Single Payer Suitors

[Fly Rod]

telling the American people that they will still have a choice between public health care or a private insurer. This is very true, this is what they want the naive and gullible people to believe, but, their goal is eventually to have a single payer system over the next 10-15 years as the private insurers will have to go out of business. If this bill is passed private employers will make there employees go on the government plan. No employer in his right mind would keep shelling out big monies for health care.

[JohnnyD]

Why exactly will they have to go out of business?

Under the current proposal, the national plan is much more likely to go out of business because the private companies will be able to cut out even more people and accept only healthy 20-30 somethings. Where as the national plan will be paying for all the high-cost people since there won't be an exclusion for pre-existing conditions.

[detbuch]

Originally Posted by JohnnyD

Why exactly will they have to go out of business?

Under the current proposal, the national plan is much more likely to go out of business because the private companies will be able to cut out even more people and accept only healthy 20-30 somethings. Where as the national plan will be paying for all the high-cost people since there won't be an exclusion for pre-existing conditions.

When employers sponsor private insurance, they usually pay a portion of the premiums. If they have the option of offering the national plan, they save that portion. If you were the employer, would you offer expensive private plans or a "free national plan"? It is assumed that the vast majority, if not all, employers will opt for the national plan. Any remaining holdouts might well be forced by competitive costs to eventually do so as well.

As for the Government going out of business, it has been operating on deficits and will continue to do so as long as it chooses. It doesn't concern itself with the bottom line until voters pull the plug. Once "the people" are under government health care, as is demonstrated in all other socialized medical countries, they are too afraid or too ignorant to abandon it. Not to mention that the alternatives have been squelched.

[JohnnyD]

Originally Posted by detbuch

When employers sponsor private insurance, they usually pay a portion of the premiums. If they have the option of offering the national plan, they save that portion. If you were the employer, would you offer expensive private plans or a "free national plan"? It is assumed that the vast majority, if not all, employers will opt for the national plan. Any remaining holdouts might well be forced by competitive costs to eventually do so as well.

You have now made it quite obvious that you have absolutely no clue what you are talking about. You need to do a little research before discussing this topic any more.

[scottw]

Originally Posted by JohnnyD

Why exactly will they have to go out of business?

Under the current proposal, the national plan is much more likely to go out of business because the private companies will be able to cut out even more people and accept only healthy 20-30 somethings. Where as the national plan will be paying for all the high-cost people since there won't be an exclusion for pre-existing conditions.

sorry Johnny but you whack Det after making comments like this???

ummm...which govt. program/plan has ever gone out of business???

private companies can't arbitrarily "cut out" people, have you ever seen the state to state health insurance regulations???

only healthy 20-30 somethings??? there aren't that many of those if the private companies decide to "only" insure them and many don't bother with health insurance in that age group anyway, those that are insured are likely under company plans and as Det said, companies will be very quick to move the burden/responsibility to the "government option".....

the national plan will simply refuse you treatment...then where do you go?

[JohnnyD]

Originally Posted by scottw

private companies can't arbitrarily "cut out" people, have you ever seen the state to state health insurance regulations???

By cut out, I meant not take new customers. In most states, an insurance company doesn't have to pay for anything related to what they can "prove" as a pre-existing condition. I use "prove" loosely, as they refuse treatment for whatever reason they want and then the customer is force to take them to court.

only healthy 20-30 somethings??? there aren't that many of those if the private companies decide to "only" insure them and many don't bother with health insurance in that age group anyway, those that are insured are likely under company plans and as Det said, companies will be very quick to move the burden/responsibility to the "government option".....

You're correct many don't bother, right now. But they will have to have insurance when this passes. You obviously need to read up on the actual bill as well I see. Companies can't use the government option as a way of not paying for employee health care.

the national plan will simply refuse you treatment...then where do you go?

First, many treatments are frivolous and unnecessary. Second, the current bill does not include anything where the national plan can simply refuse treatment.


Here's the principle issue with your argument.

and as Det said...

Learn the actual facts for yourself. Listening to you guys is like being 12 years old and playing the telephone game, where a person tells you something and then you say the same thing to the person next to you but with one or two words changed.

