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This is the archive for March 2010

Tuesday, March 23, 2010

Schedule of benefits, Maddow version:

Rachel Maddow Show, March 22, 2010, "GOP seeks to take health care away from Americans," includes interview with Representative Barney Frank

The item Rachel Maddow points out from the health legislation I find striking is that the companies are only required to use 80% of our mandatory premiums for actual medical expenses. That's awful! Medicare, by contrast, averages about 96% payout on actual medical expenses. Yet Rachel presents it as some sort of benefit.

In the last post, I call this "loony time." And it is. There is an unnatural spasm of celebration on the pro-Democrat side, for a bill that at best has minor, compromised insurance reforms. Meanwhile the opposition is reduced to political threats mostly unrelated to the bill except occasionally focused on the bill's cost, not to mention bigoted wingnut protesters hurling epithets at gay and black members of Congress. Oy.

My take on the bill is aligned with the pro-single-payer doctors:

Pro-single-payer doctors: Health bill leaves 23 million uninsured
A false promise of reform
For Immediate Release
March 22, 2010 ...

Instead of eliminating the root of the problem - the profit-driven, private health insurance industry - this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:
  • About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
  • Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
  • Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.
  • The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
  • People with employer-based coverage will be locked into their plan's limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
  • Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
  • The much-vaunted insurance regulations - e.g. ending denials on the basis of pre-existing conditions - are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
  • Women's reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn't have to be like this. ...
No it didn't. But the opposition to the actual provisions of the bill (as opposed to that of Republican / wingnut lying looniness) is pretty close to zero outside the single-payer community. Rachel Maddow missed that the companies will be "covering an average of only 70 percent" of medical expenses for those with insurance! To me that does not look like a formula to eliminate medical bankruptcy.

I suppose now the senate bill is law, and "fixes" probably will pass the senate and also become law. I won't join the crazy Republican "repeal" movement. But it sure does look to me like real health reform is now off the table for at least another twenty years.

Sunday, March 21, 2010

The health bill neither is the "Armageddon" that the Republicans claim, nor the greatest social legislation since Civil Rights and Medicare in the 1960s. Rather, it's a warmed over version of Republican Bob Dole's individual private insurance mandate proposal from 1994. It is what Barack Obama campaigned against versus Hillary Clinton and later John McCain in 2008. But you know, that's all ancient history for the Democrats now.

Will it "cover" the uninsured millions and prevent anyone from ever again having to declare bankruptcy due to health costs? Or will millions who for one reason or another can't/won't pay the premiums (that will still be exorbitant) remain uncovered? Meanwhile will insurance companies enjoy not having to pay out on 40% of the health costs the bill says can be charged out-of-pocket as the taxpayer dumps in trillions in subsidies?

Oy. This legislation does say that insurance must be issued to everyone who pays. I guess that's progress. It might cut back on insurance company cherry picking, if they can't find a way around. After all, the potentially significant pieces of the legislation will not even begin to take effect until 2013!

So those who predict the end of time, as well as those who hail the second coming of Doctor King sorely will be disappointed. By the time fall midterm elections roll around, today's spasms of looniness will have receded in the collective memory.

Related posts:
Family of Sandhill Cranes
Sandhill Crane family in the back yard

Gator country
Gator on the fountain head

Stump Pass Beach
Old mangroves at Stump Pass Beach on the Gulf coast

We had a great trip to Florida last week. Despite all the built-up sprawl, the natural areas and bird life really impressed me.