Health and Human Services Secretary Kathleen Sebelius said providing citizens with the option of government-run insurance isn’t essential to the Obama administration’s proposed overhaul of U.S. health care.
“What’s important is choice and competition,” Sebelius said today on CNN’s “State of the Union.” The public option itself “is not the essential element.”
Asked if a cooperative plan is a possible replacement, Sebelius said she didn’t know what alternatives Congress would settle on among competing versions of the health legislation now under consideration. The Senate Finance Committee is discussing cooperatives, or networks of health-insurance plans owned by their customers, that would get started with government funds.
Madaam HHS says: “What’s important is choice and competition”. Maam, here’s how you do it: Congress returns to the powers granted to it by the Constitution (make laws, not 1000 page bills) and it passes a series of laws which reflect the will of the people as to how healthcare will be structured in this country, for example:
1. Guaranteed issue…..can’t be denied for pre-existing conditions
2. 12 months written notice to be dropped from a policy
3. Each person buys a private, ala carte, policy that is his/hers. No more employer provided healthcarre
4. Whatever else the people want
Then, get the Government out of the way and let the unbridled, unfettered free market, capitalistic economy go after those billions and billions of customer dollars. The guys who give the best service, provide the highest customer satisfaction at the lowest cost will be huge winners. The only bigger winners will be We The People. Who will be the losers? Power hungry politicians with God-sized egos who won’t get to micro-manage this part of our lives.
If competition is important, why not start by repealing the federal law that prevents people from buying policies across state lines?
[blockquote] “The smallest minority on earth is the individual. Those who deny individual rights cannot claim to be defenders of minorities.” – Ayn Rand[/blockquote]
Any plan – any plan – that treats people as groups, that fails to provide for individual responsibility and individual choice is still a plan that must be opposed. In the President’s column in Sunday’s NYT he said “In the end, this isn’t about politics.” Among his other misrepresentations (see, I refrained from calling them “lies”) that has to be the most egregious. The plans on the table are nothing but politics – trying once more to impose control on people. Last I checked, that still translates to tyranny.
I’m not sure I see how cooperatives will be different from current non-profits, except that they are to be “started with government funds.” Back to the Post Office comparison. My automobile insurance is with a mutual insurance company, and sometimes I get refunds if their claims have been lower than expected for the year. If this is such a great idea, why aren’t people already starting them? Why does the federal government need to be involved?
From the CEO of Whole Foods across the spectrum to conservative legal analysts, suggestions are being made which would increase competition, increase individual responsibility, and cover the uninsured, including those with pre-existing conditions — all without much government funding. These Congressional proposals need to be thrown out, and more effective and realistic proposals enacted, targeted at the actual problems.
Maybe it’s time we asked Congress why the American people can’t be covered by the same health insurance plan that they’ve reserved for themselves! What’s good for the goose should be good for the gander, folks!
“Maybe it’s time we asked Congress why the American people can’t be covered by the same health insurance plan that they’ve reserved for themselves! What’s good for the goose should be good for the gander, folks! ”
How about let’s ask in the strongest of terms!
[blockquote]Maybe it’s time we asked Congress why the American people can’t be covered by the same health insurance plan that they’ve reserved for themselves! What’s good for the goose should be good for the gander, folks! [/blockquote]
Be careful what you wish for.
Katherine says, “Back to the Post Office comparison” and then talks about automobile insurance. I don’t think the Post office is in the business of auto insurance.
But I think it is an interesting comparison. The Post Office is often put forward as an example of horrible government inefficiency. Could be. I’ll not argue that point. But if a government run health insurance option would be as inefficient as the USPS, then it should be any serious competition to a well run private company. After all, both United Postal Service and FedEx do a very good and successful job competing with USPS. Maybe USPS does better with junk mail–but I’ve even received junk mail by way of FedEx!
Most of the criticism I’ve seen of what an imaginary government run health system is at least as true of private insurance in my experience. Before I turned 65 and became eligible for Medicare, the private insurance company told me what doctors I could go to, what procedures the doctors could use and what medicines they could prescribe. Now under Medicare I have much more freedom of choice; and a lot less hassle.
Why not everyone have the same health benefits as Congressmen? Well, they have a government run program–the same one that federal employees have.
