HCR Passes - Page 9

scaeagles · 03-22-2010, 05:44 PM

Quote:

Originally Posted by Not Afraid

How in the HELL can anyone look at this list and say: "It's the end of the world as we know it". Maybe it's because they've had health insurance forever and no illnesses and they can say "I feel fine". (Thank you REM.)

Because that's not all it is. If those was the sum total of the bill I doubt there would be nearly as much controversy. It's easy to go in and pick out a list of stuff from a 2700 page bill.

BarTopDancer · 03-22-2010, 05:51 PM

Quote:

Originally Posted by scaeagles

Because that's not all it is. If those was the sum total of the bill I doubt there would be nearly as much controversy. It's easy to go in and pick out a list of stuff from a 2700 page bill.

Please pick some stuff you are opposed to and post it for discussion. I'm still curious what in the bill you are opposed to. I know you said up thread you weren't well versed in it, yet you are opposed to it. There must be a reason beyond principal.

Alex · 03-22-2010, 06:00 PM

Just some thoughts on the Huffington Post 14 items.

Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014. - I'm fine with this so long as there is a universal individual mandate with teeth. Don't give any time to anyone who says they support eliminating pre-existing decision eliminations but not mandated coverage. Unfortunately the individual mandate passed and soon to be weakened by the reconciliation bill is not "teeth" in my opinion and if it isn't strengthened could be the fatal flaw that puts the whole thing on the economy crashing track feared by the opposition.

Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums. Fine. Another source I saw said it was 35% of benefit for companies with 25 or fewer but wherever the number is it is somewhat arbitrary and within an order of magnitude of what seems reasonable.

Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled. The reconciliation bill will change this but I can't remember specifically how. This however, if doom happens, will be the second door through which it might come. We're mandating demand with only minimal tools for controlling costs in a political environment (an insurance company may be willing to make the unpopular decision to not cover an expensive drug of questionable value but your local congresscritter never will).

The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27. Don't really like this one, at least not without some "means testing" attached. This really does feel like infantilization to me. I understand the idea behind it, but I still don't like it.

Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. - Fine, but this really will mean "rationing" though not necessarily any different than the rationing now but now it can be blamed on people we vote for which is a much stronger incentive to push off the bad news until it destroys the system. All the sooner if the mandate isn't given some bite.

A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014. Fine.

New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018. - Fine, but I really need to track down the exact language on this. Once there is a way for something to be completely "free" then the lobbying will begin to get everything defined as preventative care. Chemotherapy for lung cancer will be preventative because it can prevent the need for radiation therapy or something. Manipulable labels are a dangerous thing.

Insurance companies can no longer cut someone when he or she gets sick. - Very good and one of the few major pieces that could have been done as a standalone without the mandate.

Insurers must now reveal how much money is spent on overhead. Irrelevant so long as they are meeting the requirements established for participation in the exchanges. But not a huge deal depending on how the terms are defined. It'll just become the next accounting game on how to redefine things so as to minimize overhead.

Any new plan must now implement an appeals process for coverage determinations and claims. Fine.

This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. - Stupid and reeks of scope creep. Also a foreboding sign of how they'll justify taxing anything just by attaching any kind of "health" consequence to it.

New screening procedures will be implemented to help eliminate health insurance fraud and waste. - Fine in itself. However, overall a relatively unimportant element and also a chimera. If fraud were easy to squeeze from the system it would have been done already.

Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. No opinion.

Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits. Fine, but then I already think we're too liberal on granting tax benefits to non-profits.

Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. Stupid nannyism.

The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55‐64 in order to help reduce the often-expensive cost of that coverage. No strong opinion.

The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. Meaningless feel good measure. If you feel this is an important element first please explain without doing any new research in what ways the current federal and state information provided on health insurance options is inadequate.

A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases. Nice, but meaningless from the point of view of health care reform.

Not Afraid · 03-22-2010, 06:07 PM

More links:

10 things....

CNN

NOTHING I'm reading helps me to fathom what the "problem" is.

Alex · 03-22-2010, 06:19 PM

I think it is easy to see the primary problem the honest dissent has, but like abortion it is fundamentally a philosophical disagreement so there really isn't room for compromise and the opposite view is somewhat incomprehensible.

But I think to a large population Health Care Reform and this would be roughly equivalent:

We as a society think it is important for everybody to have access to university education. Studies show that such education leads to happier, longer, more vibrant lives. So we're going to require everybody to pay tuition to the University of Phoenix regardless of whether they are actually going to be taking classes any time soon, have any interest in classes, and even if they agree that they will never actually complain about not being able to take a class in the future if they reject kicking in their share.

