House Dems release health care outline

Shirleypal · Post by **Shirleypal** » 06-20-2009 11:29 AM

By: Carrie Budoff Brown
June 19, 2009 01:38 PM EST

House Democrats released the outline of their health care reform bill Friday — a proposal that would create a public insurance option, expand Medicaid and require employers to provide coverage or pay a tax.

The outline did not include details on how Democrats would pay for the plan.

It does provide the first look at how Democrats would structure a public insurance option — an idea favored by many in the party, but one in which the Senate has been struggling to find agreement.

The public option is more liberal than what senators are considering, and it is likely to draw fire from the American Medical Association because of the payment levels. It would pay Medicare rates during the ramp-up phase.

"This tie is severed over time as more flexible payment systems are developed," the outline stated, and physician participation would be voluntary.

The three committee chairmen who drafted the outline unveiled it at an afternoon press conference.

"Today marks a historic moment," said Rep. George Miller (D-Calif.), chairman of the House Committee on Education and Labor.

"We know inside the Beltway turf battles will not advance reform," Miller said. "If there is one thing off the table, it is saying no to health reform."

Rep. Henry Waxman (D-Calif.), the head of the House Energy and Commerce Committee, said the House will meet the president's July deadline.

Waxman said the House wants to close the "donut hole" in the Medicare prescription drug program and find a permanent fix for the Medicare reimbursement formula for physicians, which is a top priority for the AMA. But these proposals could add hundreds of billions to the bottom line.

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The subsidy level for low-income families is higher than the Senate Finance Committee draft, coming in at 400 percent above poverty. Medicaid would be expanded to families and individuals 133 percent above poverty.

There would be an individual mandate, except in cases of hardship, and those who do not buy coverage would pay a penalty based on 2 percent of their income above a certain level.

America’s Health Insurance Plans spokesman Robert Zirkelbach raised concerns about the government-run plan, saying it would “dismantle employer-based coverage, add additional liabilities to the federal budget and turn back the clock on efforts to improve the quality and safety of patient care.”

http://www.politico.com/news/stories/0609/23943.html

Cherry Kelly · Post by **Cherry Kelly** » 06-20-2009 12:53 PM

Requiring employers to provide health care? What about small businesses with under 25 employees? How could they afford some of these high insurance rates? Some States are ridiculously high.

Shirleypal · Post by **Shirleypal** » 06-20-2009 12:57 PM

Cherry the idea here is create competition and as a result lowing health care costs so it's affordable for everyone..

Cherry Kelly · Post by **Cherry Kelly** » 06-22-2009 09:23 AM

To create competitive pricing -- but what would be competitive? We have gov't programs now for people - but those are going broke, so who will pay for this NEW insurance?
WalMart set an example by going to $4 drug prescriptions for a lot of common type prescriptions and lower prices on many others. They were quickly followed by WalGreens, Target and other pharmacy related places. That helped a LOT of people.
Some States tried to force insurance companies to go to insurance savings type programs - where if you didn't use monthly payment for med insurance a portion was put into a savings program. But that was dependent upon home of these companies to be in the State - so didn't work as home offices just moved to nearby states and just kept satellite offices available.
We do not need another gov't control medical program. What we need are reforms with what we have for people. Now some might ask why -- but all you have to do is take a look at what the gov't has now and realize SOMEONE is going to have to pay for these gov't programs - ask yourself how and the answer is simple. TAXES.

Kaztronic · Post by **Kaztronic** » 06-23-2009 09:56 PM

Amidst all of the debate about Democratic plans, VS. Republican plans and whether or not bi-partisan support is needed for healthcare reform or not, a little known plan/strategy has sort of slipped under the radar - created by former Democrat and Republican Senate leaders; Tom Daschle, Bob Dole, and Howard Baker.

Two links below, first to an article about the plan, second to a .pdf of the plan itself for anyone interested in reading further.

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The Democratic-led Congress maintains it is working to create a health care reform package that can win Republican support, but if the bill is to be truly bipartisan, it should get in the range of 20 Republican votes, former Senate Majority Leaders Tom Daschle (a Democrat) and Bob Dole (a Republican) said Wednesday.

