McCain for less group plans, and why that's really bad.

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McCain for less group plans, and why that's really bad.

Post by SirNitram »

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Senator John McCain’s top domestic policy adviser, former Congressional Budget Office director Douglas J. Holtz-Eakin, recently said in a conference call with reporters that Mr. McCain’s health care proposal would “put 25 to 30 million individuals out of the ranks of the uninsured, into the ranks of the insured.” In an article released Tuesday, a panel of prominent health economists concludes that Mr. Holtz-Eakin’s projection is off by, well, 25 to 30 million.

The article, published in the journal Health Affairs, argues that “initially there would be no real change in the number of people covered as a result of the McCain plan.” After a short-term reduction of 1 million in the number of people without coverage, the number of uninsured would increase by 5 million after five years, the authors predict. There are currently 45 million people without insurance, or 15 percent of the population, according to the Census Bureau.

Mr. McCain’s plan is designed to create greater equity between the group and individual insurance markets. He would end the exclusion of employer-provided health benefits from federal income taxes, an advantage not enjoyed by those who buy insurance on their own, and replace it with health care tax credits of $2,500 per individual and $5,000 per family.

That, the McCain campaign asserts, would drive more people into the individual market, fomenting competition, reducing premiums and discouraging consumers from buying more coverage than they need or can afford. The economists wrote that many “people are likely to have far less generous policies than those they have today.”

The analysis was written by Thomas Buchmueller of the University of Michigan, Sherry A. Glied of Columbia, Anne Royalty of Indiana University-Purdue University of Indianapolis, and Katherine Swartz of Harvard.

Eliminating the tax exclusion, they wrote, “would greatly reduce the number of people who obtain health insurance through their employers.” They put that figure at 20 million, and calculated that it would be offset at first by the 21 million who would be able to afford individual coverage using Mr. McCain’s tax credits.

Within a few years, however, the trend would reverse, the study asserts. That is because, according to Mr. Holtz-Eakin, the McCain health care tax credits would be indexed to “regular inflation,” presumably the Consumer Price Index, which is typically lower than annual increases in health care costs. Unless costs can be substantially reined in, the credits would therefore enable fewer people to afford coverage each year, leading to an eventual rise in the number of uninsured.

Mr. Holtz-Eakin did not respond to a request for comment.

The estimates in Health Affairs are comparable to those made in July by the Urban Institute and Brookings Institution, which projected that 1 million people would gain coverage after one year under Mr. McCain’s plan, that almost 5 million people would gain coverage after four years, and that the number of uninsured would then creep upward.

By comparison, Senator Barack Obama’s plan, which would provide heavy government subsidies for insurance for low-income workers, would reduce the number of uninsured by 18 million in 2009 and by 34 million in 2018, according to the Urban Institute/Brookings Institution report. That would still leave Mr. Obama well shy of his goal of achieving universal coverage.
Why do we want group plans, employer originated or not? Here's why. A bit of law that will become very important if this goes through. It's part of HIPAA. Link

What is the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?

HIPAA amended the Employee Retirement Income Security Act (ERISA), to provide new rights and protections for participants and beneficiaries in group health plans. Understanding this amendment is important to your decisions about future health coverage. HIPAA contains protections both for health coverage offered in connection with employment (group health plans) and for individual insurance policies sold by insurance companies (individual policies).

If you find a new job that offers health coverage, or if you are eligible for coverage under a family member's employment-based plan, HIPAA includes protections for coverage under group health plans that:

*

Limit exclusions for preexisting conditions
*

Prohibit discrimination against employees and dependents based on their health status
*

Allow a special opportunity to enroll in a new plan to individuals in certain circumstances

If you choose to apply for an individual policy for yourself or your family, HIPAA includes protections for individual policies that:

*

Guarantee access to individual policies for people who qualify
*

Guarantee renewability of individual policies
Forget legal protection to let someone with a pre-existing who gets dropped like a hot potato out of a now economically unfeasible(Thanks to McCain taxing the insurance) group plan. You could then be excluded by all who wish to. To say nothing of the massive increase in costs people will wind up paying for equal.. Or far more likely, as the companies are now given Government backing to do this.. Worse, coverage.
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Post by Surlethe »

This reminds me of what's happened with employment all over the country. Deregulation and globalization sent cushy manufacturing jobs overseas, and people switched to working jobs in the service sector. So, in hypothetical Smallville, USA, if 5,000 manufacturing jobs went overseas and were replaced by 6,000 service sector jobs, you can claim that jobs grew 20%, right? Wait -- those manufacturing jobs paid $55,000 annually (including benefits), and the service sector jobs have shit benefits and pay $20,000 annually. It's the same deal: you increase one nice statistic (in this case, the number of insured people rises), and claim that everything's better!
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Re: McCain for less group plans, and why that's really bad.

