Consumerism Commentary - Latest Comments in What’s Important to You in Healthcare Reform?

Re: What’s Important to You in Healthcare Reform?

Sarah — Sun, 30 Aug 2009 19:02:53 -0000

Health care reform should be for American taxpayers, not big business. I read a news article that said that the health care industry has 6 lobbyists assigned to each legislator in DC. The American taxpayer has exactly ZERO lobbyists to represent our interests.

With all the disinformation (a polite word for lies) being distributed in the media, I don't really think I have enough facts to have an opinion on whatever Congress is blathering about.

But I am sure of one thing: The health care industry will win at the expense of the American taxpayer.

Re: What’s Important to You in Healthcare Reform?

Apex — Thu, 27 Aug 2009 17:22:41 -0000

This was a surprisingly good summary. Worth going through. Interestingly he makes the point that there are not real savings here. That every plan costs us more money. And that the provider side still needs to be addressed in order to find real savings (mal practice, efficiency, drug companies, etc).

I find myself in agreement with most of that. And I do agree that the current system is broken and doesn't work right. If we could all be convinced that we will get something better, more portable, and will work on reducing costs at the provider level, I think you could get a lot of people on board.

I think a lot of people have very little confidence that what is currently being done accomplishes any of that. And I am in that camp.

Let's work together, put all the ideas on the table, discuss them, do a little compromise if needed, and find something American's can get broad based support behind and it will sail through. We have a good system right now that has some serious problems. But since it is working pretty well still for most of the people (my wife just had 50K surgery and we will hit our max out of pocket of $1,200 and be done paying), we aren't going to be willing to trade that in for a bunch of unknowns based on promises that we will work out the kinks.

Sorry but no thanks. Work out the kinks on paper for everyone to see and understand and get us all on board, and then lets get it done.

Re: What’s Important to You in Healthcare Reform?

Apex — Thu, 27 Aug 2009 16:59:42 -0000

Interesting Resource? It comes out of the house energy and commerce committee who is pushing to pass the bill.

Regarding the surtax the resources says:

"The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals."

Here we have 50% of the savings coming from this magical reduction in medicare costs again which only comes about by simply lowering what they will pay.

As to the surtax, they say it only hits the wealthiest 1% or so. For how long? How are those numbers arrived at? Are they remotely reliable? This is the house energy and commerce committee. The committee has a large Democratic majority that wants to pass this bill. This is not the non-partisan CBO.

Meanwhile at least one liberal Democrat is so upset with the blue dogs, who are trying to use CBO numbers and demanding some fiscal discipline that he is calling them all kinds of nasty names:

http://news.yahoo.com/s/ap/...

I am sure calling people in your own party who you need to vote with you "brain dead", "wanting to cause trouble", "promoting a right wing agenda" and "looking to raise money from insurance companies" is a good way to win them over.

But we are assurred this is going to be a bi-partisan effort to pass the best bill possible that will be better for everyone. No attempt to ram through an agenda at all costs.

Re: What’s Important to You in Healthcare Reform?

Smithee — Thu, 27 Aug 2009 16:08:08 -0000

Here's another interesting resource that analyzes the impact of the House bill (HR 3200) on a district-by-district basis.

http://energycommerce.house...

For example, in my Texas district, we could provide health insurance to 114,000 people, and only raise taxes for 1.8% of the people.

Re: What’s Important to You in Healthcare Reform?

Apex — Thu, 27 Aug 2009 14:42:11 -0000

"Could you give me a few more details about how the success of a few entrepreneurs and stock traders bubbled up into a federal surplus? Sincerely, I don’t get that."

Thats actually quite easy.

1. The stock market achieved returns that were on the order of 20% per annum from 1995 - 2000. The capital gains revenue that generated alone were a huge boon to the treasury. This level of return had not been sustained for any such period in recent history. Certainly not since prior to the 60s.

2. This also resulted in tons of jobs being created that paid huge wages (programmers were in very short supply), so people were leaving good solid jobs at reputable companies to go work for a start up that was flush with venture capital paying them 50-100% higher wages vastly increasing tax revenues.

3. One company after another was reporting fraudulent earnings, earnings that they had to pay taxes on mind you and they did, but the earnings drove the stock price and they were happy to pay those taxes on fraudulent earnings as long as it kept the stock going up, the options vesting, the deals coming and the bonuses being hit, all resulting in increased tax revenues.

4. All this extra stock market gains resulted in huge broker business, M&A business, wall street bonuses, etc, also bringing in huge tax revenues off of some of those numbers.

