Hooray for America...

[Pine Barrens Mafia]

We've got our nanny-state healthcare. You people who voted for these fools in the Congress and the White House out of anger for GW Bush...you can hold your heads high knowing you personally have caused this abortion. That's right, you twits. It's YOUR responsibility. Enjoy the burden of that responsibility.

[IDBillzFan]

We've got our nanny-state healthcare. You people who voted for these fools in the Congress and the White House out of anger for GW Bush...you can hold your heads high knowing you personally have caused this abortion. That's right, you twits. It's YOUR responsibility. Enjoy the burden of that responsibility.

We're going to ALL be carrying this burden for years and years to come. At least we'll have the entertainment of watching Pelosi and Reid put these together.

 

Or maybe not. Everything else has been done in secret. We're not likely to watch that happen either.

 

The good news is, they're wrecking the house so much, it'll be a gzillion years before the libs ever get all the keys again.

[Gene Frenkle]

We're going to ALL be carrying this burden for years and years to come. At least we'll have the entertainment of watching Pelosi and Reid put these together.

 

Or maybe not. Everything else has been done in secret. We're not likely to watch that happen either.

 

The good news is, they're wrecking the house so much, it'll be a gzillion years before the libs ever get all the keys again.

Yes, because "The Revolution" is coming.

[IDBillzFan]

Yes, because "The Revolution" is coming.

No. Because they're incompetent beyond anything we've ever seen.

 

But keep laughing, Gene. As loud as you can.

[Gene Frenkle]

Because they're incompetent beyond anything we've ever seen.

Now that's funny!

[Adam]

No. Because they're incompetent beyond anything we've ever seen.

 

But keep laughing, Gene. As loud as you can.

When was the last time we saw competence? Abraham Lincoln, maybe? And America couldn't even handle his greatness, as we know how that worked out.

 

As I have said ad nauseum, government involvement in health care makes more sense than in social security- which may be one of the few things Bush was right about. Privatize social security, with some regulation to make sure that the cookie jar isn't run off with and have medicare eliminated- then maybe we could have had healthcare taken care of.

 

To be honest, I don't expect this to change to many things, as we ALREADY were paying for those without health care- ever notice how those without healthcare that were on the lower end of the pay scale were being taken care of- without financially ruining them? I know several people who received treatment for illness and broken bones, where the hospital "Took care of the bill for them"

[The Big Cat]

From this morning's Democracy Now:

 

AMY GOODMAN: The $871 billion Senate bill must now be reconciled with the House bill once Congress goes back into session. Democrats are hoping to be able to present a bill to President Obama to sign before his State of the Union address in late January or early February.

 

Well, Trudy Lieberman is the contributing editor to the Columbia Journalism Review. She blogs on healthcare at cjr.org and joins us here in our firehouse studio.

 

Welcome to Democracy Now!

 

TRUDY LIEBERMAN: Thank you.

 

AMY GOODMAN: Can you explain, what does this bill do and what doesn’t it do?

 

TRUDY LIEBERMAN: There’s a lot of confusion among the public about how they’re going to be helped or hurt by the bill.

 

Very simply, people who have insurance right now are probably not going to see very much change from the bill. In fact, what they are going to see, as the years go on, are probably increasing premiums, and a lot more of the cost is going to be shoved onto them through high-deductible plans and co-payments and co-insurance that are probably quite high. So they’re not going to see a lot.

 

The people who will see some benefit from this bill are those who are uninsured right now. Some 47 million people are uninsured. This bill does not cover all of those 47 million people, including immigrants who are here illegally. What it will do is cover some portion of the uninsured, and that is still to be worked out between the House and the Senate, by giving them subsidies, paid for by taxpayers, to buy health insurance in the open market. And they will be able to do that through this gigantic shopping service, brokerage service, if you will, called the exchange, where a variety of policies will be offered.

 

There are so many questions, however, about the affordability for people who will get the subsidies, because there will always be somebody over the line who will not qualify for a subsidy and will have to buy insurance on their own, because there will be an individual mandate. And the mandate means that people who do not have coverage from an employer or through Medicare or Medicaid have to buy coverage from a private insurance company.