And I’ll bet a majority of people in the U.S. want employer health benefits. Since that is what most people under 65 have–and even some people over 65 have–and most people are happy with their insurance according to the polls, I suspect outlawing that would be extremely unpopular.
Of course, what people voted for back in November was something that would contain the costs of private insurance, would prevent companies from dropping one if one got sick, make affordable insurance available to people with pre-existing conditions, and make some sort of affordable insurance available to unemployed, self-employed or workers whose employers don’t provide affordable insurance. So far, I’ve not heard the critics of the proposals being put forth to offer any sort of rational, meaningful alternatives that would achieve what many of us voted for in November.
What I see affluent folks do all the time is form Medicare Trusts so that the Government will pay their or their mom and dad’s medical and nursing home bills and leave their assets alone to the greatest degree possible. But ideological consistency seems lost on them as they prattle on about the welfare freeloaders and getting Government out of our lives.
The White House has now said Sebelius “misspoke” – from The Atlantic:
Ken Peck, that throwaway line about the Post Office was, of course, because the President used it. It’s a big money-loser.
It’s not clear to me that people voting in November were voting for any particular programs. I think image had a great deal to do with it.
#8 wrote, And I’ll bet a majority of people in the U.S. want employer health benefits…………..
I would not be so sure. Talk to folks who have stuck with a job simply for the health benefits. Different employer plans have differrent doctor/provider groups which you growled about. Your own plan, purchased in part to get the docs you wanted would be your plan for however long you wanted it.
I really don’t understand the folks in love with Government backed healthcare. Medicare has a horrible unfunded liability and there is this faith that somehow, this time, we are going to get it right and despite the examples of the Post Office, Amtrak and all the other Government led boondoggles, Healthcare will be the magic bullet.
That is a whole lotta faith!
I have a government run health plan. It works fine. It may have an unfunded liability. The solution to that would be to either reduce costs or increase revenue. (Dealing with unemployment would help with the latter.) I might note that Federal employees (including members of Congress) have tax subsidized government health insurance.
Obama wants a cafeteria plan were everyone can obtain affordable health care. That includes employee plans, private plans and a competing public plan. There are actually several ways to achieve a competing public plan. The insurance companies don’t want competition, and so they oppose any sort of public option. Why? Because they would have to cut the fat out of their bureaucracies and possibly trim their profits. I am amazed that people want to bring up the United States Postal Service as an example in this debate. Can private business compete with a private firm? You bet. And USPS is a perfect example. Both United Parcel Service and Federal Express are successfully competing with USPS in the parcel business. They even are being used for “First Class” mail by some now. And I’ve gotten junk mail via FedEx–even from a company in direct competition with Kinko’s!
The insurance companies do not want health care reform. Period. They are poring millions of your premiums into a massive public relations campaign. Check out these “organizations” paying for the T.V. ads. You’ll find they are being funded by insurance companies. See for example [url=http://www.cnn.com/2009/POLITICS/08/17/potter.health.insurance/index.html]How insurance firms drive debate[/url].
The idea of insurance (whether private or public) is shared risk. If an insurance company can eliminate high risk individuals, they can increase their profitability. For decades Texas teachers have tried to get a state teachers health insurance plan similar to that enjoyed by state employees. One group opposes it–the insurance companies. Why? Because they do not want to have to compete against each other for one single pool of over a half million employees. By being able to divide and conquer among the 1,100 school districts in Texas they can charge higher rates and increase profitability. And so they pour huge sums of our premiums into political campaigns and lobbyists to defeat any action from the legislature.
The reality is that many self-employed people cannot afford private health insurance–especially if they have a pre-existing condition. The reality is that insurance companies will cut people with pre-existing conditions, cap people who experience catastrophic medical costs–the later being one of the major causes of personal bankruptcies and mortgage defaults in the U.S. And if you are laid off from a company that provides health insurance, you will not be able to afford COBRA–unless you were a top executive that got a multimillion dollar golden parachute.
[blockquote]The insurance companies do not want health care reform. Period. They are poring millions of your premiums into a massive public relations campaign. Check out these “organizations†paying for the T.V. ads. You’ll find they are being funded by insurance companies. See for example How insurance firms drive debate.[/blockquote]
You mean these companies are resisting being driven out of business by the Central State? Viscious! When attacked, they defend themselves!! Isn’t it awful that money is being so wasted fending off government all the time?