[fishbones]

You obviously need to read up on the actual bill as well I see. Companies can't use the government option as a way of not paying for employee health care.

JD, I know you don't have much time to do any research, but maybe you should look into the government plan a little yourself. I actually have plenty of time because it's part of my job to be informed on this. The government doesn't want companies to offer private plans.

Sec. 113, Pg. 21-22 of the Health Care (HC) Bill MANDATES a government audit of the books of ALL EMPLOYERS that self-insure in order to “ensure that the law does not provide incentives for small and mid-size employers to self-insure”.
Sec. 313, Pg. 149, Lines 16-23 - ANY employer with payroll $400,000 and above who does not provide public option pays 8% tax on all payroll.
Sec. 313, Pg. 150, Lines 9-13 - Businesses with payroll between $251,000 and $400,000 who do not provide public option pay 2-6% tax on all payroll.[/I]

First, many treatments are frivolous and unnecessary. Second, the current bill does not include anything where the national plan can simply refuse treatment.

[COLOR="black"]You're mostly correct in that treatment cannot be refused, but the government can decide what treatment someone can/will receive in most cases.

Sec. 123, Pg. 30 - THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get.
Sec. 142, Pg. 42 - The Health Choices Commissioner will choose your benefits for you.
Sec. 1145, Pg. 272 - Treatment of certain cancer hospitals: Well, let's just hope no one you know gets cancer.[/COLOR]

Learn the actual facts for yourself. Listening to you guys is like being 12 years old and playing the telephone game, where a person tells you something and then you say the same thing to the person next to you but with one or two words changed.

Before playing intellectual superior and bashing others with your own junior high school insults, you should take some time to actually read the bill yourself. Then you could try to see where they are coming from.

[Swimmer]

LETS PUT THIS IN A PERSEPCTIVE THAT EVERYONE CAN UNDERSTAND..............HAS ANYONE EVER SEEN OR HEARD OF A GOVERNMENT PROGRAM THAT RAN WELL, OR IN A MANNER THAT BENEFITED ANYONE OTHER THAN OUR ELECTED OFFICIALS AND THIER FRIENDS?

[Fly Rod]

Check this out.

www. youtube. com/watch?v=zZ-6ebku3_E

[JohnnyD]

Originally Posted by fishbones

You obviously need to read up on the actual bill as well I see. Companies can't use the government option as a way of not paying for employee health care.

JD, I know you don't have much time to do any research, but maybe you should look into the government plan a little yourself. I actually have plenty of time because it's part of my job to be informed on this. The government doesn't want companies to offer private plans.

Sec. 113, Pg. 21-22 of the Health Care (HC) Bill MANDATES a government audit of the books of ALL EMPLOYERS that self-insure in order to “ensure that the law does not provide incentives for small and mid-size employers to self-insure”.
Sec. 313, Pg. 149, Lines 16-23 - ANY employer with payroll $400,000 and above who does not provide public option pays 8% tax on all payroll.
Sec. 313, Pg. 150, Lines 9-13 - Businesses with payroll between $251,000 and $400,000 who do not provide public option pay 2-6% tax on all payroll.[/I]

First, many treatments are frivolous and unnecessary. Second, the current bill does not include anything where the national plan can simply refuse treatment.

[COLOR="black"]You're mostly correct in that treatment cannot be refused, but the government can decide what treatment someone can/will receive in most cases.

Sec. 123, Pg. 30 - THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get.
Sec. 142, Pg. 42 - The Health Choices Commissioner will choose your benefits for you.
Sec. 1145, Pg. 272 - Treatment of certain cancer hospitals: Well, let's just hope no one you know gets cancer.[/COLOR]

Learn the actual facts for yourself. Listening to you guys is like being 12 years old and playing the telephone game, where a person tells you something and then you say the same thing to the person next to you but with one or two words changed.

Where is this from? As it appears to be an interpretation and not the actual bill.

Because my company will potentially fall within the $250k-400k bracket, I have consulted with a few people that deal directly with health care. Combine those consultations with my own research, and my understanding is that companies that don't offer *any* health care and have a total payroll obligation > $250k will have to pay the additional tax.