 

JUAN GONZALEZ: And the penalty for not buying the insurance in the Senate version? And also, if you could talk a little bit about—wasn’t—the mandate issue was one of the big debating points between Barack Obama and Hillary Clinton in the Democratic—

 

TRUDY LIEBERMAN: Right.

 

JUAN GONZALEZ: —in the Democratic presidential primaries, with Obama opposing a mandate.

 

TRUDY LIEBERMAN: Right. During the campaign, Hillary Clinton supported the individual mandate for everyone, and the President supported a mandate only for kids. He says we have to require coverage of kids, but not everybody else. So, obviously, somewhere along the line, the administration changed their position on this.

 

And so, you ask about the penalties. The penalties are not very steep. And the members of Congress knew that if they made those penalties too high, they would have a revolt on their hands. On the other hand, they’re not high enough, in some people’s view—surely the insurance companies’ view—to bring people into the risk pool to spread the risk. At its maximum, the penalty will be $750 several years from now. It starts out at about $95 and then grades up. The House penalties are somewhat different. So it will be very interesting to see what happens, whether people will just take the penalty, which is not very much, or do they buy an insurance policy which could cost them $15,000 a year for a family policy by then.

 

JUAN GONZALEZ: One of the—in terms of how the bill would affect the majority of the population, one of the things that you’ve written about that, I haven’t seen anywhere else, is this whole issue of how premiums will be affected by wellness programs and how insurance companies will use that to penalize certain employees. Could you talk about that?

 

TRUDY LIEBERMAN: Yeah, that can happen. What’s written into the bill are incentives to encourage better health behavior, better cholesterol levels, lower body mass index, and so forth. So what’s going to happen is an employer can set certain targets, that you have to have a BMI, say, below twenty-six or twenty-five, whatever they decide, cholesterol will be lower than—

 

AMY GOODMAN: BMI being body mass index?

 

TRUDY LIEBERMAN: Body mass index—cholesterol levels below x amount. And employees will have to check in, weigh in every year, so to speak, and those that don’t meet the targets very well may be penalized, in terms of the price of insurance. We see employers also—

 

JUAN GONZALEZ: And the individual employer would set this?

 

TRUDY LIEBERMAN: Exactly.

 

JUAN GONZALEZ: So you’re going to have a whole industry of consultants just to get the employers—

 

TRUDY LIEBERMAN: Right.

 

JUAN GONZALEZ: —to figure out the best way to determine how their employees will meet the criteria.

 

TRUDY LIEBERMAN: Right now, the employers can have a 20 percent differential in premiums between so-called healthy employees and unhealthy employees. That can go up to 30 percent in the bill, under the Senate bill, and up to 50 percent down the road, if the Secretary of HHS and other administration officials decide that’s what’s necessary.

 

The employers want the flexibility to penalize, if you will, or reward, depending on what side of the fence you’re on, healthy workers versus unhealthy workers. So those people who can’t meet those targets will be paying more premiums than people who can. So they can look forward to, again, as I said earlier, higher premiums down the road.

 

AMY GOODMAN: Trudy Lieberman, what about the Cadillac plans? This is the taxing of the Cadillac plans, something unions have been very much opposed to—

 

TRUDY LIEBERMAN: Right.

 

AMY GOODMAN: —because often they have traded higher wages for better healthcare plans, and now this possibility of taxing them.

 

TRUDY LIEBERMAN: Well, historically, that’s what happened. Workers have given up wages for better healthcare benefits. This has been going on for decades. That could end very quickly with this excise tax that will be placed on the so-called high-end plans, which will force the insurance companies and the employers to offer their workers lesser plans with lesser benefits.

 

And, of course, when you do that, that leaves more people underinsured. And I think most people believe, in this bill, we’re going to see a lot of under-insurance taking place both in the individual market and on the employers’ side. So the people who have these plans may well lose them down the road. This is also a contentious issue between the House and the Senate and will have to be resolved in the conference.