But what about the $150 million that the Obama administration has arm-twisted the pharmaceutical indistry into spending on TV ads supporting nationalized medicine? Is that bad, too, or is it good?
And what about the huge sums of tax money being used by the President and Congress to push this plan?
We have paid COBRA, and we are nowhere near multimillion dollar income status. My husband keeps asking where he can go get one of those golden parachutes. Full cost COBRA for an inclusive health plan was over $9000 per annum with dependent coverage. It’s about $7000 now for a couple, with deductibles and co-pays. I do not properly understand, yet, exactly what Medicare charges, but from reading blogs it seems that the full Medicare deal and a nice Medicare Plus policy is going to run us around $5000, that is, $2000 or so less than the full private policy. Medicare can do this because it is tax-funded by people still working and because it underpays medical care providers. This can’t keep up, and to expand it to the entire population will make it even less financially viable. They’re going to have to raise premiums, raise taxes, or cut benefits. There are no other options.
You mean the way the United States Postal Service is driving United Parcel Service and Fed Ex out of business? Ridiculous! If the insurance companies provide a good product at a reasonable cost, they will run circles around the public plan, just the way that UPS and FedEx run circles around the USPS and make a good profit doing so. But of course, that will mean they will need to be driven by consumer needs rather than greed.
Apparently the pharmaceutical industry thinks it will be good for business and is even willing to absorb 80 billion of the cost of health care reform over the next 10 years. Apparently they believe that 45 million more Americans able to buy prescription drugs and the improved public image of the industry will be good for business. Obama Health Care Reform Effort Gets $150 Million Boost From Unlikely Ally
The Postal Service has a monopoly on regular non-urgent mail. It loses money and requires regular infusions of taxpayer cash.
The PHRMA deal was a stop-loss deal between the White House and the pharmaceutical lobby.
Blog comments here over the past few days have had lots of common-sense regulatory and other changes which would solve a great number of the current problems without massive increases in public debt (and therefore taxes). We should insist that our legislators do these things first and see how it goes before constructing this awkward and top-heavy and very expensive new federal bureaucracy which is being proposed — and even without the “public option” plan, the bureaucracy is still the core of the proposal.
[blockquote]You mean the way the United States Postal Service is driving United Parcel Service and Fed Ex out of business? Ridiculous! If the insurance companies provide a good product at a reasonable cost, they will run circles around the public plan, just the way that UPS and FedEx run circles around the USPS and make a good profit doing so. But of course, that will mean they will need to be driven by consumer needs rather than greed. [/blockquote]
The health insurance industry makes about a 3% profit. That might be 3% too much for you, but it doesn’t seem terribly excessive to me. But tell me, if the “public option” runs multi-billion-dollar losses every year like the post office does, will premiums of its enrollees go up accordingly, or will we free market types be forced to subsidize our insurers’ competition? Will the “public option” be allowed to go out of business?
[blockquote]Apparently the pharmaceutical industry thinks it will be good for business and is even willing to absorb 80 billion of the cost of health care reform over the next 10 years. Apparently they believe that 45 million more Americans able to buy prescription drugs and the improved public image of the industry will be good for business.[/blockquote]
Indeed it will, as it will now be engaging in political entrepeneurship instead of innovating for its cash. Maybe you can instruct us on how this bold, brave cooperation with the Central State is different from the money-grubbing greed of health insurance companies.
Medicare Part B costs me $96.40 a month. The top of the line TRS-Care supplemental policy (with a drug benefit) costs me $100 a month. Add to that dental insurance with AARP at $500 a year and vision insurance with AARP at $100 a year. Out of pocket expense with these plans runs around $500–mostly copay for drugs and contact lenses. O.K., so I paid for Medicare (and still do) with payroll taxes and TRS-Care through payments to TRS throughout my teaching career. It’s still cheaper than COBRA and I have my choice of doctors (but not opthamologists and dentists–one of the differences between public insurers and private insurers.)
And no, I never had a golden parachute either. But then I was never a corporate executive pulling down 7-8-9 figure benefit packages. My best salaries were as a mere school executive that never pulled down more than 5 figures.
I think one of the funniest things I ran across recently was the bank that paid their executives with the toxic assets the executives had negotiated for the bank. And the weird thing, is that those toxic assets are paying off at better than 10%.
