I would like to first start by saying how much I respect Senator John Rockefeller, Democrat, from West Virginia for bringing up a robust Public Option, amendment to the Baucus plan. I would like to follow up on a part of the Senator's discussion and follow his rationale for his amendment.
Under the Baucus plan, there is a mandate, meaning every one in America will be required to carry insurance. To help those who cannot afford insurance there is a provision that the Federal government will give subsidies to people to pay for all and in some cases a portion of the premiums.
The federal subsidies, meaning the money the Federal Goverment will pay insurance companies to make insurance affordable, is in the range of half a trillion to cover lower income people.
If we do not get a public option how do we make sure that the billions we pay insurance companies, get us the most healthcare? There is metric called Medical Loss Ratio. What is that? Medical Loss Ratio means if I pay an insurance company $100 in premium, there is an amount they pay for medical care and another amount they put in their pocket for administrative costs and profits.
All the nations that have a private insurance model regulate this ratio and in some cases, like Germany, do not allow for a profit. There are some private insurers for luxury coverage, but the mandated insurers are non profit. The Swiss cap the insurance companies share to 15%. ( I need to check if this is just profit or admin as well)
The Baucus plan, says, insurance companies have to report the ratios, but there is no limit. The House proposal that is currently in play, requires that the insurance company that gets public subsidy is capped to a 15% portion for their pocket, and 85% towards medical costs, for me the insured.
So, imagine this, we offer no Public Option, nothing that we can control through public policy avenues, and yet we give billions to insurance companies without a requirement how much they will pay for coverage. I did not see the Republicans argue against this give away as being fiscally irresponsible.
The issues are not just the Public Option, if an insurance company gets a subsidy, we must cap the Medical Loss Ratio. We must make sure that the public dollars and our lowest income families get the most in healthcare from the public dollars.
The fight continues and nothing is lost. To the gloater right wingers who visit my blog, the most recent New York Times polling on how your friends, the Republicans are doing on Healthcare and other issues, this is what the people think of you:
Would you favor or oppose the government offering everyone a government administered health insurance plan — something like the Medicare coverage that people 65 and older get— that would compete with private health insurance plans?
Favor 65%
Oppose 26%
Just found this great information Inter Shame
(sorry the image is blurry)
Max Baucus got $7,734,102, Blanche Lincoln received $4,190,592, Ken Conrad took in $3,287,891, Bill Nelson was given $2,414,895 and Tom Carper accepted $1,592,380 from health industry interests. If money is the reason these five Democrats rejected the public option, then it only took a little over 19 million dollars over 20 years to buy the five votes the health insurance industry needed to kill any meaningful reform to their industry.
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Senate will vote on Public Option Tuesday Act NOW!!
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Martha Nichols
Jeanette DeMain
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Patton Lee Beaugus
halfof42
Salon.com
Comments
These clowns can never keep it simple.
Remember, Medicare has only a 12$ admin cost, the rest is for services.
You see these guys create the noise about the illegals, when Americans will be skinned alive by the insurance companies.
On my comment above it should be 12% nor 12$.
I'll never understand why it is that we would ever want insurance companies to make a profit on health claim administration. Any money that goes to insurance companies, either in the form of administrative costs, profit on administration, or profit on money not paid out in claims, simply siphons money out of the health care system with no benefit to health care. You could just as well pile up that money in the parking lot and set fire to it for all the good that it does to the system of health care.
Claims administration is what in the business world would be called a "non-value-added" activity. While you can never completely get rid of non-value-added activities, you should try to minimize them. Instead, we build large pieces of our health care system around them, taking care to insure that they survive and prosper.
Rated, with thanks.
I just arrived in Philly and am just about to go down to the conference, but wanted to send this first.
http://www.communitycatalyst.org/resources/
You'll see some good resources, especially the new one on affordability. You'll also see the stuff we use to defend Medicaid, the health coverage for the very, very poor.
Great work here, as always.
And not just the poor but very sick and medically indigent. For example, if you unfortunately need a heart valve replacement and have no insurance, Medicaid is most likely the insurer of last resort -- unless you have a spare $200,000 in assets that you can give to the hospital and doctors.
Medicaid also picks up the tab for people who are sick and disabled. The includes people with advanced cancer, serious mental illnesses, and other kinds of disabilities or disabling chronic conditions.
That's why I love it when people on the right say things like "we should eliminate Medicaid." Oh yeah, great idea. Then what? What is Plan B for the people who were on Medicaid? Then the right-wingers typically utter their magic, cure-all, fix-all phrase: "The Free Market."