Along with former Republican Sen. Howard Baker, another former Senate Majority Leader, Daschle and Dole have created a set of recommendations for achieving bipartisan health care solutions. Speaking to CBS News political consultant John Dickerson on CBSNews.com's politics Web show "Washington Unplugged," the two men shared their idea of "bipartisanship."

"I'd like to have 20 Republicans" in the Senate vote on the health care reform package, Dole said.

Daschle concurred. "It has to be something where you have a double-digit number of Republicans and Democrats," he said.

The two men explained how they compromised on hot-button issues like a mandate for all Americans to have insurance and a government-sponsored, plan (or "public option"), to produce their report for the Bipartisan Policy Center.

"On the mandate, it was not an easy thing for me to give on," Dole said. "When we started, we decided we weren't going to let two or three things kill our effort."

Daschle and Dole are two founders of the Bipartisan Policy Center, which has made health care its signature issue. The center's report, which the founders intend to discuss with Congress, takes a broad approach to addressing health care challenges like delivery, cost, coverage and financing -- in a manner that is politically palatable for both the left and the right. The policy center spent a year and a half conducting research, analysis, public policy forums and targeted meetings and workshops with health care experts to come up with their approach.

"We've offered some solutions that may offer ways in which to compromise on some of the tough issues," Daschle said.

The report does not recommend a public plan, a sticking point for many Democrats.

"We compromised on that substantially," said Daschle, President Obama's first nominee for the position of Secretary of Health and Human Services. Daschle withdrew his nomination in February amid tax problems.

The report does recommend creating state or regional health insurance exchanges, and implementing a federal fallback if the exchanges are not set up in a timely manner. It also suggests an individual mandate and other solutions like limiting out-of-pocket premiums and investments in comparative effectiveness research.

CBS News

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Bipartisan Policy Center

ibme · Post by **ibme** » 06-23-2009 10:43 PM

"bipartisanship."

That means both sides sold us out.

Post by **Linnea** » 06-24-2009 03:30 AM

Got to page 42 of 68 in the Bipartisan Policy Center PDF. It's a hard slog reading it too. The language used in it is coded for certain meanings which you need to make a real effort to understand.

Tried to keep an open mind, as Baker and Dole have a strong connection to policies which favor business and dis-favor government and public programs, and tax dollars to support public programs. Also, Dashle had been aligned with the private health care industry.

At page 42, took a break, and it became apparent to me this plan is primarily a plan to oversee and ration health care delivery via Medicare and Medicaid with concerns as 'cost' and 'value' taking precedence (managed care), and addressing the rising costs of expenditures in this area -and without specifically understanding or stating the role of private health insurers in increasing costs driven by the goals of preserving profit margins.

The centralization of electronic health information records is also presented as a means of 'containing costs' in Medicare and Medicaid. It is styled as promoting 'personal responsiblity' and imposing penalities on those who would not comply with 'managed, co-ordinated' health care plans.

There does need to be improvement in these areas, but the tone here is on rationing care and mandating treatment plans, including limiting coverage for hospital care - and ensuring 'end of life' plans are signed on to and entered into the electronic info systems - so 'pallative care', rather than expensive tests and procedures are phased in for the 'chronically ill'. If you are poor and elderly - there is a 'dual eligible' designation, and you get an even more 'managed' level of care.

There is also a discussion of state and regional plans for providing affordable health insurance for those who earn up to 400% of poverty level - a kind of patchwork proposal, which again does not address adequately, imo, these concerns regarding the uninsured.

This plan does not address issues of the impact on costs to the health care system in this country, or lack of quality care - caused by the profit driven system of private health care insurers. Do not think there will be any real progress in addressing health care in this country without this issue being examined, and this policy plan does not provide any information or remedy regarding 'for profit' health care insurance.

Has anyone else read the Bipartisan Policy Center plan? Have any comment on it?

Cherry Kelly · Post by **Cherry Kelly** » 06-24-2009 10:14 AM

Linnea -- kinda what I got from reading -- managing who will and will not receive care and what care...

sounds to me like - oh you are old - byebye; or you have bad genetic problems (no matter age) so we aren't going to bother with you -too expensive - byebye. You smoke, drink, are overweight - well we will think about maybe providing something for you.

Fining any dr/hospital/etc who doesn't digitize (put all files on computers) -- so they can be accessed anywhere.