That’s funny, because my Medicare taxes are more than twice that, and I don’t get so much as an Advil for them. Apparently, it’s easy to “reduce costs” to folks by picking the pockets of other folks.
Bureaucracies are the core of private insurers as well. I know, I’ve had to try to deal with those people. It’s no fun.
Government bureaucrats are interested that the government regulations are followed and that fraud isn’t being committed. Insurance company bureaucrats are interested in increasing the company’s bottom line. I’d much rather deal with the former than the latter. Now maybe the day will come when I will experience something different, but so far my experience with dealing with Social Security and Medicare bureaucrats has been far more pleasant than dealing with insurance company bureaucrats.
About the only proposal that has appeared on this blog has been tort reform–something that the trial lawyers (many of whom we’ve elected to Congress) are dead set against. The present situation with tort is one major factor that is driving up medical costs and insurance rates–although insurance companies that sell medical malpractice insurance love it because they can charge more to doctors and hospitals.
Ken Peck, I don’t know what the Medicare supplemental policy will cost us, since we won’t have access to a government supplemental policy as you do, but it sounds like my estimates were about right for two, about $5k per annum. The extra $2k comes from someone else. At these rates we will not be making the a contribution to the insurance pool which, in aggregate, covers what people will spend on medical care. Medical care is not free. Somebody is paying. In the case of Medicare, providers are paying because they are under-compensated for their services, people in private insurance plans pay because providers shift some of that cost to the under-65 insured, and taxpayers pay. It’s unsustainable.
There have been other proposals beside tort reform here, and that’s one we should enact. Others have been to allow insurance plans to be sold across state lines, to restore tax equality between people on employer-paid and individual plans, and to change regulations to allow the establishment of clinics in stores and pharmacies which could dispense medications for routine illnesses without seeing an M.D., and to encourage more high-deductible major medical plans in which routine expenses are shouldered by the patients (this last would be made illegal under the House bill). I have seen an ingenious plan which sounded quite practical to allow insurance companies to sell the right to hold insurance in the future, so if you leave your current employer you could take your insurance with you.
18. Jeffersonian wrote:
[blockquote]The health insurance industry makes about a 3% profit.[/blockquote]
A quick check shows that Cigna’s Price/Earnings TTM is 12.9 and the industry average is 10.4. [url=http://quote.morningstar.com/Stock/s.aspx?t=NYSE:CI&culture=en-US®ion=USA&r=971025&byrefresh=yes]Cigna Corporation[/url]. I notice that Cigna stock is soaring today at well above 3% while the broad based indexes are falling around 2%.
I suspect that Cigna’s Profitability Index would be considerably higher.
Ken, can you source that? I’ve seen those industry-wide figures, but they included all sorts of other insurance products, with life insurance being the cash cow. Medical insurance, from what I’ve seen and heard, is a far lower-margin business.
23. Katherine wrote:
[blockquote]There have been other proposals beside tort reform here, and that’s one we should enact. Others have been to allow insurance plans to be sold across state lines,[/blockquote]
That really isn’t a solution to anything. The major players in health insurance easily get around the restriction by simply creating subsidiaries in any state they want to do business in. Cigna, Blue Cross/Blue Shield, Aetna, etc. all operate in many states. It is advantageous for them to do that, because it is generally easier for them to manipulate state legislatures and regulators than the federal government.
[blockquote]allow the establishment of clinics in stores[/blockquote]
Around here that isn’t really necessary. There are clinics in strip malls all over the place. The question is would insurance companies allow us to use those clinics. Probably not; they already dictate what doctors and hospitals we can use.
[blockquote]pharmacies which could dispense medications for routine illnesses without seeing an M.D.,[/blockquote]
That already exists. It’s known as Over The Counter drugs. I can get my allergy medicine that way–it used to be a prescription drug, but is now sold OTC.
[blockquote]insurance companies to sell the right to hold insurance in the future, so if you leave your current employer you could take your insurance with you.[/blockquote]
It’s known as COBRA. And the costs are generally prohibitive. At least some of the things being considered are to make it more affordable–particularly to those who are laid off and lose their insurance that way and also to not limit the length of time one could keep the insurance.
Of course none of things you mention will do much to help those without insurance for whatever reason and who show up in our public emergency rooms with serious illnesses which would have been minor had they been able to see a doctor at the earliest signs of illness. And, of course, we the tax payers pick up the bill for that.
