Sunday, October 25, 2009
Public option winning?
Sunday, September 13, 2009
Tea baggers stage a small protest against big government.
Here's a short summary from Talking Points Memo.
http://www.talkingpointsmemo.com/archives/2009/09/small_protest_agst_big_govt.php?ref=fpblg
Obama’s Squandered Summer -- Frank Rich
THE day before he gave his latest brilliant speech, Barack Obama repeated a well-worn mantra to a television interviewer: “My job is not to be distracted by the 24-hour news cycle.” The time has come for him to expand that job description. His White House has a duty to push back against the 24-hour news cycle, every 24 hours if necessary, when it threatens to derail his agenda, the nation’s business, or both. This was a silly summer, as wasteful in its way as the summer of 2001, when Washington dithered over the now-forgotten Gary Condit scandal while Al Qaeda plotted. The president deserves his share of the blame.
After a good couple of years of living with the guy, we know the drill that defines his leadership, for better and worse. When trouble lurks, No Drama Obama stays calm as everyone around him goes ballistic. Then he waits — and waits — for that superdramatic moment when he can ride to his own rescue with what the press reliably hypes as The Do-or-Die Speech of His Career. Cable networks slap a countdown clock on the corner of the screen and pump up the suspense. Finally, Mighty Obama steps up to the plate and, lo and behold, confounds all the doubting bloviators yet again by (as they are wont to say) hitting it out of the park.
So it’s a little disingenuous for Obama to claim that he is not distracted by the 24-hour news cycle. What he’s actually doing is gaming it for all it’s worth.
As a mode of campaigning, this tactic was worth a great deal. Obama not only produced eloquent speeches — especially the classic disquisition on race that silenced the Jeremiah Wright pogrom — but also executed a remarkably disciplined tortoise-vs.-hare battle plan that outwitted and ultimately vanquished the hypercaffeinated political strategies of Hillary Clinton and John McCain. As a style of governing, however, this repeated cycle of extended above-the-fray passivity followed by last-minute oratorical heroics has now been stretched to the very limit.
Wednesday night’s address on health care reform was inspired, lucid and, in the literally and figuratively Kennedyesque finale, moving. It was also (mildly) partisan, a trait much deplored by high-minded editorial writers but in real life quite useful when your party is in the majority and you want to rally the troops to get something done. But there was little in the speech that Obama couldn’t have said at the summer’s outset. Its practical effect may prove nil. Short of signing a mass suicide pact, the Democrats were always destined to pass a bill. Will the one to come be substantially better than the one that would have emerged if the same speech had been delivered weeks earlier? Not necessarily — and marginally at most.
In the meantime, a certain damage has been done — to Obama and to the country. The inmates took over the asylum, trivializing and poisoning the national discourse while the president bided his time. The lies that Obama called out so strongly in his speech — from “death panels” to “government takeover” — ran amok. So did all the other incendiary faux controversies, culminating with the ludicrous outcry over the prospect that the president might speak to the nation’s schoolchildren on a higher plane than, say, “The Pet Goat.”
None of this served his cause of health care reform or his political standing. The droop in Obama’s job approval numbers isn’t remotely as large or precipitous as the Beltway’s incessant doomsday drumbeat suggests. But support for his signature program declined, not least because he gave others carte blanche to define it for him. Perhaps the most revealing of all the poll findings came in an end-of-August Washington Post query asking voters what “single word” first came to mind to describe their “feelings” about Obama and his health care proposals. For Obama, the No. 1 feeling was “good.” For the policy package he’d been ostensibly selling all summer, the No. 1 feeling was “none.”
It’s not, as those on the right would have us believe, that Obama’s ideas are so “liberal” that the American public recoiled. It’s that much of the public didn’t know what his ideas were. Even now I’m not convinced that most Americans know what a “public option” really means or what Obama’s precise position on it is. But I’d bet that many more have a working definition of “death panels.” The 24-hour news cycle abhors a vacuum, and the liars and crazies filled it while Obama waited for his deus ex machina descent onto center stage.
That he let the hard-core base of a leaderless minority party drive the debate only diminished his stature. That’s why his poll numbers on “leadership” declined. The right-wing fringe has become so deranged that it will yank its kids out of school to protest the president and risk yanking more Americans off assembly lines by boycotting General Motors to protest the administration’s Detroit bailout. Even Laura Bush and Newt Gingrich stepped in last week to defend Obama’s classroom homily from the fusillades by some of their own party’s most prominent ideologues. The White House should have landed a punch before they did.