And what about old fashion x-rays - how will they digitize those? Do these "idiots" in DC have any idea how expensive the equipment is? Oh ya and what happens when there are power outages? Or major disasters where drs and hospitals are not going to have the TIME to access some computer and must tend patients immediately?

Post by **Linnea** » 06-24-2009 02:12 PM

Yep, Cherry. This plan makes me shudder and envision some post-apocalyptic nightmare.

I think the best health care plan would provide for federal subsidy and oversight of local/state health insurance pools to reach and provide health insurance for everyone who currently falls through the cracks. Costs could be offset through having sliding scale fees, but everyone pays something. This could include continuing insurance for those who have lost health insurance coverage from employers - a sort of bridge like current COBRA plans, but less expensive.

If there became a 'habit' of coverage for everyone - great strides could be made in health education and preventive care and wellness. Costs of health care would balance out over time. Burdens could be eased on small business owners, and they could make contributions to this state insurance pool - rather than deal with the expense and paperwork of providing coverage to individuals in the private, for-profit market.

Plans as these could be implemented and studied. It is unfortunate politicians and lobbyists dominate discussion of these issues, and there is this feeling of 'now or never'. In this sort of atmosphere, we will probably get a plan that is very flawed at many different levels.

Cherry Kelly · Post by **Cherry Kelly** » 06-24-2009 02:42 PM

Linnea - indeed

one of our local talk guys - KC - said - ahh if the politicians think its sooo good - let them try it out for a year first....

As you know both hubby and I are self-employed and pay all our own insurance - but mostly its major med with high deductible... We do have decent coverage - but for most part - no major health problems. Unfortunately we are getting older and everyone says - as you get older - health gets worse. I'd just like to see dental added (no extra costs) - even if its only co-pay thing. Ours recently added co-pay for eye-care stuff.

So how about all the nurses and drs getting gov't loans - have to put in X hours of work - free clinics or 24/7 type clinics - and get loans reduced?? Might help a lot of people.

Cynthia Lynn · Post by **Cynthia Lynn** » 06-24-2009 03:01 PM

I personally believe that Health Care ought to be a Human Right.

Why must a profit-making corporation stand between a patient and a physician?

It's insanity.

Shirleypal · Post by **Shirleypal** » 06-24-2009 03:09 PM

Cynthia Lynn wrote: I personally believe that Health Care ought to be a Human Right.

Why must a profit-making corporation stand between a patient and a physician?

It's insanity.

You have that right Cynthia, it is treated that way in most European countries and they have excellent health, these anti-healthcare people in this country will tell you differently but that is a lie..'

.

As you know both hubby and I are self-employed and pay all our own insurance - but mostly its major med with high deductible... We do have decent coverage

What deductible is high enough Cherry, and what happens if you get sick and your Ins. company denies your claim, am curious also what your monthly premium is..

Cynthia Lynn · Post by **Cynthia Lynn** » 06-24-2009 03:25 PM

Shirleypal wrote: You have that right Cynthia, it is treated that way in most European countries and they have excellent health, these anti-healthcare people in this country will tell you differently but that is a lie..'

Yes, I've lived in other countries that provided Health Care, and I agree.

Shirleypal · Post by **Shirleypal** » 06-24-2009 03:47 PM

What is always interesting is the opposition always use examples where they are problems, a good example of this (sorry off-topic) is no fault auto insurance, California used an example of a state where it was a nightmare, they wouldn't dare use Michigan where we have had no fault for years and it works great..included in our no fault is a law on frivolous law suits which make lawyers responsible if they are filed, those Ca. lawyers didn't like that, California leads the nation in frivolous lawsuits which ties up the courts and wastes major tax payer dollars.

Cherry Kelly · Post by **Cherry Kelly** » 06-25-2009 09:27 AM

Shirleypal -- I will not post what we pay per month as that is personal information which I do not feel should ever be posted on an open forum.

Our policy is pretty standard 80/20% with about 2K$ deduction. As most people know the amount of deduction raises or lowers your monthly premiums - higher your deduction, less you pay per month.

what serious illness are you asking about? The insurance companies outline what they cover, so you need to be more specific.

==
My major opposition is the 'control group' who will decide who is to be covered and how far - gov't proposal.

As noted - let those gov't employees go on this program for a year or two before they attempt to foist it upon the public.