Here, I found this online…not sure now accurate it is:
[blockquote]The pure health insurance companies: Aetna, United Healthcare, Humana, and Cigna had 2008 Net Profits of 4.4%, 3.6%, 2.6% and 2.3% respectively. (Source: Annual Reports)[/blockquote]
[blockquote]That really isn’t a solution to anything. The major players in health insurance easily get around the restriction by simply creating subsidiaries in any state they want to do business in. Cigna, Blue Cross/Blue Shield, Aetna, etc. all operate in many states. It is advantageous for them to do that, because it is generally easier for them to manipulate state legislatures and regulators than the federal government. [/blockquote]
But if they can sell insurance across state lines, then they don’t have to manipulate the state government, do they? Furthermore, having to set up 50 separate business entities certainly increases costs, does it not?
I’d have to find it, but I read a recent study that said allowing health insurance to be sold across state lines alone would reduce the number of uninsured by around 12 million people (that’s about 1/3 of the total American uninsured population). So why not do it?
[blockquote]Around here that isn’t really necessary. There are clinics in strip malls all over the place. The question is would insurance companies allow us to use those clinics. Probably not; they already dictate what doctors and hospitals we can use. [/blockquote]
We already use one at a local Walgreens. My insurance covers it.
Of course the big insurance companies have an advantage today, Ken Peck. They have the resources to develop plans to meet all 50 state requirements. Smaller companies don’t. The proposal is to allow citizens to buy insurance across state lines. That’s a change.
The clinics I’m talking about would be clinics where you could go get treatment for minor illnesses for cash. I could take my routine bronchitis, or my child’s routine ear infection, and get antibiotics without seeing an M.D. Walmart, for instance, sells a lot of common drugs at low prices. If illegals and poor not covered by Medicaid, for instance, could get cash services for minor illnesses the pressure on emergency rooms would drop dramatically. You might not use your insurance there. It’s a low-cost clinic to serve that market need. Antibiotics aren’t OTC.
No, I’m not talking about COBRA. The op-ed was in the WSJ opinion section recently. He was proposing a new insurance product which you could buy. Can’t find the link offhand.
And the real changes which would affect the market would be equalization of tax status for private plans and along with that the continued availability of low-cost high-deductible major medical policies which this proposal makes illegal.
Ultimately, we need to get back to a point where everyone isn’t spending everyone else’s money for healthcare. That’s what we have now, and it’s almost axiomatic that it means the highest possible costs.
With cobra if you were laid off since September of last year the government already pays 70% of the cost. Your former employer actually pays the 70% then deducts what they pay from what they owe for Social security taxes. I would guess the government did it that way since in the short term SSI was the only pocket that could be picked that was in a “surplus”. That means if you had a plan that cost your company $1000 per month you would only pay $300. In addition if your company offered things like dental that you didn’t sign up for you can also sign up under cobra for the same 30%. That is without any health care reform passing congress.
Also – you can stay on that cobra deal even if you get another job that offers health insurance (assuming it is cheaper for you) – just ask your company to pay you the cobra payment – its probably cheaper for them too.
#30 writes: “Ultimately, we need to get back to a point where everyone isn’t spending everyone else’s money for healthcare”.
Exactly, what we have are huge Ponzi schemes like Social Security and Medicare. And we have roughly 40% of workers who no longer are paying income taxes, so why shouldn’t they vote FOR every “free” program a politician can dream up?
The best bumper sticker I have seen in the last few weeks said, “honk if I’m paying your mortgage!” To that we could add “honk if I’m your Social Security Paycheck”, “honk if I’m paying for your healthcare”, and on and on and on.
But the one I want to put on my car is “Pound sand if you want me to pay your way”
Cap, I heard something recently that might fit the bill. A guy was running for some office in New Hampshire saying “Here’s my healthcare plan: Go get your own d*** healthcare.”
Aetna isn’t a “pure health insurance company”.
Apparently United Healthcare isn’t doing well. Morningstar reports a P/E for Humana of 6.7% Humana. Humana is also doing quite well in today’s down market.
I’ve already provided you with the same information (and link twice) to the figures for Cigna, which is doing quite well.
As I said, insurance companies have a way of making profit figures look lower than they actually are.