Post by Darth Wong »

That, the McCain campaign asserts, would drive more people into the individual market, fomenting competition, reducing premiums and discouraging consumers from buying more coverage than they need or can afford.
Damn those working-class people, trying to get more medical coverage than they need! Everyone knows that working-class people don't need as much medical coverage as rich people like John McCain. When they get sick, they can rely on the power of prayer and "rugged individualism".
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Post by Surlethe »

Remember, in a free market it's not about what you need. It's about what you can afford. The whole point of a free market is that it automatically triages based on ability, and then willingness, to pay; as a consequence, the people who can't pay don't get any goods, and everyone who buys and sells the good gets to go home happy.
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Post by 18-Till-I-Die »

"More than they need?"

Wut?

The fuck is that noise. I have had so many Republicans say that when talking about healthcare, people may get "more than they need"...they even say that about medicine. What the fuck is more than they "need"? Isn't what they need, like, to make them not sick, or keep them alive if they are?

Seriously i'm in the dark how the fuck can i have more healthcare than i need? Is this a commodity now like gold? Can i sit around in my mansion with 20,000,000 healthcare in a money bin like Scrooge McDuck?
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Post by Broomstick »

Yes, they view it as a commodity.

Meanwhile, I'm sitting here with a serious infection in my leg and no health insurance. I am lucky - I am an educated adult with a small stash of emergency funds so I was able to recognize the early symptoms of something potentially very serious, and to walk into a doctor's office on Monday evening able to pay $80 for the visit. I was lucky in that the antibiotic I needed is on Meier's list of "free" meds (a PR move by the company, but I'm not arguing with it - their willingness to dispense antibiotics to the community has done more real good for healthcare than the entire Republican party has in the past 8 years).

My leg seems to be getting better, but if it doesn't continue to improve I'm looking hospitalization which WILL wipe us out entirely financially and leave us completely bankrupt.

But, you know, it's my own damn fault for being laid off. My own damn fault I'm not from a wealthy family. My own damn fault I'm not independently wealthy.

Meanwhile, I believe I have finally assembled the required paperwork and will be limping off to fax it to the state of Indiana, in the hopes of being able to acquire some sort of health insurance before something worse happens than MRSA.
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Post by PainRack »

18-Till-I-Die wrote:"More than they need?"

Wut?

The fuck is that noise. I have had so many Republicans say that when talking about healthcare, people may get "more than they need"...they even say that about medicine. What the fuck is more than they "need"? Isn't what they need, like, to make them not sick, or keep them alive if they are?

Seriously i'm in the dark how the fuck can i have more healthcare than i need? Is this a commodity now like gold? Can i sit around in my mansion with 20,000,000 healthcare in a money bin like Scrooge McDuck?
Unneccessary tests, excessive stays are some of the things that come to mind.

However, none of this is actually due to the "We can afford it" factor but rather to the insecurity factor. Hell, over here, a lot of it is due to the kiasee culture on BOTH the patient and doctor. People don't go around saying"Well, I think I have an MRI cause I have 10k lying loose around".
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Post by Darth Wong »

PainRack wrote:Unneccessary tests, excessive stays are some of the things that come to mind.
And rich people "need" more of those than poor people? Is there a health insurance policy you can buy which guarantees that you can get "unnecessary tests and excessive stays"?
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Post by Broomstick »

It's called "boutique" medicine where, for an additional fee(s), you can more access to the doctor's time, and can have more creature-comforts in a hospital room, and so forth. The lower end of the concept basically lets you buy a less-harried doctor, but on the higher end we're talking about medical luxury which may, indeed, shade into areas where some of the "extra" services provided aren't really necessary.
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Post by Darth Wong »

Broomstick wrote:It's called "boutique" medicine where, for an additional fee(s), you can more access to the doctor's time, and can have more creature-comforts in a hospital room, and so forth. The lower end of the concept basically lets you buy a less-harried doctor, but on the higher end we're talking about medical luxury which may, indeed, shade into areas where some of the "extra" services provided aren't really necessary.
Ah, I see. We try to ban that kind of behaviour in Canada because that would restrict medical access for poorer people.
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Post by Broomstick »

Yes. Canadians feel that it is not necessary to punish the poor for the fact of being poor. Unlike some people.
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Post by 18-Till-I-Die »

Well i think this goes without saying, but as every schoolchild knows it's the poor's job to shut up and die so the wealthy can live. Obviously.

But on a serious note, yeah so it's official: the US healthcare system is totally royaled. You know i recall not too long ago when i developed a blood disease that required a rather substantial amount of healthcare...the only reason, literally, that i'm not dead now is because my mom's job assures us an ironclad health insurance. Under any other amount of coverage i'd be dead now.

So, yeah...totally royaled.
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Post by Glocksman »

18-Till-I-Die wrote:Well i think this goes without saying, but as every schoolchild knows it's the poor's job to shut up and die so the wealthy can live. Obviously.

But on a serious note, yeah so it's official: the US healthcare system is totally royaled. You know i recall not too long ago when i developed a blood disease that required a rather substantial amount of healthcare...the only reason, literally, that i'm not dead now is because my mom's job assures us an ironclad health insurance. Under any other amount of coverage i'd be dead now.

