Socialism - Round One

Senate bill fines people refusing health coverage______________...   By RICARDO ALONSO-ZALDIVAR, Associated Press Writer Ricardo Alonso-zaldivar, Associated Press Writer – Thu Jul 2, 7:03 pm ET__...   WASHINGTON – Americans who refuse to buy affordable medical coverage could be hit with fines of more than $1,000 under a health care overhaul bill unveiled Thursday by key Senate Democrats looking to fulfill President Barack Obama's top domestic priority.

The Congressional Budget Office estimated the fines will raise around $36 billion over 10 years. Senate aides said the penalties would be modeled on the approach taken by Massachusetts, which now imposes a fine of about $1,000 a year on individuals who refuse to get coverage. Under the federal legislation, families would pay higher penalties than individuals.

In a revamped health care system envisioned by lawmakers, people would be required to carry health insurance just like motorists must get auto coverage now. The government would provide subsidies for the poor and many middle-class families, but those who still refuse to sign up would face penalties.

Called "shared responsibility payments," the fines would be set at least half the cost of basic medical coverage, according to the legislation.

In 2008, employer-provided coverage averaged $12,680 a year for a family plan, and $4,704 for individual coverage, according to the Kaiser Family Foundation's annual survey. Senate aides, who spoke on condition of anonymity because they were not authorized to speak publicly, said the cost of the federal plan would be lower but declined to provide specifics.

The legislation would exempt certain hardship cases from fines. The fines would be collected through the income tax system.

The new proposals were released as Congress neared the end of a weeklong July 4 break, with lawmakers expected to quickly take up health care legislation when they return to Washington. With deepening divisions along partisan and ideological lines, the complex legislation faces an uncertain future.

Obama wants a bill this year that would provide coverage to the nearly 50 million Americans who lack it and reduce medical costs.

In a statement, Obama welcomed the legislation, saying it "reflects many of the principles I've laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."

The Senate Health Education, Labor and Pensions bill also calls for a government-run insurance option to compete with private plans as well as a $750-per-worker annual fee on larger companies that do not offer coverage to employees.

Sens. Edward M. Kennedy, D-Mass., and Christopher Dodd, D-Conn., said in a letter to colleagues that their revised plan would cost dramatically less than an earlier, incomplete proposal, and help show the way toward coverage for 97 percent of all Americans.

In a conference call with reporters, Dodd said the revised bill had brought "historic reform of health care" closer. He said the bill's public option will bring coverage and benefit decisions driven "not by what generates the biggest profits, but by what works best for American families."

The two senators said the Congressional Budget Office put the cost of the proposal at $611.4 billion over 10 years, down from $1 trillion two weeks ago.

However, the total cost of legislation will rise considerably once provisions are added to subsidize health insurance for the poor through Medicaid. Those additions, needed to ensure coverage for nearly all U.S. residents, are being handled by a separate panel, the Senate Finance Committee. Bipartisan talks on the Finance panel aim to hold the overall price tag to $1 trillion.

The Health Committee could complete its portion of the bill as soon as next week, and the presence of a government health insurance option virtually assures a party-line vote.

In the Senate, the Finance Committee version of the bill is unlikely to include a government-run insurance option. Bipartisan negotiations are centered on a proposal for a nonprofit insurance cooperative as a competitor to private companies.

Three committees are collaborating in the House on legislation expected to come to a vote by the end of July. That measure is certain to include a government-run insurance option.

At their heart, all the bills would require insurance companies to sell coverage to any applicant, without charging higher premiums for pre-existing medical conditions. The poor and some middle-class families would qualify for government subsidies to help with the cost of coverage. The government's costs would be covered by a combination of higher taxes and cuts in projected Medicare and Medicaid spending.     ______________________...   I can't imagine this getting passed given that last paragraph. The insurance industry won't stand for giving up underwriting surcharges. The middle class won't stand for tax increases to subsidize the poor. And senior citizens won't stand for cuts in Medicare.

It's wonderful to see the government regulating insurance.

I know someone on Government insurance in Illinois and they took their child to the doctor - it took about 2 months to get an appoitment.

Their child also needed glasses and they went to the eye doctor to get the exam. Then when they went to pick out the glasses they said we don't offer those here. they had to drive about 40 minutes to get to a place that did offer glassed under this program and it will take about 2 months to get the glasses.

The government is so wonderful - can they please regulate more and more items for us?