28. Jeffersonian wrote:
[blockquote]But if they can sell insurance across state lines, then they don’t have to manipulate the state government, do they? Furthermore, having to set up 50 separate business entities certainly increases costs, does it not?[/blockquote]
Only if the federal government forbids state regualtion of health insurance. I don’t think advocates of “states rights” would like that. Neither do the big insurance companies. Remember they are opposing reform. They want to keep things the way they are.
[blockquote]Cap, I heard something recently that might fit the bill. A guy was running for some office in New Hampshire saying “Here’s my healthcare plan: Go get your own d*** healthcare.†[/blockquote]
That’s a nice, self-centered way of going about it. It really does not make any sort of rational economic sense. It may make sense to ration luxury cars on the basis of who can pay for them; it doesn’t make sense to ration health care on the basis of who can pay for it. That’s why cosmetic surgery is such a big deal. And that may make sense. But it immoral to say “Because you cannot afford chemo, you must let your cancer kill you.”
Good grief, I thought we were supposed to be Christians and obey Jesus when he said “Heal the sick”. I don’t think he intended for us to apply a means test.
#35, those are P/E ratios, not profit margins. I posted actual profit margins, which are right in line with what I cited earlier…around 3%.
[blockquote]Only if the federal government forbids state regualtion of health insurance. I don’t think advocates of “states rights†would like that. Neither do the big insurance companies. Remember they are opposing reform. They want to keep things the way they are. [/blockquote]
Well, tough. The Constitution clearly empowers the federal government to regulate (which doesn’t mean “to restrict,” but “to make regular”) interstate commerce. Since purchasing health insurance across state lines is clearly interstate commerce, the federal government would be within its power to restrict state regulation of same. This would have the salutary effect of providing a less-restrictive regulatory model for states to compete with, too.
[blockquote]That’s a nice, self-centered way of going about it. It really does not make any sort of rational economic sense. It may make sense to ration luxury cars on the basis of who can pay for them; it doesn’t make sense to ration health care on the basis of who can pay for it. That’s why cosmetic surgery is such a big deal. And that may make sense. But it immoral to say “Because you cannot afford chemo, you must let your cancer kill you.â€
Good grief, I thought we were supposed to be Christians and obey Jesus when he said “Heal the sickâ€. I don’t think he intended for us to apply a means test. [/blockquote]
Well, which is it: Economic, moral or Christian? I’ll point out that we are also admonished to not covet that which is our neighbors’, Ken, nor to steal it. That doesn’t mean we can use the mechanism of the State to do it for us. That’s neither Christian nor moral.
What if the law, however, stated that UPS and FedEx couldn’t take in any new customers after the effective date of the law, and after that date every new person wanting to use a mail delivery system had to use USPS? What if the law said that existing UPS and Fedex customers couldn’t switch to any other mail service than USPS? What if the law said that if UPS or FedEx ever made any change in their terms of service in a contract with customers, none of those customers could use them any more and those customers would have to use USPS? What if the law said that UPS and Fedex could not change their rates except with the approval of the head of USPS? (Check out section 102 of H.R. 3200.)
[blockquote]You mean the way the United States Postal Service is driving United Parcel Service and Fed Ex out of business? Ridiculous! If the insurance companies provide a good product at a reasonable cost, they will run circles around the public plan, just the way that UPS and FedEx run circles around the USPS and make a good profit doing so.[/blockquote]
People won’t go on the public plan because it is better or worse. Small businesses and Wal-mart’s will tell their employees, “No more insurance from us, go get it from Uncle Sam.”
38. Jim the Puritan wrote:
[blockquote]What if the law said that UPS and FedEx could not change their rates except with the approval of the head of USPS? (Check out section 102 of H.R. 3200.) [/blockquote]
I did. It doesn’t say way you seem to think it says. It is similar to the Republican Medicare Part D. To use that as an example, TRS-Care Plans B and C have a drug benefit which existed before Medicare Part D went into effect and which was as good as or better than a Medicare Part D qualified plan. So each year, before the enrollment period for Medicare Part D, I receive a letter from TRS-Care stating that it is as good as or better than a Medicare Part D qualified plan. Now if they decide for some reason to make a change in the drug coverage so that it was no longer qualified, then they would have to tell me so and give me the option to opt out and go to any other qualified plan. They can raise or lower premiums, so long as the change applies to all TRS-Care members and not just, for example, those who have hypertension or are over weight or have diabetes.