And because we need the people who aren't taking classes to contribute so that we can subsidize those who can't afford to take the classes we're going to make it against the law to simply sit back and pay for your classes when you take them, regardless of your ability to pay and certainty that you'd personally never be a financial burden on the university education system.

I can see why mandating that every citizen buy a private product regardless of their need, intent, or ability is a very scary road. And it is not really equivalent to car insurance, medicare, social security. That's why I'm of the opinion that the right course is either to go more libertarian and accept the brutal outcomes that implies or go totalitarian and nationalize the entire healthcare industry both payer and provider.

I'm not too worried about the current bill because I don't think it really does much and it isn't likely to change in the future but I can see the seeds of something to be afraid of, especially as the logic is further internalized and inevitably begins to spread to other areas that seem nonsensical now (as the logic of anti-smoking regulations are inevitably moving into other areas).

I'm not on board with it (the assumption that this is the first step to ruination), but I don't dismiss it out of hand.

innerSpaceman · 03-22-2010, 06:23 PM

Also, Morrigoon - according to the stuff I've seen - the prohibition on co-pays applies only to check-ups and other preventative care. So the Doc will have to bill it as preventative, otherwise co-pay you pay. The hypochondric-disincentive remains!

innerSpaceman · 03-22-2010, 06:33 PM

And it seems to me the mandate to buy private insurance is thankfully toothless, because I object to it, too - and would expect it to be overturned on constitutional grounds.

But the fines for not buying it are pretty minimal (especially in comparison with the costs of the insurance otherwise have to buy). I can't see them being any big incentive to comply, and it's not expected that enforcement will be robust in any event.

BarTopDancer · 03-22-2010, 06:46 PM

Is the 10% on tanning salons on top of the 8.75% tax? If the new tax will be 18.75%, it's only $2-$3 for the average package. It's certainly not going to deter anyone.

Bornieo: Fully Loaded · 03-22-2010, 07:10 PM

Oh, no wonder there are that many new posts....

As one without health care - I'd like some. Thank you very much...

innerSpaceman · 03-22-2010, 07:19 PM

yeah, i think this thread doubled the LoT post count for the last fortnight.