Before playing intellectual superior and bashing others with your own junior high school insults, you should take some time to actually read the bill yourself. Then you could try to see where they are coming from.

It goes both ways. At least I'm not underhanded about it. Would it be more acceptable if I put some emoticons in my posts as the people my comment was directed at do when they dish out insults?

[JohnnyD]

Originally Posted by Fly Rod

Check this out.

www. youtube. com/watch?v=zZ-6ebku3_E

Minus the Single-Payer stuff, which I whole-heartedly disagree with, I do agree that our current employer-bases system is failed. A person loses their job and they are now without health care, change jobs and you potentially lose your doctor or some benefits.

There are serious problems with health care in this country and the most concerning part is that this bill addresses very, very few of them.

[Fly Rod]

U R Wrong!

When you are let go from your job you collect unemployment and you could get medical coverage while collecting unemployment.

Unless you were fired from your job.

[fishbones]

Originally Posted by JohnnyD

Where is this from? As it appears to be an interpretation and not the actual bill.

Because my company will potentially fall within the $250k-400k bracket, I have consulted with a few people that deal directly with health care. Combine those consultations with my own research, and my understanding is that companies that don't offer *any* health care and have a total Wage obligation > $250k will have to pay the additional tax.

Johnny, what is listed after the section and page is what I call a "bumper sticker" version of what the bill states. I wanted to spare everyone all the legalise so I didn't c&p the entire section. Yes, it's my wording, but if you read it all it's what the bill states.

The bill is pretty clear that companies who self insure with private insurance are going to be hit with the payroll tax if they choose not to offer Uncle Sam's HC plan. It's utterly ridiculous that the government can strong-arm a small company by taxing them like that.

I know no one really has the time to read the entire plan, but there is some scary stuff in it. I hope that if the govenment HC plan is ever passed that it is nothing like the current proposal.

[scottw]

There are serious problems with health care in this country and the most concerning part is that this bill addresses very, very few of them.[/QUOTE]


you are off message minion...it's "health insurance reform now", 16% of Americans believe we have a healthcare crisis...it's tough to demonize healthcare when most are happy with it so they're going to try to demonize the health insurers...always have to demonize someone to accomplish their goals..pretty sad..., they changed the language a week or so ago because they can't seem to convince Americans that our healthcare sucks, you know...Global Warming isn't working out so change to Global Climate Change..Socialist in the new N-word...just keep making it up as you go along...we have fantastic healthcare in this country, many of the problems in health insurance have been caused by meddling politicians and ambulance chasing lawyers, all of these democrats seem to be both....

the "Stimulus" addresses very little if any of what is wrong with the economy, and that isn't stopping them....

[JohnnyD]

Originally Posted by fishbones

Johnny, what is listed after the section and page is what I call a "bumper sticker" version of what the bill states. I wanted to spare everyone all the legalise so I didn't c&p the entire section. Yes, it's my wording, but if you read it all it's what the bill states.

The bill is pretty clear that companies who self insure with private insurance are going to be hit with the payroll tax if they choose not to offer Uncle Sam's HC plan. It's utterly ridiculous that the government can strong-arm a small company by taxing them like that.

I know no one really has the time to read the entire plan, but there is some scary stuff in it. I hope that if the govenment HC plan is ever passed that it is nothing like the current proposal.

Just had my paralegal review the above referenced sections.

The following is according to him:

SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
"Section 313 deals with Employer contributions to the public plan if the employer does not provide any health coverage, not necessarily the public option."

For people that wish to reference the actual bill:
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

[scottw]

Originally Posted by JohnnyD

Just had my paralegal review the above referenced sections.

The following is according to him:

SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
"Section 313 deals with Employer contributions to the public plan if the employer does not provide any health coverage, not necessarily the public option."

For people that wish to reference the actual bill:
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

sooo, the "public plan" and the "public option" are two diferent things? or are we just changing words to muck things up again?

where may I reference Obamas actual plan? or is that "Obama's option" ?

[fishbones]

Johnny, did you just put a statement from your paralegal in quotes? If your paralegal read the section, it states employers must offer the government plan along with any private plan or be subject to a payroll tax. It's very clear. Section 313 only deals with employers who offer medical plans. And in the case of employees who choose the government plan, the company has to pay the government whatever portion they would have paid to their private insurance company.