Your example is so much “apples to oranges” that it is laughable. USP and FedEx were not “grandfathered” into anything nor is there any such thing as a “qualified mail service”.
What section 102 of H.R. 3200 would do is protect those whose medical insurance is “grandfathered” in as “qualified” are not subject to arbitrary and capricious actions of their insurance company–something that is all too often the real case.
39. robroy wrote:
[blockquote]People won’t go on the public plan because it is better or worse. Small businesses and Wal-mart’s will tell their employees, “No more insurance from us, go get it from Uncle Sam.â€[/blockquote]
The reality is that an awful lot of small businesses do not offer their employees health insurance. And many of those who do have been dropping it in the last couple of years. If any employer doesn’t offer health insurance, then the employee can go for individual insurance–either an insurance plan or the public plan–which ever is competitive. If insurance companies offer a better deal, the individual will go for it, just as shippers around the country go for UPS and FedEx for most of their shipments.
#40–CNN Money and Fortune Magazine (“5 freedoms you’d lose in health care reform“) would beg to differ with your analysis.
[blockquote]Freedom to keep your existing plan
This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It’s worth diving into the weeds — the territory where most pundits and politicians don’t seem to have ventured.
The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don’t have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.
The House bill states that employees covered by ERISA plans are “grandfathered.” Under ERISA, the plans can do pretty much what they want — they’re exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.
The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the “qualified” policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we’ve already discussed. So for Americans in large corporations, “keeping your own plan” has a strict deadline. In five years, like it or not, you’ll get dumped into the exchange. As we’ll see, it could happen a lot earlier.
The outlook is worse for the second group. It encompasses employees who aren’t under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only “qualified” plans to new customers, via the exchanges.
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there’s a catch. If the plan changes in any way — by altering co-pays, deductibles, or even switching coverage for this or that drug — the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it’s likely that millions of employees will lose their plans in 12 months.
http://money.cnn.com/2009/07/24/news/economy/health_care_reform_obama.fortune/.%5B/blockquote%5D
41. Jim the Puritan wrote:
[blockquote]#40—CNN Money and Fortune Magazine (â€5 freedoms you’d lose in health care reformâ€) would beg to differ with your analysis.[/blockquote]
Yeah, I saw that. I was surprised. Usually CNN does a better job with the facts.
Even Lou Dobbs does a better job. He’s been carrying a series on health care in industrialized nations, talking about their strengths and weaknesses. And the general result of the analysis is that we pay more (even figuring in the taxes) for less.
Well, maybe we need to do away with the “qualified” business. Maybe it’s O.K. for Dewey, Cheatham and Howe to peddle comprehensive health insurance policy that covers only the removal of warts by a witch doctor in the full of the moon when you read the fine print.
But curiously the Republicans thought that “qualified plans” were a Good Idea when they passed Medicare Part D. There is something to be said for setting minimal standards. Cities do it with building codes. States do it for all sorts of things.
Sometimes even with standards you get insurance companies screwing their customers. For example, people along the Gulf Coast have learned that hurricane insurance only covers wind damage if you read the fine print. Now if the cat 4 wind whips up a 20 foot tidal surge that washes away your house, too bad. That’s water damage, not wind damage. You get nothing, but the insurance company gets rich. Well, maybe if you can show that the wind blew the shingles off the roof before the tidal surge washed away your house, you can get the insurance company to pay for new shingles–if you can ever find your house. Oh btw, we’re going to raise your rates (even if you live in Dallas), because the Gulf Coast is prone to hurricanes.
Ken Peck responds:
[blockquote] The reality is that an awful lot of small businesses do not offer their employees health insurance. And many of those who do have been dropping it in the last couple of years. If any employer doesn’t offer health insurance, then the employee can go for individual insurance—either an insurance plan or the public plan—which ever is competitive. If insurance companies offer a better deal, the individual will go for it, just as shippers around the country go for UPS and FedEx for most of their shipments. [/blockquote]
I agree. A lot of small businesses don’t offer insurance anymore. That number would drop to zero if a public plan was offered. I would certainly drop my employees. Great solution! More people on Medicaid for all. You seem to not understand economic leverage. The talk of individuals going to United Healthcare and asking it for a decent insurance plan is silly. As an employer of seven, trying to go to one of the two remaining viable insurers in the state and tell them to give me a good deal is also silly.
Individual plans