5. Companies like Broadcomm & Cisco (and tons of other networker suppliers), SUN (and tons of other hardware suppliers), Oracle (and tons of other software suppliers), sold tons of product to put fiber in the ground, sell switches and network gear to drive the information super highway (remember that term), and sell the hardware and software to run the businesses on the super highway. They all made huge profits doing this and it was all over capacity and when the bubble burst in 2000, those companies all crashed (very hard because they had basically sold all kinds of equipment that far outstripped real demand). They had basically sold equipment over the final few years of the 90s for demand that would take them well into the mid 2000s. So they paid taxes on all those profits in 97,98,99 when it should have been spread over about 8 years instead of 3. Lots of companies were in the same situation and thats partially why things crashed so hard in 2000 and if it hadn't been for the artificial boost of the housing industry the 2001 recession would have been much worse. Thats why this recession has and will continue to be much worse. There are no more artificial industries to pump us up and drive us out of the recession, so it will be slow and painful.

6. All this artificial demand and fraudulent earnings drove demand for employees to the point that unemployment reached levels previously believed to be only theoretically possible without massive inflation. Thus just the sheer number of people who had taxable income had increased bringing in all those extra marginal tax dollars to the treasury.

So when you add all those things up it results in increases in tax revenue that were artificially inflated. And when you are dealing with a 2.5 trillion dollar budget, a 10-20% artificial increase in tax revenue is 250-500 billion dollars and presto, you have an artificial surplus.

You are right that Bush should not have lowered taxes in 2001. Not because he wasted the surplus, but because it was never real and it was going away all on its own anyway, lowering the taxes just made it go away faster and harder.

Re: What’s Important to You in Healthcare Reform?

Apex — Thu, 27 Aug 2009 14:03:55 -0000

Healthiness and life expectancy is not a measure of health care efficacy.

Americans eat a lot of unhealthy food.
Americans are obese.
Americans shoot each other at rates much higher than other countries (yes we are violent).
Americans have a lot higher percentages of people dying in car accidents.

None of these are a reflection of the health care system.

What is a reflection is cure level for disease.

American's are cured of major diseases at a level that exceeds every other nation on the planet and for some of the other major industrialized countries like Britain, American's cure rate literally blows their numbers out of the water.

Here is proof from the British Journal the Lancet: about Cancer survival rates.

http://www.telegraph.co.uk/...

Re: What’s Important to You in Healthcare Reform?

Apex — Thu, 27 Aug 2009 12:03:54 -0000

We could, and I suspect we will, and we must because the debt/deficit is a impending disaster. However our current fiscal structural problems would not even be dealt with sufficiently by such a change. It would still leave us with a deficit (although smaller) and it would not have addressed the impending social security and medicare/medicade problems that are coming.

In addition Obama correctly states regularily that Medicare is our biggest long term problem due to balooning costs. However medicare regularily decreases what it will re-imburse and hospitals regularily lose money on medicare patients and make up the difference by charging the private sector insurers extra to cover the gap. I have a sister-in-law who works as a hospital financial auditor so she knows the books. If the government were to take over more of health care and attempt to create "cost savings" in the same way medicare does it just pushes private rates even higher and if private insurers eventually leave the system there will be no one to pass the bill on to. Obama has seniors upset now because of the proposed savings in medicare by simply reducing medicare payments for procedures by 500 billion over the next 10 years. It doesn't save any real costs if you simply "save money" by declaring that you will pay less. As far as I can tell thats what is being proposed with respect to medicare.

I don't know how to get the savings out of the system and I believe there are savings to be gotten there but I have yet to see any proposals that actually save money, just propose to spend less. Baring any real savings (Medicare has failed to find any in 40 years) the only solution is to simply pay more money to cover more people and people who are considered uninsurable. Taxes must rise significantly in order to pull this off. I am confused by the inclusion of 2 choices on this survey to raise taxes by 1% to pay for health care reform. Where did that number come from? Any kind of reform that insures everyone and guarantees coverage for all people with all pre-existing conditions, would not even be touched by a 1% increase in taxes. If someone in congress has suggested it would, they are simply horrendously wrong. You can look at the tax as a percent of GDP in most contries that provide government health care.

http://en.wikipedia.org/wik...

Nearly all of them are over 40% of GDP. The US is 28% of GDP (and our numbers already include partial government health care with the medicare/medicaid program and military spending that vastly exceeds those nations). So to get to any kind of universal coverage, simply takes a lot of money. A lot more tax revenue than we currently spend compared to other nations anyway.

Re: What’s Important to You in Healthcare Reform?

Smithee — Thu, 27 Aug 2009 07:24:05 -0000

Here's something I found after I posted the poll:

Healthcare reform explained on the back of a napkin.

