance companies change the plans (or they change the plans just because they view it in their business interest) and you have no say in the matter no matter how much you preferred the previous version.

Also, the hassle of your employer administering multiple plans due to grandfathering is definitely not an issue (though it wouldn't have really been an issue anyway).

====

Can you point me to your list of 100 things? I'd be interested in seeing what is on it?

Question: If you have confirmed for yourself that many of the things on the list are BS, how does that sway your default skepticism setting on the others you haven't checked? Do you start out assuming they're true until proven otherwise?

Finally, for anybody who cares to read primary sources here's a link to the Ways & Means Committee version of a health insurance bill and is the specific one we've been talking about here. Hopefully the 100 things list sticks to a single version for criticism (or at least is clear on which version they're criticizing at any given time).

[scaeagles]

Here is a list similar to what I referenced. Not the one, but the one I had seen was forwarded to me by someone in my home email which I can't access at present. This one is much shorter (ends at page 494 for some reason).

Haven't gone through even close to all of them, just a few really. I read the page they are referring to, see if there is anything that could possibly be interpretted that way, and research as necessary.

Really, though, most of my personal research has been done at the Heritage Foundation site.

[JWBear]

Originally Posted by scaeagles

Really, though, most of my personal research has been done at the Heritage Foundation site.

And we all know what a bastion of impartiality they are!

[sleepyjeff]

Originally Posted by JWBear

And we all know what a bastion of impartiality they are!

No less impartial than the World Health Organization whose numbers seem to go unchallenged around here

[innerSpaceman]

Um, Huh? I've been posting here a long time, and I don't recall there being any prevalence of World Health Organization numbers bandied about.


That said, what dirt do you have on that organization? I wasn't aware they had a reputation for inaccuracy. I'm sincerely curious. I don't know anything about them.

[sleepyjeff]

Originally Posted by innerSpaceman

Um, Huh? I've been posting here a long time, and I don't recall there being any prevalence of World Health Organization numbers bandied about.


That said, what dirt do you have on that organization? I wasn't aware they had a reputation for inaccuracy. I'm sincerely curious. I don't know anything about them.

You can count on one hand the number of posts you would have to go back....World Health Organization = WHO.

[innerSpaceman]

ok, so what makes their numbers unreliable?

[Gn2Dlnd]

Originally Posted by innerSpaceman

ok, so what makes their numbers unreliable?

What, don't you understand that for every fact presented there must be an equal and opposing "fact?" Don't you ever watch Fox News? Jeez.

[Alex]

Ok, here's some of my responses to the list of concerns scaeagles linked to (this gives me something to look at so if I'm going to research for my own learning I'll bore everybody).

Probably will get really long so I'll spoiler it. All responses are my own (unless I cite something else) and will contain my own errors.

Spoiler:

Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!
Both sentences are completely untrue. It says that keeping your current plan (if you are self insured) is an option. If you don't want to keep your current plan you'll be able to change to any other plan you want. You do not have to purchase the public option established in Title 2 of the bill.

Page 22: Mandates audits of all employers that self-insure!
I do not see anything on this page, or any nearby page, requiring audits of individual insurers. It does require that a demographic report be developed reporting on the nature of insurance, general features offered, risk of regulatory impacts, etc.

Now, it certainly may turn out that this information is gathered in the course of actual audits, but the bill says nothing about performing audits (at least not here).

Page 29: Admission: your health care will be rationed!
First of all, of course health care will be rationed. Health care is already rationed and there is no reason to expect that will change. All that might be changing is the basis on which it is rationed.

That said, I see nothing on page 29 that involves rationing. It does say that costsharing will be limited to $5,000 for an individual and $10,000 for a
family. But that is a cap on the cost to the individual or family, not a cap on the cost to the insurer. On page 27 it explicitly says that for those things required as part of an approved health care plan (whether public or privately sold):

Originally Posted by Page 27

...does not impose any annual or lifetime limit on coverage of covered health care items and services;

So, if it is covered, you may have a deductible or copay up to a certain amount but beyond that there is no cap.

Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)

Starting on this page the creation of a Health Benefits Advisory Committee is laid out. This board will have up to 26 members serving 3-year terms and will make recommendations about a couple of things.

1. What should be the minimal services covered by qualifying healthcare plans. Plans are, so far as I can tell, completely allowed to exceed those minimums to their heart's desire.

2. Cost sharing recommendations for the Health Insurance Exchange plans (a pool of plans made available for peole who are otherwise not insured. If you're receiving other insurance through your employer these plans aren't relevant to you.

Either way, the statement is inaccurate for a couple reasons. The committee only establishes the floor on coverage, not a ceiling. And it does not bar coverage for other services.

No appeals process is mentioned. But that is probably because the committee does not actually set policy. It is hard to imagine how you'd accommodate appealing a recommendation.

Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
But I thought just the previous item said that Health Benefits Advisory Committee would be in charge of that?

But yes, the bill does put someone in charge of managing the regulations contained within it. However, the same caveats apply to him as to the previous item. All that is defined for non-Exchange private health insurance is the minimum level of coverage required, the plans are free to exceed them all they want. So if coverage is denied in such a plan, it won't be because of a government bureaucrat (it may be in violation of the government bureaucrat but that burueacrat has no ability to declind coverage in a private health care plan).

Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
Not enough information for me here without a more thorough reading of the bill. PolitiFact, however, labels this claim as Pants on Fire. (I'm avoiding their detailed analysis of this list while I come to my own conclusions.)

Page 58: Every person will be issued a National ID Healthcard.
Well, every person is going to need some means of demonstrating their insurance coverage when using health services. This section lays out goals for electronifying and simplifying such issues.

But if a card were used it would be a national ID card in the same sense that your Social Security Card is. Which may not be good, but that horse is already out of the barn.

And I'm not clear on what the impact, if any, would on peopel using non-Exchange insurance plans.

Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.

Almost couldn't figure out what this was talking about. But the language in question seems to be:

Originally Posted by Page 59

enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice.

First of all, that section is talking about electronifying payments between health care providers and insurance companies, not between you and the health care company. Second, the automated part is reconcilation not remittance. Third, if they wanted to use the power (not that anything in this section suggests they do), the federal government already has all the information on my individual bank accounts and could take it.

Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (example: SEIU, UAW and ACORN)
Extremely Misleading. Yes, there are subsidies for continuing existing health coverage for employer-based health plans between retirement at 55 and eligibility for other existing government health coverage.The fact that an employer may be a union has nothing to do with the program. It would be true of Wells Fargo and Microsoft employees as well.

Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
True to an extent, but as said previously, currently any health insurance offering must conform to government rules. That isn't new, only the rules would be changing.

If insurer's want to provide direct individual insurance they'll have to quality to participate in the Exhange. Today they have to quality in different ways. It should also be said that while all individual insurance would have to be part of the Exchange, other insurance (such as employer based) are not required to be part of the Exchange (though as is universal must be minimal government requirements).

Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
The bill does say that qualify Exchange plans will "provide for culturally and linguistically appropriate communication and health service."

I would certainly like more clarity on what that means. But it only means "illegal aliens" to the extent that one assumes that lacking facility with English means you are here illegally. I have a coworker who speaks very good English in general but when were were talking about my meat restrictions we had to go find a follow Chinese speaker to translate "mammal." I'd guess she also doesn't necessarily know the English worrds for her internal organs. Searching the word Aliens finds on page 143:

Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

So at least in one program in the bill illegal immigrants are excluded.

So. That's the first twelve on the list. Of those, only one item is - in my opinion - a remotely accurate representation of what is in the bill. At what point does it become prudent to start assuming, lacking affirmative evidence otherwise, that the entire list is BS?

Now off to read if Politifact thinks I got anything wrong.