 

JUAN GONZALEZ: The other big issue was importation of prescription drugs. How has that fared in the Senate bill versus the House bill? And what are the prospects for that?

 

TRUDY LIEBERMAN: Well, as listeners may recall, that Barack Obama was for reimportation and negotiated drug prices under the Medicare program. In the Senate bill, neither of those things will happen. In the House bill, those provisions are still part of the House bill. But the money is that the Senate bill will prevail on most issues, so I think it’s probably not going to happen that those two things will be in the final bill.

 

AMY GOODMAN: Senator Lieberman and the effect he had on the Senate bill? And any relation, Trudy Lieberman?

 

TRUDY LIEBERMAN: No, no relation.

 

AMY GOODMAN: What about his effect?

 

TRUDY LIEBERMAN: He was very influential. In fact, he was really the pivotal person to kill the public plan in the Senate. In my post on cjr.org, I said he was probably the best lobbyist the insurance industry—and the doctors and the hospitals—could have had, because neither of those two groups of stakeholders were keen on a public plan. And I think that point has been forgotten.

 

In the end, Lieberman held all the cards, and he said that he would not provide the sixtieth vote if a public plan were part of it. Obviously, he is from Connecticut. Connecticut is the insurance capital of the world—or of America. And I’m sure he was listening to his constituents in the insurance industry that did not want a public plan.

[DC Tom]

From this morning's Democracy Now:

 

Very simply, people who have insurance right now are probably not going to see very much change from the bill. In fact, what they are going to see, as the years go on, are probably increasing premiums, and a lot more of the cost is going to be shoved onto them through high-deductible plans and co-payments and co-insurance that are probably quite high. So they’re not going to see a lot.

 

[PearlHowardman]

Obama promised a public option (July 17, 2009)

 

"Any plan I sign must include an insurance exchange -- a one-stop shopping marketplace where you can compare the benefits, costs, and track records of a variety of plans -- including a public option to increase competition and keep insurance companies honest."

 

 

Obama said mandates weren't the answer (February 5, 2008)

 

"I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don’t buy a house is they don’t have the money."

 

[Magox]

AMY GOODMAN: Senator Lieberman and the effect he had on the Senate bill?

 

TRUDY LIEBERMAN: He was very influential. In fact, he was really the pivotal person to kill the public plan in the Senate. In my post on cjr.org, I said he was probably the best lobbyist the insurance industry—and the doctors and the hospitals—could have had, because neither of those two groups of stakeholders were keen on a public plan. And I think that point has been forgotten.

 

In the end, Lieberman held all the cards, and he said that he would not provide the sixtieth vote if a public plan were part of it. Obviously, he is from Connecticut. Connecticut is the insurance capital of the world—or of America. And I’m sure he was listening to his constituents in the insurance industry that did not want a public plan.

 

That is absolutely false. Lieberman was the one received the blame for killing the public option, but the reality is that there were more than a few that had serious reservations regarding the public option. Ben Nelson, Blanche Lincoln and Landrieu all publicly expressed doubt regarding this government run option. Lieberman was the one who came out with the strongest statement, and was the only one who had the balls to draw a clear line in the sand.

 

When Lieberman came out with his statement, which shouldn't of been a surprise to anyone because he had said this for months, there was a collective sigh amongst many of the moderates, and Obama should be thankful that Lieberman did this because if he hadn't, it would of been dragged out for much longer with the same result.

[drnykterstein]

We've got our nanny-state healthcare.

 

I wish we did Really we have nothing close to it.

[DC Tom]

Really we have nothing close to it.

 

You're right.

 

I wish we did

 

 

You're an idiot. Learn to take care of yourself.

[Nanker]

From Today's NYTimes

On the generous end, about a fifth of employers now offer health plans that could be affected by a new 40 percent excise tax in the Senate bill on so-called Cadillac policies, according to an estimate by Mercer, a benefits consulting firm. That tax, to be imposed on annual premiums that exceeded $23,000 for family coverage, would go into effect in 2013. For example, if an insurer, or a self-insured employer, offers a plan costing $25,000, it must pay a 40 percent tax on the $2,000 that is above the threshold, or $800.