[JohnnyD]

Originally Posted by fishbones

Johnny, did you just put a statement from your paralegal in quotes? If your paralegal read the section, it states employers must offer the government plan along with any private plan or be subject to a payroll tax. It's very clear. Section 313 only deals with employers who offer medical plans. And in the case of employees who choose the government plan, the company has to pay the government whatever portion they would have paid to their private insurance company.

Yes and he only read section 313.

I'm picking up what you're putting down now. I need a guy like you to keep track of this crap for me. Having to do it myself, run a business and argue with scottw are too time consuming and details sometimes get overlooks.

Thanks for the heads up FB.

[spence]

Originally Posted by detbuch

When employers sponsor private insurance, they usually pay a portion of the premiums. If they have the option of offering the national plan, they save that portion. If you were the employer, would you offer expensive private plans or a "free national plan"? It is assumed that the vast majority, if not all, employers will opt for the national plan. Any remaining holdouts might well be forced by competitive costs to eventually do so as well.

There would be no "free national plan" as they would pay the 8% tax. The argument, which I believe is a valid argument, is that the cost of coverage under the private plans will increase faster than the government will increase the 8% tax...but the net result would be the same as you have suggested.

So far I'm not that impressed with what the House or Senate has put together. They appear to be adding liabilities without any real reductions in cost. In fact by normalizing the coverage and costs that the plans will have to offer to be considered "qualified" by the State Gateways, they could well drive costs up faster.

That being said, I don't think the major insurance companies are going to be flat lining any time soon. Even under heavy regulation they will be more nimble than any government offered system, and will continue to spend billions to lobby Congress for advantages.

That's not to say the consumer won't suffer.

I'd like to see higher deductibles offered for healthy or younger people, interstate shopping and other elements that will help contain costs.

Obama is getting killed on this issue for one simple reason. His rhetoric and what's coming from the draft legislation don't line up. This is giving the fear mongers free reign to say what ever they want...Same thing happened to Bush over SS.

-spence

[fishbones]

Johnny, I've spent a lot of time looking into this plan and it's pretty freakin' scary. The government plans on accessing participants banking and personal finance records, along with any other personal information (either published or not) that they deem fit to collect. Talk about big brother watching over you.

Oh, and one of my favorite things in the entire document is in section 441. It reads “The tax imposed under this section shall not be treated as tax.” Good, then I won't feel guilty if I don't pay it.

Although I think healthcare needs an overhaul, these are some of the reasons I'm not convinced that the government is the right entity to do it.

[scottw]

Originally Posted by JohnnyD

Yes and he only read section 313.

I'm picking up what you're putting down now. I need a guy like you to keep track of this crap for me. Having to do it myself, run a business and argue with scottw are too time consuming and details sometimes get overlooks.

Thanks for the heads up FB.

come to Newport tonite, we'll go fishing, the water was looking tantalizing this afternoon, we won't mention politics, just catch fish

[JohnnyD]

Originally Posted by fishbones

Johnny, I've spent a lot of time looking into this plan and it's pretty freakin' scary. The government plans on accessing participants banking and personal finance records, along with any other personal information (either published or not) that they deem fit to collect. Talk about big brother watching over you.

Oh, and one of my favorite things in the entire document is in section 441. It reads “The tax imposed under this section shall not be treated as tax.” Good, then I won't feel guilty if I don't pay it.

Although I think healthcare needs an overhaul, these are some of the reasons I'm not convinced that the government is the right entity to do it.

I'm dead on with you sir. Working as an EMT and my girlfriend fishing up her degree to be a PA, I've been intimately involved with the treatment part of health care. The 80/20 rule intimately applies here - 20% of the people take up 80% of the cost.

One item about this "let's get everyone insured" that annoys me: for the bottom 15-20% of the population, the government is paying the bill. They need to determine how to reduce costs on the treatment side of things, determine where costs are exploding and how wait times can be reduced.

One example I have used many times before: CT Health (state medicaid) used to (and possibly still do) require anyone going to the hospital to go by ambulance. I have literally driven someone across the street for a head cold.