So, yeah...totally royaled.
The plural of anecdote isn't data, but when I was a kid my mother worked at a freaking hospital and didn't have very good insurance.

Luckily for us, the Docs and nurses in the ER (she was an aide at the time) where she worked saw us kids for free when something came up.

Later on she went back to school and became an RN making a hell of a lot more money, but her insurance at the time she died still wasn't as good as the HMO I get from my employer.

I guess this is why when even I was a near total dittohead wingnut, I favored some kind of socialized medicine scheme and didn't buy into the 'fuck the poor' mentality on healthcare.
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Post by Alyrium Denryle »

Unneccessary tests, excessive stays are some of the things that come to mind.
In my experience that is code for "patch them up and kick them out" Our system now encourages doctors (mandates it actually) to provide the bare min care to get the person looking healthy and then boot them our the door. Those "unnecessary tests" and "excessive stays" are what allow doctors to diagnose and treat underlying conditions. A friend of my mom was just recently diagnosed with terminal lung cancer that wouldnt be terminal if the doctors had been free to run the tests necessary. What they did instead when he went into the hospital not being able to breathe, was give him anti-biotics and an anti-inflammatory and send him out the door... for 6 months.

Again, annecdotes are not data... but you end up with the fundamental problem

A socialized healthcare system's sole purpose is to deliver healthcare, and maximize patient care while minimizing costs.

A private systems purpose is to use healthcare to ensure a profit, by minimizing costs.
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Post by Justforfun000 »

Broomstick Wrote:
Meanwhile, I'm sitting here with a serious infection in my leg and no health insurance. I am lucky - I am an educated adult with a small stash of emergency funds so I was able to recognize the early symptoms of something potentially very serious, and to walk into a doctor's office on Monday evening able to pay $80 for the visit. I was lucky in that the antibiotic I needed is on Meier's list of "free" meds (a PR move by the company, but I'm not arguing with it - their willingness to dispense antibiotics to the community has done more real good for healthcare than the entire Republican party has in the past 8 years).

My leg seems to be getting better, but if it doesn't continue to improve I'm looking hospitalization which WILL wipe us out entirely financially and leave us completely bankrupt.
:shock:

That's fucked. It's so weird to me that you actually have to PAY to see the doctor. It's just such a given here in Canada that the province pays automatically for major AND minor basic health care.

Now we have to pay for our prescriptions, but even THAT is subject to provincial help. A friend of mine on a very low income only had to apply to a facet of the Ontario Drug Benefit Program called Trillium, and after reporting their yearly income ends up only paying a deductible of $250 a year and now practically all prescriptions (except newer or unusual drugs which can STILL be appealed through an Exceptional Access program), only cost him $2.00 each.

Thank God I"m here! Oops...well you know what I mean. Thank kismet. :wink:

I dearly hope you get Obama and he starts adjusting your system to a model more along ours. It's absolutely unconscionable that you have to risk serious infection and potentially death by the fucked up for profit scam you have going on down there.
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Post by His Divine Shadow »

Broomstick wrote:Yes, they view it as a commodity.

Meanwhile, I'm sitting here with a serious infection in my leg and no health insurance. I am lucky - I am an educated adult with a small stash of emergency funds so I was able to recognize the early symptoms of something potentially very serious, and to walk into a doctor's office on Monday evening able to pay $80 for the visit. I was lucky in that the antibiotic I needed is on Meier's list of "free" meds (a PR move by the company, but I'm not arguing with it - their willingness to dispense antibiotics to the community has done more real good for healthcare than the entire Republican party has in the past 8 years).

My leg seems to be getting better, but if it doesn't continue to improve I'm looking hospitalization which WILL wipe us out entirely financially and leave us completely bankrupt.

But, you know, it's my own damn fault for being laid off. My own damn fault I'm not from a wealthy family. My own damn fault I'm not independently wealthy.

Meanwhile, I believe I have finally assembled the required paperwork and will be limping off to fax it to the state of Indiana, in the hopes of being able to acquire some sort of health insurance before something worse happens than MRSA.
Have you considered compiling your experiences in a blog some day? You've written alot of useful information on this subject and your personal insight into the system and repoting of it's various (loathsome) quirks have been very revealing of the state of the healthcare system in america. It's real good ammo in debates, I could see someone reading these posts and having a helluva lot of trouble going "lalala american healthcare best in world lalala"
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Post by Broomstick »

Frankly, I don't think I have the energy for that.

That's the other thing about being poor and uninsured - you have to spend so much fucking time and energy negotiating, running around the bureaucratic maze, and otherwise scrambling to survive it doesn't leave much for anything else. And on top of all that, my local area has had two natural disasters in as many months.

Or maybe it's just that I'm up at 3 am and having a major brain fart over the bad things in life.

Fact is, there are blogs out there along those lines and it doesn't make a damn bit of difference because, you know, it's just "anecdote". Nevermind there are probably 50 or 100 million such anecdotes in this country right now.
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If a free society cannot help the many who are poor, it cannot save the few who are rich. - John F. Kennedy

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