Re: What’s Important to You in Healthcare Reform?

Smithee — Thu, 27 Aug 2009 07:23:11 -0000

tmk, I'm glad you brought that up, as it's a popular misconception.

The proposals being discussed aren't "government-run health care" as you describe it. The result would be all the same doctors at all the same hospitals, but doing their jobs smarter, and for reasonable amounts of money.

Re: What’s Important to You in Healthcare Reform?

Grace — Thu, 27 Aug 2009 00:00:44 -0000

"The plan doesn’t make sense, and the American people just want cheaper healthcare. Universal healthcare is something that is an aside in most people’s minds, not the *point* of reform."

I think you should have a little more faith in the American people. And even if it's hard for you to believe that most americans can be compassionate people that truly want our country to be a healthy one, at least look at it from a logical standpoint. Think of all of the people that have become incapacitated because their insurance won't cover treatment for injuries or diseases, or they simply can't afford insurance in the 1st place. Are those people in the workplace? In many cases No, and if they are they are certainly not performing at optimum levels to make production and services function as well as they should. That makes the American economy suffer.

Think of what could happen if everyone had some form of affordable healthcare that wasn't trying to find any loophole to screw people out of getting help. Healthier people make for happier, more productive people, and more productive people make for a better economy, thus raising up funds and helping the healthcare change pay for itself.

I think that's something the American people want to see too.

One of the main gripes against this plan is the money it's going to cost 'it's not practical when looking at the debt that we're already in.' Well here's the thing. The fact that we are one of the most developed countries in the world and yet we have so many problems with such a basic thing as caring for our citizens is not something we can deal with later. We have to deal with it now. It's going to be difficult and it's going to cost, but it's necessary and i believe the ultimate results are worth it.

And didn't Britain implement universal healthcare after WW2? I'm sure their national debt wasn't looking to peachy.

Re: What’s Important to You in Healthcare Reform?

Grace — Wed, 26 Aug 2009 23:40:31 -0000

I'd have to disagree with you slightly. It's true that other companies, including insurance companies can charge more or choose who they want to insure, but it is an entirely different situation charging someone for reckless driving, something that is self inflicted and thus deserves those consequences, and charging someone more or denying coverage simply because they are older or were born with a pre-existing condition. Speaking from personal experience, it is difficult enough navigating life with certain health concerns, never mind the fear of rising costs for health care just because someone at the insurance company deems you a 'high-risk case'.

Re: What’s Important to You in Healthcare Reform?

tmk — Wed, 26 Aug 2009 19:09:00 -0000

I don't understand why poeple think the government should be in charge of healthcare. Look at Indian Health Services or the VA. Those are 2 badly run health programs run by the government. The health care is rationed as are the drugs the doctors are allowed to prescribe at the VA. Basically there are tons of negative stories from these 2 government run programs. The govt can stay out of running anymore healthcare.

What needs to happen is to stop the lawsuits so malpractice insurance isn;t so high. That would stop all the duplicate testing you get when you get referred from md to md. THe doctors right now are covering their asses with unnecessary retesting to stop a lawsuit

Next, make healthcare portable across state lines. If I want to buy a plan the is sold in North Dakota because it meets the parameters of the coverage I want, I should be able to. If I want a plan without maternity and mental health benefits I should be abole to buy a plan right now. Between the states and fed govt mandating what HAS to be covered we are getting insurance that some poele don't need/want.

Re: What’s Important to You in Healthcare Reform?

Smithee — Wed, 26 Aug 2009 18:01:49 -0000

FactCheck.org runs through several scenarios regarding the five-year grace period part of the House Bill.

http://factcheck.org/2009/0...

Re: What’s Important to You in Healthcare Reform?

Terry — Wed, 26 Aug 2009 17:37:02 -0000

See this Fortune article on money.cnn.com

5 freedoms you'd lose in health care reform

http://money.cnn.com/2009/0...

4. 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.[/B]

[Continue reading and you'll see that your large-employer plan is grandfathered for five years, at which point you'll be dumped into the "exchange" to change to a different plan...and small-employer plans are grandfathered for only 12 months.)

Re: What’s Important to You in Healthcare Reform?

Terry — Wed, 26 Aug 2009 17:19:33 -0000

That's not what I keep hearing on talk radio!

Somebody is either lying or unclear on the subject.

A lot seems open to interpretation and depends on who writes the implementing regs, and on who is appointed to decide what's covered and what isn't.

I keep hearing Obama say that the bill does not mandate coverage for abortion. True enough, but highly misleading:

If Obama gets to appoint the decider, does anyone doubt that coverage for abortion WILL be mandated for all plans? Which sets us up for turning every presidential election into a referendum on abortion.