Hospitals get used as PCP offices.

[detbuch]

Originally Posted by spence

There would be no "free national plan" as they would pay the 8% tax. The argument, which I believe is a valid argument, is that the cost of coverage under the private plans will increase faster than the government will increase the 8% tax...but the net result would be the same as you have suggested.-spence

Thanks for the civil response. I appreciate that. Although I knew the PLAN was not free (that's why I put it in quotes), I certainly deserved to be slapped down for suggesting it was. I had just begun to read the bill and am finding it to be a heavy plow. I did find your reference to the 8% tax on employers with annual payroll of over $400,00 who choose not to participate, and also a descending 6%, 4%, 2% tax on smaller payrolls of $400,000, $350,00, $300,000, and 0% tax on payrolls of $250,00 or less. Your reference to normalizing costs in order to "qualify" assured me that I correctly interpreted that Insurance companies had to meet standardized specs to be acceptable. Not only is the legaleze thick but you have to read sections of The Employment Retirement Income Security Act of 1974, The American Recovery and Reinvestment Act of 2009, The Public Health Service Act--as in "A qualified health benefits plan may not impose any pre-existing condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act or otherwise impose any limit or condition on coverage under the plan with respect to an individual or dependant based on any health status related factors . . ."--(take note, JohnnyD). I found it a bit jolting to read under the section "Retiree Reserve Trust Fund" this--"There are hereby appropriated to the trust fund, out of any moneys in the treasury not otherwise appropriated, an amount requested by the Secretary as necessary to carry out this section, except that the total of all such amounts requested shall not exceed $10,000,000,000"--nice number! I found reference to a start-up funding for the plan of 2 trillion dollars to be amortized and repayed in 10 years. Does that mean that monies collected by the PLAN will not only pay for medical costs but also repay the start-up fund? I will continue to try to read the thing, but it may take some time to digest. I agree that some of your suggestions would be better, but I fear they are too simple and sensible for politicians to implement. Also, they don't give them power or votes. So far, I am not seeing the need for a competing government plan. The Gov could just ram the PLAN'S regulations on the Ins. Cos. and force those who presently choose not to be insured to get insurance and provide another medicade type of insurance for the remainder of the presently, so called, uninsured. What's the need for a Government plan for the rest of us?

[JohnnyD]

Originally Posted by scottw

come to Newport tonite, we'll go fishing, the water was looking tantalizing this afternoon, we won't mention politics, just catch fish

As tempting as that was, had a long day in the office, long one tomorrow, then taking the grandmother for a consult to have a bit of skin cancer removed from her forehead.

Fortunately, tomorrow finishes off with a drive to Truro and fishing straight through Sunday.

One of these days, I'll actually take you up on those offers. But I'm telling every person I know where I'm going and who with.

[spence]

Originally Posted by detbuch

Your reference to normalizing costs in order to "qualify" assured me that I correctly interpreted that Insurance companies had to meet standardized specs to be acceptable.

Yes, this element in particular I find to be particularly counter-intuitive as it restricts the individual from making choices that might lower their personal burden and hence the liability of the entire system.

The progressives clearly consider 100% coverage and parity between plans to be critical success factors, but as presented to date these goals appear to threaten the entire system.

What needs to happen is before we draft a bill, both sides should hash out a document of common goals so we can at least agree on what improved health care could look like...then argue about how to get there.

I'm very concerned that the GOP is really going to screw this up. The party's only response these days seems to be to rile up the fringe, which isn't going to get them very far. The Dem's will pass a version of their bill anyway.

Republicans should present a simple 5 item list of principals on which to build a solution, good common sense stuff that the average person would agree with, and clearly articulate how these principals can enable a solution to the real issues. With the proper marketing they could force the Dems to rewire the DNA of the proposal.

This would take the debate into the mainstream where Democratic Congress people would feel very threatened in their home districts. Yes, there's some of this happening today, but as this thread clearly demonstrates, there's so much obfuscation and confusion few really know what the hell is even being proposed.