Speaking to you from MA:

The report on how the MA system works is not really accurate. No one gets fined. Rather, they lose out on tax credits.

 

Hi All, 

Just checking in. It's fine to discuss this, but please recognize that not everyone shares your views and keep the conversation level-headed.

Thanks, Kris

The wait time and the driving time will get longer and farther if this government plan gets passed.  This will be because of the sheer numbers of physicians and health care providers that will either 1) leave medicine all together or 2) not participate in this government forced health care plan. If you think it won't happen guess again.  Physicians are already silently planning it.  Some publicly.

While the masses howl about "covering everyone" and how to pay for it what no one stops to realize is that even with Medicare and all the different versions of Medicaid TODAY, you CANNOT force providers to ACCEPT it.  So what is the big governmental plan when providers stop practicing or don't accept the new plan?  When the huddled masses who don't have transportation to drive 150-300 miles to the nearest provider who now has a practice that can't accept anymore patients because they are at capacity.  What then? 

It will still be a free market system.  You call the local specialist and say you need an appointment because you have XYZ problem.  The first question the person on the phone asks is:  "what type of insurance do you have?"  You respond "oh, I have the government card."  He/she immediately says "we don't participate in that program.  Sorry."  They are also not required to know who does either. 

It is already that way.  Anyone who has ever used health insurance knows the first thing you do is check and see if a physician is on that plan.  Not every physician participates in every plan.  Some doctors who are partners in some practices aren't even all on the same plans. 

So Washington can sit there and plan to push the country deeper into debt coming up with a health care plan but it isn't going to cover anyone any better.

ClydesMom:

This will be because of the sheer numbers of physicians and health care providers that will either 1) leave medicine all together or 2) not participate in this government forced health care plan. If you think it won't happen guess again. Physicians are already silently planning it. Some publicly.

I dare say such comments as this are overblown. There is not likely to be some mass exodus out of medicine as a result one of these healthcare bills passing. Some may leave, it is true. But the numbers are not likely to be vast. There are flaws, certainly, with each of the proposals now on the table, but we ought not to react as if the entire medical system will collapse if the reform goes though because that's terribly realistic. After all, Medicare and Medicaid did not have that effect, and quite a few medical practices do take those plans. There isn't any reason to believe that this plan would be so much different in that regard.

The "government option" is a government insurance company to compete with the private insurers. If, as you suggest, large numbers of providers simply won't accept the government insurance plans, then as you noted, the public won't buy it because they won't see any providers they can use. In that case, the government option would be a failure and we'd be left, as we are now, with private insurance providing most coverage, albeit under new rules. That's not to say I favor having the government option in the bill; I don't. But for other reasons, which I won't go into here.

ClydesMom:

So Washington can sit there and plan to push the country deeper into debt coming up with a health care plan but it isn't going to cover anyone any better.

For those that are uninsured now, the reform very likely would cover them better and improve their care. Done right, that can be accomplished without degrading care for all those already covered by decent health insurance. The biggest problem (though not the only one) that I have with the various reform proposals on the table is that they do add considerably to the already huge national debt that we have. That's simply a recipie for doing severe economic damage down the road.

The president has been less than forthright about the likely need to raise taxes in order to accomplish any of the plans currently under discussion. The reason, of course, is that he made a "no tax increase" pledge, much like the first President Bush did back in the 1988 election. And President Obama well remembers the defeat President Bush suffered to President Clinton in the next election in 1992 — and he fears the same may happen to him in 2012 should he break his tax pledge.

 

I'm thinking of a relative, who has a degenerative disc disease and is now on SSDI in her 30s.

Her deductible under Medical (CA's version of Medicare) is over $900 per month - more than 1/2 her income.  Because of the number and cost of medicines her doctor has her on, most months she spends that.

That is a ridiculous amount for someone unable to work and on a limited income.  I also have a family member who spends more than 1/2 of his income to cover just the monthly premium on the insurance his employer offers.  Of course, they don't have their son on the insurance - that would be another $400 per month! 

Things can't go on the way they are now.  I can't say any of the plans I've read about are great, but something's gotta give for the working poor.

Personally I feel that any plan that get created should include every member of the federal Government as their first participants. That includes every member of the Congress, Senate, Supreme Court, White House Staff member and the President of the USA.

If the plan is drafted well enough then they can migrate everyone from Medicade, Medicare and every other government health care program and finally add everyone else who is not covered by health care insurance.