Re: What’s Important to You in Healthcare Reform?

Tom Dziubek — Wed, 26 Aug 2009 16:31:41 -0000

Thanks Jim. What you're reporting is capital gains and the tax income from that. However, I have to assume the dot-com bubble had even more of an impact than just in stock sales, and particularly regarding tax income from new & better jobs (putting people in a higher income tax bracket), commerce, etc...you know, trickle down things that would have been generated from a healthy economy.

Re: What’s Important to You in Healthcare Reform?

freeby50 — Wed, 26 Aug 2009 15:12:31 -0000

In 1993 capital gains reported on tax forms was about $111B. By 2000 capital gains had increased to $525B. If the stock market hadn't gone up so much then we wouldn't have seen such an increase in capital gains. Thats a $414B increase per year. The capital gains tax on that increase would be about $84B (the rate was 20% at the time).

You could assume that a large % of those capital gains are from stock sales. So a large % of that $84B in additional tax revenue is directly due to increases in the stock market.

From 1993 to 2000 we went from a deficit of $255B to a surplus of $236B. Thats a swing of $491B. The $84B from increased capital gains is about 20% of that.

Re: What’s Important to You in Healthcare Reform?

freeby50 — Wed, 26 Aug 2009 14:48:46 -0000

Terry,

Yes COBRA would work the same way as it does now.
Yes if you change jobs you would be able to get insurance from your new employer.

Re: What’s Important to You in Healthcare Reform?

freeby50 — Wed, 26 Aug 2009 14:42:07 -0000

"What happens in cases where employers drop current benefit levels to an extremely expensive level to their employees, forcing them into the public option? Why wouldn’t they?"

Employers will be required to either provide a basic level of coverage OR pay 8% of payroll into a fund. So they either have to provide a decent level of coverage as mandated by the government or pay 8% of wages. Small businesses will get a credit to help them pay for it.

Re: What’s Important to You in Healthcare Reform?

Terry — Wed, 26 Aug 2009 11:41:40 -0000

Hey Smithee:

Until I get an answer to my questions, I'll keep asking them:

If I lose my job, will I be able to keep my unchanged coverage the same way I can keep it now through COBRA by paying the premiums?

If I change jobs, will I be able to sign up for my new employer’s plan?

Re: What’s Important to You in Healthcare Reform?

UH2L — Wed, 26 Aug 2009 11:41:25 -0000

Ask yourself the question of why we would want to take this on when you are out of a job, or close to retirement age, unemployed, but too young to get Medicare. That's what happened to my father. He and my mom would have had to pay $3,000 a month for health care coverage due to pre-exisitng conditions. If it weren't for his consulting business, he would have not been able to get a more affordable group rate. That is a crisis that many people face. Everything's fine with you right now because I'm assuming you have a job. Wait until you don't or until, God forbid, you have some kind of medical condition that makes insurance companies not pay for your expenses or not accept you as a new customer.

We can't improve the healthcare situation unless we try. We may have to increase the debt now to reduce future debt from our health care system. If we don't fix our medical system, it will be an economic burden on our whole economy, our people will continue to be collectively unhealthy, and again, we will be less competitive as a nation. Sick people aren't productive. People who are bankrupt from medical bills, (even the insured), are not good for our economy. They probably tend to foreclose on their homes. And we know how that's bad.

As for being financially responsible, the tax cuts for the wealthy were a bad idea fiscally because they lead to higher debt. At some point, a cut-off income level has to be decided on, one above which people's taxes will go up. A reasonable number can be figured out based on income distribution, cost of living. The lower tax rate on capital gains is another tax cut that should be eliminated since it tends to help the wealthier among us only.

Re: What’s Important to You in Healthcare Reform?

Tom Dziubek — Wed, 26 Aug 2009 10:53:51 -0000

"Could you give me a few more details about how the success of a few entrepreneurs and stock traders bubbled up into a federal surplus? Sincerely, I don’t get that."

Well, I'm no economist here (and perhaps one can chime in) but I'm going to go off the simple supposition that greater wealth & more taxable transactions = more tax income. Besides, I think you're greatly underestimating the impact. Success for only "a few entrepreneurs and stock traders"? C'mon, the tech-heavy NASDAQ went from under 1000 points in 1995 to over 5000 points in 2000 before the bubble burst. There were more than a few who profited, and well at that.

Re: What’s Important to You in Healthcare Reform?