-spence

[justplugit]

Originally Posted by spence

What needs to happen is before we draft a bill, both sides should hash out a document of common goals so we can at least agree on what improved health care could look like...then argue about how to get there.

-spence

You nailed it, Spence.
This is one of the most important domestic issues we will ever face and the most expensive.
It needs the best minds and cooperation from both parties to make this the best possible plan for the uninsured.
Politics need to be put aside, and our representatives need to do whats best
for the American people.

Right now, it's if they can't explain all the facts they try to dazzle us with BS.

[scottw]

Originally Posted by justplugit

make this the best possible plan for the uninsured.

why does the federal government need to come up with a plan for the uninsured? it's established that many of the uninsured can afford health insurance and choose not to purchase it, many are illegal aliens, the actual numbers of involentary uninsure is quite small in comparison to those currently insured and happy with the current system, it has also been well established that this entire debacle/plan is nothing more than a trojan horse sent to put the entire health care system under the control of the federal government, many of the uninsured can be covered by relaxing all of the mandates state to state including allowing high deductible major medical policies which many states restrict or do not allow, I've had one for years...tort reform and loser pay as they have in England...emphasis on individual policies rather than large brokered deals...I refuse to accept the premise that healthcare is broken and the insurance companies are just greedy bastards which is the curent montra from the supporters....this is about creating a massive government entity and with it a direct revenue stream to fund bigger government...you can argue about and study the details but in the end this is simply a question of whether you want more government involvement in your day to day life and to a much larger extent, your children's lives as they will bear the burden of all of this, more government intrusion into your personal life and the decisions that you make and the government demanding more and more from you to pay for all of their intrusion into your life...

[justplugit]

Let me clarify what i mean by the uninsured, Scott.
That would be American CITIZENS who are unable to work because they are truly DISABLED or UNEMPLOYED and seeking work. In order to qualify you would need to prove you are actively seeking employment and submit to random drug testing in order to keep it.
Before considering any plan they should know the actual number of those that fit that category. I have heard #s under the current plan being proposed as many as 47 million and few as 20 million. How can you formulate a plan and it's costs without knowing the actual # ?
I am 100% against the current plan or any other single payer plan.

Work within the programs we already have, the ones that 80% of Americans
are happy with.

[detbuch]

Originally Posted by spence

The progressives clearly consider 100% coverage and parity between plans to be critical success factors, but as presented to date these goals appear to threaten the entire system.

Not only threaten the system, but call into question the need for a Public option to compete with the existing private insurance options. The National or Public Health Insurance will offer the same tier of plans--basic, enhanced, premium, or premium plus, and be under the same regulations and requirements as private insurance. In reading the bill, the Public plan just seems to be an extension of Social Security, Medicare, and Medicaid, and the private plans have to follow suit. The bill could be written, basically as it is, without the inclusion of the Public option. In effect, the private plans will be unpaid private contractors (unfunded mandates) for the Government.

Originally Posted by Spence

I'm very concerned that the GOP is really going to screw this up.

You mean the GOP is going to screw up the MESS?

Originally Posted by Spence

The party's only response these days seems to be to rile up the fringe, which isn't going to get them very far. The Dem's will pass a version of their bill anyway.

The GOP has been responding with their version of reform. I don't think the Party is riling "up the fringe." The rile is more extensive than you think and is only evident in the voice of what you call "the fringe."

Originally Posted by Spence

Republicans should present a simple 5 item list of principals on which to build a solution, good common sense stuff that the average person would agree with, and clearly articulate how these principals can enable a solution to the real issues. With the proper marketing they could force the Dems to rewire the DNA of the proposal.

Sounds simple enough. The Republicans, being so outnumbered, beleaguered, and lacking in political moxie, are probably not the vehicle for such a presentation. Where are the powerful, persuasive, and influential voices of the MAINSTREAM MEDIA when you need them?

Originally Posted by Spence

This would take the debate into the mainstream where Democratic Congress people would feel very threatened in their home districts.-spence

I think the loud riling of the fringe, if it keeps up, may scare those Congress people.

[buckman]

I believe over 50% oppose National Health Care.....Is this the fringe everybody is refering to?

http://www.rasmussenreports.com/publ...lls_to_new_low