03-22-2010, 06:00 PM	#83
Alex . Join Date: Feb 2005 Posts: 13,354	Just some thoughts on the Huffington Post 14 items. Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014. - I'm fine with this so long as there is a universal individual mandate with teeth. Don't give any time to anyone who says they support eliminating pre-existing decision eliminations but not mandated coverage. Unfortunately the individual mandate passed and soon to be weakened by the reconciliation bill is not "teeth" in my opinion and if it isn't strengthened could be the fatal flaw that puts the whole thing on the economy crashing track feared by the opposition. Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums. Fine. Another source I saw said it was 35% of benefit for companies with 25 or fewer but wherever the number is it is somewhat arbitrary and within an order of magnitude of what seems reasonable. Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled. The reconciliation bill will change this but I can't remember specifically how. This however, if doom happens, will be the second door through which it might come. We're mandating demand with only minimal tools for controlling costs in a political environment (an insurance company may be willing to make the unpopular decision to not cover an expensive drug of questionable value but your local congresscritter never will). The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27. Don't really like this one, at least not without some "means testing" attached. This really does feel like infantilization to me. I understand the idea behind it, but I still don't like it. Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. - Fine, but this really will mean "rationing" though not necessarily any different than the rationing now but now it can be blamed on people we vote for which is a much stronger incentive to push off the bad news until it destroys the system. All the sooner if the mandate isn't given some bite. A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014. Fine. New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018. - Fine, but I really need to track down the exact language on this. Once there is a way for something to be completely "free" then the lobbying will begin to get everything defined as preventative care. Chemotherapy for lung cancer will be preventative because it can prevent the need for radiation therapy or something. Manipulable labels are a dangerous thing. Insurance companies can no longer cut someone when he or she gets sick. - Very good and one of the few major pieces that could have been done as a standalone without the mandate. Insurers must now reveal how much money is spent on overhead. Irrelevant so long as they are meeting the requirements established for participation in the exchanges. But not a huge deal depending on how the terms are defined. It'll just become the next accounting game on how to redefine things so as to minimize overhead. Any new plan must now implement an appeals process for coverage determinations and claims. Fine. This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. - Stupid and reeks of scope creep. Also a foreboding sign of how they'll justify taxing anything just by attaching any kind of "health" consequence to it. New screening procedures will be implemented to help eliminate health insurance fraud and waste. - Fine in itself. However, overall a relatively unimportant element and also a chimera. If fraud were easy to squeeze from the system it would have been done already. Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. No opinion. Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits. Fine, but then I already think we're too liberal on granting tax benefits to non-profits. Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. Stupid nannyism. The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55‐64 in order to help reduce the often-expensive cost of that coverage. No strong opinion. The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. Meaningless feel good measure. If you feel this is an important element first please explain without doing any new research in what ways the current federal and state information provided on health insurance options is inadequate. A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases. Nice, but meaningless from the point of view of health care reform.
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03-22-2010, 06:07 PM	#84
Not Afraid HI! Join Date: Jan 2005 Posts: 17,108	More links: 10 things.... CNN NOTHING I'm reading helps me to fathom what the "problem" is.
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03-22-2010, 06:19 PM	#85
Alex . Join Date: Feb 2005 Posts: 13,354	I think it is easy to see the primary problem the honest dissent has, but like abortion it is fundamentally a philosophical disagreement so there really isn't room for compromise and the opposite view is somewhat incomprehensible. But I think to a large population Health Care Reform and this would be roughly equivalent: We as a society think it is important for everybody to have access to university education. Studies show that such education leads to happier, longer, more vibrant lives. So we're going to require everybody to pay tuition to the University of Phoenix regardless of whether they are actually going to be taking classes any time soon, have any interest in classes, and even if they agree that they will never actually complain about not being able to take a class in the future if they reject kicking in their share. And because we need the people who aren't taking classes to contribute so that we can subsidize those who can't afford to take the classes we're going to make it against the law to simply sit back and pay for your classes when you take them, regardless of your ability to pay and certainty that you'd personally never be a financial burden on the university education system. I can see why mandating that every citizen buy a private product regardless of their need, intent, or ability is a very scary road. And it is not really equivalent to car insurance, medicare, social security. That's why I'm of the opinion that the right course is either to go more libertarian and accept the brutal outcomes that implies or go totalitarian and nationalize the entire healthcare industry both payer and provider. I'm not too worried about the current bill because I don't think it really does much and it isn't likely to change in the future but I can see the seeds of something to be afraid of, especially as the logic is further internalized and inevitably begins to spread to other areas that seem nonsensical now (as the logic of anti-smoking regulations are inevitably moving into other areas). I'm not on board with it (the assumption that this is the first step to ruination), but I don't dismiss it out of hand.
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03-22-2010, 06:23 PM	#86
innerSpaceman Kink of Swank Join Date: Jan 2005 Location: Inner Space Posts: 13,075	Also, Morrigoon - according to the stuff I've seen - the prohibition on co-pays applies only to check-ups and other preventative care. So the Doc will have to bill it as preventative, otherwise co-pay you pay. The hypochondric-disincentive remains!
	Submit to Quotes

03-22-2010, 06:33 PM	#87
innerSpaceman Kink of Swank Join Date: Jan 2005 Location: Inner Space Posts: 13,075	And it seems to me the mandate to buy private insurance is thankfully toothless, because I object to it, too - and would expect it to be overturned on constitutional grounds. But the fines for not buying it are pretty minimal (especially in comparison with the costs of the insurance otherwise have to buy). I can't see them being any big incentive to comply, and it's not expected that enforcement will be robust in any event.
	Submit to Quotes

03-22-2010, 06:46 PM	#88
BarTopDancer Prepping... Join Date: Jan 2005 Location: Here, there, everywhere Posts: 11,405	Is the 10% on tanning salons on top of the 8.75% tax? If the new tax will be 18.75%, it's only $2-$3 for the average package. It's certainly not going to deter anyone. __________________ Spork is the new MacGyver Postcards From My Edge
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03-22-2010, 07:10 PM	#89
Bornieo: Fully Loaded Lego Join Date: Jan 2005 Location: Disneyland, USA Posts: 3,704	Oh, no wonder there are that many new posts.... As one without health care - I'd like some. Thank you very much...
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03-22-2010, 07:19 PM	#90
innerSpaceman Kink of Swank Join Date: Jan 2005 Location: Inner Space Posts: 13,075	yeah, i think this thread doubled the LoT post count for the last fortnight.
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