I think that one of the greatest fears is that the government will impose fines for not having health care that are so low that companies will find out that it is cheaper to pay the fine so they can drop their health care coverage. I know that health care is not required but wen most people look for jobs they look for this benefit.

Once companies start dropping their health care coverage and people are forced to take the government option what will happen to the current insurance companies that are out there?

I know that all of this will not happen over night and may never happen but the future is impossible to predict and the government has a hard time controlling costs. Corruption seems to infilturate these agencies while the people who rely on the service seem to get shoved aside and costs seem to grow faster than should be expected.

I know someone who is on a government health care plan and they had to go to two different places to get an eye exam and purchase glasses for their child. They were told that it would be more than two months before they would get the glasses. if they have to see a doctor then it is another two months before they can get an appoitment or they have to go to the emergency room.

Something has to be done but my wish would be to have the Congress and Senate take their time and work on a plan that will benefit us instead of rushing something through because the great god Obama wants it done now. He has his tripple titanium card in his hand at 5000% interest with no spending limit and he seems to want to spend spend spend.

Our national debt is out of control and we need to get spending under control. Personally when I don't have the money to purchase something I save up and buy it later. If our governemt took that approach we woudl be in better shape.

I am for a hybrid social medicine system. Create a social medicine system in which all US citizens/taxpayers are eligible with the option to opt out and pay for private insurance/services. Do away with mandatory referrals and cap fees to a national average of usual and customary charges. All eligible users are charged a co-pay. Fund the program by taxing tobacco, alcohol, cell phones, fast food, ect...all vices that lead to illness and injury.

Those not interested can pay as you go.

The number of folks who are truly uninsured or uncovered are not anywhere near as large as fear mongers would have us believe.

 

(Sure there are some folks who do have serious problems getting care--matched perhaps in numbers  by the folks who are experts at ripping off the system and a whole industry of coding medical services so as to max up the $$  recovery for an otherwise basic proceedure)

1. Many millions are folks who are here illegally in first place. Some whose own countries won't even take them back! And we sort of refuse to really push to send the rest back anyway!

1.1 And thousands who entered legally with sponsors but who never really were sponsored as intended but very quickly signed up for various social services

2. Several more millions are relatively healthy young adults who in thier private opinion feel it is cheaper to take the risks and pay as you go than to subscrive to relatively expensive plans they are entitled to otherwise participate in.Or simply place other issues ahead with more priority.

3. And a few are folks who cross the border for the express  purposes of securing better medical care--with no intention or ability of paying for it!

Drew:

2. Several more millions are relatively healthy young adults who in thier private opinion feel it is cheaper to take the risks and pay as you go than to subscrive to relatively expensive plans they are entitled to otherwise participate in.Or simply place other issues ahead with more priority.

Back when I was going to college I was one of these people - I did not have insurance for about 10 years and did not go to the doctor.

Now that I have insurance I still very very very rarely go to the doctor. I never meet the family deductible for my health insurance plan.

One of the reasons it takes so long is that few doctors participate and the demand is very high.

My own dentist, who does see children on Medical (but not adults), says that she is not reimbursed even the cost of treating these children.  The wait for an appointment for a child on Medical is @ two months.

I am fortunate enough to have excellent medical/dental coverage:  I pay nothing towards the premium, pay nothing for doctor visits, x-rays, hospital stays, etc, and $5 per prescription.  I pay nothing for dental checkups; and as long as I have regular checkups, I pay nothing for needed treatment.  I get free glasses or contacts every year.

But for those whose employers don't offer coverage, or whose coverage is costly, or who earn too much to qualify for government assistance but not enough to afford coverage, something's gotta give.  No one should have to choose between food on the table and a doctor's appointment - and those who don't believe that happens are out of touch.

I had a medical emergency while I was in a foreign country with a national health insurance plan. I was seen in the ER immediately, then admitted into the hospital that night. I had an operation the next morning.

My medical care in that country was excellent. I have nothing but praise for the doctors, nurses and other staff who treated me. I walked out perfectly fine. Since I was not a citizen of that country, I was billed the same as what they would have billed their national health insurance.

The cost for my treatment was a fraction as it would have been in the United States. My doctor was amazed when I showed him the bottom line of the medical bills. I paid, total, about $800. My US doctor told me a similar hospitalization in the US would have been about $5000.

I have been told by British people that had I had the same medical emergency in the UK my medical care would have been free of charge, even though I would have been a visitor from the US.