 

If the excise tax survives the House-Senate negotiations, it is hard to predict how employers will respond. But almost two-thirds of the employers Mercer recently surveyed said they were likely to reduce employee benefits rather than pay the tax.

 

“They’re going to work hard to find a way to keep the cost of their plans below the threshold,” said Beth Umland, Mercer’s director of health and benefits research.

 

She predicts that many of those companies will rely on what she described as “the tried-and-true method” — passing along more of the costs to employees, in the form of higher deductibles and co-payments, in order to reduce overall premiums.

 

The public policy goal of the tax, in theory, is to have everyone spend less on medical care, even if it means using it less.

 

“We know people will use less care under such plans,” said Paul Ginsburg, president of the Center for Studying Health System Change, a nonpartisan group.

 

What is not so clear, Mr. Ginsburg said, is whether people will make — or be able to make — rational choices between treatments that are not particularly effective and treatments that may help them from becoming sicker later.

 

Merry Christmas

[PearlHowardman]

If the excise tax survives the House-Senate negotiations, it is hard to predict how employers will respond. But almost two-thirds of the employers Mercer recently surveyed said they were likely to reduce employee benefits rather than pay the tax.

 

Or perhaps not hire any new employees!

 

Happy New Year

[Chef Jim]

You very rarely here the good stories.

There Shelia Brunson, a direct services specialist, advised Hughes of her short-term options, including state disability assistance and other resources. But in the meantime, the Season of Sharing fund bridged the gap by paying her rent.

 

Government run? Nope.

 

Brunson said Hughes went to Toys for Tots so she could provide Christmas gifts for her children, but ultimately left empty-handed.

 

Mostly, if not all, funded privately

 

Health benefits covered by her employer paid all but $500 of the $100,000 surgery, Hughes said, adding that she plans to return to work in January.

 

Those evil insurance companies.

[PastaJoe]

We've got our nanny-state healthcare. You people who voted for these fools in the Congress and the White House out of anger for GW Bush...you can hold your heads high knowing you personally have caused this abortion. That's right, you twits. It's YOUR responsibility. Enjoy the burden of that responsibility.

 

The more the radical right complains, the more confident I am that we made the right decision.

[BLZFAN4LIFE]

The more the radical right complains, the more confident I am that we made the right decision.

 

I suppose it's still a free country, you've got the right to be as ignorant as you want.

[Chef Jim]

The more the radical right complains, the more confident I am that we made the right decision.

 

Yup because the radical right are the only ones complaining.

 

And it's just as easy to say the more the radical left rejoices the more convinced I am they've made a terrible decision.

[Adam]

You very rarely here the good stories.

 

Government run? Nope.

 

Mostly, if not all, funded privately

 

Those evil insurance companies.

Insurance companies aren't always in the righ (not that you said they are). A year ago, I had a near life threatening bout of insomnia- Most of the medication came out of pocket. Now that might sound like a funny complaint- but if something is that serious, it doesn't matter what the name of the problem is.

 

I suppose it's still a free country, you've got the right to be as ignorant as you want.

Personally, I like complaint- particularly from whoever disagrees with me. Makes you learn more about your own viewpoint and the other person's viewpoint- also can even make you question the validity of your own opinion- Which is a very healthy thing

[Chef Jim]

Insurance companies aren't always in the righ (not that you said they are). A year ago, I had a near life threatening bout of insomnia- Most of the medication came out of pocket. Now that might sound like a funny complaint- but if something is that serious, it doesn't matter what the name of the problem is.

 

I had the same problem. I cured mine by watching Bills games. Instant sleep. Sorry I don't mean to make light of your situation, that's something I never hear of. Hope all is well with you. And you're right insurance companies don't always do the right thing and that is why we needed reform to make insurance more affordable and portable not a major overhaul of the health care system.