Smithee — Wed, 26 Aug 2009 10:23:29 -0000

think it’s fair to say that the bulk of Clinton’s success resulted more from the internet boom and dot-com bubble that occurred during his tenure than anything else. That was an incredibly fortuitous opportunity for any administration to happen upon

Could you give me a few more details about how the success of a few entrepreneurs and stock traders bubbled up into a federal surplus? Sincerely, I don't get that.

Then what’s another few months to allow the public time to see what exactly is being proposed and to digest it?

I agree with that, too. Of course, there's no one single bill being considered by Congress, yet, which makes this a little tricky. What makes it even trickier is that massive dis-information campaign surrounding the bill that the House put out.

The trickiest part, the part that I could do without, is the notion that if it doesn't get done in 2009, too many politicians in 2010 will be extra concerned about running for re-election.

However my beef is with the government’s planning and implementation of just about anything.

Does that include the National Weather Service, NASA, the USDA, the FDA, the National Highway Traffic Safety Administration, the EPA, the US Postal Service, GPS satellites and OSHA? I think plenty of federal programs work just fine. Is there waste and corruption to be found? Undoubtedly. But I'd never sign up to do without them.

On the other hand, if the Government asked me to sacrifice an extra $4 per paycheck to help pay for badly-needed medical care for other Americans, even people I've never met, I'd be the first to raise my hand.

In watching the "debate" as posed by the type of person to disrupt a town hall, I think that might be the core of the disagreement. I'm saying "all for one, one for all", and they're saying "every man for himself!" That's probably an insulting oversimplification, but I can't think of a better metaphor at the moment.

Re: What’s Important to You in Healthcare Reform?

Tom Dziubek — Wed, 26 Aug 2009 10:08:57 -0000

"I think the first thing to do would be to go back to the clearly successful tax system we had under Bill Clinton."

I think it's fair to say that the bulk of Clinton's success resulted more from the internet boom and dot-com bubble that occurred during his tenure than anything else. That was an incredibly fortuitous opportunity for any administration to happen upon. You might argue Gore's introduction of the High Performance Computing and Communication Act as being what greased the skids of the internet boom, but that happened in 1991 and was even signed and endorsed by George Bush Sr.

"Cash for Clunkers was a runaway success, even though some dealers fear they won’t be reimbursed. I trust that they will."

From a public perspective, Cash for Clunkers was indeed a runaway success. It's hard NOT to be a success when the government essentially prints out coupons worth several thousand dollars towards the purchase of a new car.

However my beef is with the government's planning and implementation of just about anything. The problem was that the government anticipated it would last until November and then had to bring the program to a screeching halt when its one billion dollar funds ran out after only a few days, forcing them to scramble to come up with another two billion to continue it. In addition to all that, there were other missteps, such as a last minute update of EPA info that caused multiple vehicles to suddenly become ineligible and also an astounding IT decision where the public CARS website was placed on the same server that dealers used to process their info, causing them both to crash.

"When I listen to him talk, I hear him frequently say, “Look, we’ve been talking about this for decades. Now we have a chance to actually get it done.” I guess it depends how you get your news."

Then what's another few months to allow the public time to see what exactly is being proposed and to digest it?

Re: What’s Important to You in Healthcare Reform?

derringer — Wed, 26 Aug 2009 09:53:35 -0000

Let me ask you this, then, Smithee.. why would the American people want to risk change at all if there is almost no reason for them to take on the risk, other than a desire for universal healthcare? (And there are all sorts of 'risks' to private insurance and care when you start adding a public healthcare plan which would, by conservative estimates, encompass over 25% of the US population.)

That really isn't what the American people, on average, want. And that is my point. What does 'increased consumer protections' mean? What is to stop small businesses from dropping healthcare benefits altogether? What happens in cases where employers drop current benefit levels to an extremely expensive level to their employees, forcing them into the public option? Why wouldn't they? Does the government possibly comprehend that *anyone* that is below the income threshold will be on the public option, resulting in a massive increase in proposed cost? Small business will, literally and almost without exception, do this...they will drop benefits to anyone at 3x the poverty level and under, which is a *huge* number and will be unbelievably expensive to the US taxpayer.

The plan doesn't make sense, and the American people just want cheaper healthcare. Universal healthcare is something that is an aside in most people's minds, not the *point* of reform.

Does that make any sense? The average American is a little bit liberal and a little bit conservative. Any plan that is to have public support needs to balance these two and be more in the middle. Provide for better insurance for uninsured, but possibly not universally or fully covering everything, and show a real, calculated cost for the plan, not something made up with horrible assumptions, that doesn't result in massive taxpayer consequences, regardless of what income level it is, and then you'll have a plan that will have public support.

Does that kind of plan exist? I think it could, but the currently proferred plans are not even close.