Yes, whatever is wrong the Free Market will fix what ails you. They can never explain HOW it will fix everything, but they know that it will.
MC and the rest of the Blue Dogs are entirely self-serving - it is self-evident at this point. The Republicans only declare fiscal irresponsibility when they don't have something to gain by it - they don't mind the medical loss ratio being left out even with the subsidies, it's in their golden pocket interests for everyone to have health care and be paying the premiums (much like taxes). It is such a cyclical system to keep the poor oppressed and the rich, rich.
Like BBE, I believe single payer is the best way to go but don't throw out the public option with the bath water.
I am happy to hear there are sit-ins. I proposed a march. I don't want to see us required by law to now buy insurance, with no medical loss ratio cap in place, and the top 1% of Americans getting richer, who have 95% of the wealth, and the divide (or ratio) between them and the rest of us continuing to get larger. This will simply turn into one more way for them to do that and no one gets better coverage or care. It is turning into a sham. Without competition, it will be a complete screw-over of the American people.
You Democrats should be ashamed of yourselves. Conservatives will never get it when it comes to public option, but you Dems could have made it a reality.
"So, imagine this, we offer no Public Option, nothing that we can control through public policy avenues, and yet we give billions to insurance companies without a requirement how much they will pay for coverage."
Which of course springs from this:
" Max Baucus got $7,734,102, Blanche Lincoln received $4,190,592, Ken Conrad took in $3,287,891, Bill Nelson was given $2,414,895 and Tom Carper accepted $1,592,380 from health industry interests. If money is the reason these five Democrats rejected the public option, then it only took a little over 19 million dollars over 20 years to buy the five votes the health insurance industry needed to kill any meaningful reform to their industry."
October is always check-up month for me(for *everything*) and I am very aware that if I lived in the U.S. I would have to choose maybe just the mamography, maybe just the dentist, maybe just the optometrist, etc. So glad I am living in a "communist" country. Sure, I pay a sizable chunk for my insurance since I am an "immigrant" but I really get top-notch care for what I pay. Everyone here MUST have insurance. It's the way it should be.
Four years ago I had a cyst removed from the right breast and it was a manditory 3 day hospital stay! And they had already done a biopsy. It was benign. Sure, I had a drainage tube for 2 days but big whoop. Women in the states are having babies as outpatient service. How fucked up is that??
Thanks. rated
Good point, Stella. The outcome of this can be seen mirrored in the money given to the banks with no stipulation on how it is to be spent. The same is true for the Obama "Making Homes Affordable" act of Feb 2009. When there are no rules or regulations to enforce compliance, the industry does little to nothing to perform on its own and the legislation is toothless for its lack of meaningful language delineating legal or punitive consequence for non-compliance.
There will be no health insurance reform without caps on industry profits and administration. Health care reform will be yet another government "gift" to big business. I tire of this process.
I really wish that the President could act without fear for his life. Health care reform might have a different complexion without right-wing interference encouraged by the corporate owned media and lobbying interests. If this is now the way of the world, how do we get past it?
Dem, I don't understand why "fiscal" conservatives are against making sure money gets the most.
Check this out Orin Hatch thinks we should get 70 votes to pass healthcare:
But, look, if you pass a health care bill that involves one-sixth of the whole American economy and you don‘t get at least 70 votes, meaning bipartisan votes, you‘re not doing what‘s right for the American people. And I can tell you right now, Doug Elmendorf said that it‘s virtually next to impossible to be able to have a public option which would be a level playing field.http://videocafe.crooksandliars.com/heather/hardball-orrin-hatch-thinks-health-care-bill-should
I admire your perseverance in posting on this topic. I see the entire thing as a lost cause. It is a scam being perpetrated, once again, on the American public. The only point of focus in all of the "debates" (not really much debating going on) is preserving the "profit motive".
RATED
I am with Ms Bishop on the idea of a march. For those of you frustrated that "we the people" have very little input, I'd suggest we begin to plan rallys that put the us back in the US. We will never compete with the campaign money these mega-corps can spend. So we have to figure out how to magnify our presence.
We need Rockefellers. We need to end the tenure of the Baucus's.
I agree, and I think it works. But beyond that, it also makes it less likely that any progress will be made. I think that complexity is a smoke screen that gets in the way of addressing the real issues because all the focus is deflected away from them and onto the distractions...