Obama would have looked stronger if he’d stood up more proactively to the screamers along the way, or at least to the ones not packing guns. As the Roosevelt biographer Jean Edward Smith has reminded us, it didn’t harm the New Deal for F.D.R. to tell a national radio audience on election eve 1936 that he welcomed the “hatred” of his enemies. Indeed Obama instantly gained a foot or two in height Wednesday night once that South Carolina clown hollered “You lie!” (One wonders what this congressman calls the Republican governor of his own state, Mark Sanford.) As the political analyst Charlie Cook has pointed out, Obama’s leadership poll numbers have also suffered from his repeated deference to Congress. Waiting for the pettifogging small-state potentates of both parties in the Senate’s Gang of Six is as farcical as waiting for Godot.
Now that he has taken charge, Obama will speed the process and, we must hope, secure reform that may make a real difference for everyone, starting with the 46-million-plus Americans who have no health insurance. But when we gain some perspective on the summer of 2009, the health care debate, like the crazed town-hall sideshows surrounding it, may seem very small in the history of this presidency — maybe even as small as the Condit follies and the breathlessly reported shark attacks of summer 2001 now look in the history of the previous administration.
The reason is that health care reform, while an overdue imperative, still is overshadowed in existential urgency by the legacies of the two devastating cataclysms of the Bush years, 9/11 and 9/15, both of whose anniversaries we now mark. The crucial matters left unresolved in the wake of New York’s two demolished capitalist icons, the World Trade Center and Lehman Brothers, are most likely to determine both this president’s and our country’s fate in the next few years. Both have been left to smolder in the silly summer of ’09.
As we approach the eighth anniversary of the war that 9/11 bequeathed us in Afghanistan, the endgame is still unknown and more troops are on their way. Though the rate of American casualties reached an all-time high last month, the war ranks at or near the bottom of polls tracking the issues important to the American public. Most of those who do have an opinion about the war oppose it (57 percent in the latest CNN poll released on Sept. 1) and oppose sending more combat troops (56 percent in the McClatchy-Ipsos survey, also released on Sept. 1). But the essential national debate about whether we really want to double down in Afghanistan — and make the heavy sacrifices that would be required — or look for a Plan B was punted by the White House this summer even as the situation drastically deteriorated.
No less unsettling is the first-anniversary snapshot of 9/15: a rebound for Wall Street but not for the 26-million-plus Americans who are unemployed, no longer looking for jobs, or forced to settle for part-time work. Some 40 million Americans are living in poverty. While these economic body counts keep rising, tough regulatory reform for reckless financial institutions, too-big-to-fail and otherwise, seems more remote by the day. Last Sunday, Jenny Anderson of The Times exposed an example of Wall Street’s unashamed recidivism that takes gallows humor to a new high — or would were it in The Onion, not The Times. Some of the same banks that gambled their (and our) way to ruin by concocting exotic mortgage-backed securities now hope to bundle individual Americans’ life insurance policies into a new high-risk financial product built on this sure-fire algorithm: “The earlier the policyholder dies, the bigger the return.”
When we look back on these months, we may come to realize that there were in fact “death panels” threatening Americans all along — but they were on the Afghanistan-Pakistan border and on Wall Street, not in the fine print of a health care bill on Capitol Hill. Obama’s deliberative brand of wait-and-then-pounce leadership let him squeak — barely — through the summer. The real crises already gathering won’t wait for him to stand back and calculate the precise moment to spring the next Do-or-Die Speech.
But Who Is Watching Regulators?
Fair Game
But Who Is Watching Regulators?
By GRETCHEN MORGENSON
NOTHING succeeds like failure, as the saying goes. And nowhere is this dismal truth more evident than in our financial regulatory system, one year after the bankruptcy filing of Lehman Brothers.
Even though calamitous lending practices laid waste to the nation’s economy, surprisingly little has changed about how the financial arena operates and is supervised. Sure, a couple of venerable brokerage firms have vanished, but many of the same players remain on the scene, in the same positions of power.
Senior regulators who stood idly by for years as financial firms built their houses of cards have been rewarded with even bigger jobs or are jockeying for increased responsibilities. The Federal Reserve Board, for example, wants to become the financial system’s uber-regulator, even though its officials did nothing as banks made deadly decisions to lend recklessly and leverage themselves to the max.
Awarding increased power to those who failed in their oversight duties flies in the face of all notions of accountability. Imagine hiring Angelo R. Mozilo, the former chief of Countrywide Financial, to run a global financial institution, or installing E. Stanley O’Neal, who presided over a disastrous period at Merrill Lynch, at the helm of a major investment firm.
Yet those in the public sector ask us to believe that regulators who snoozed during the credit bubble will be alert to emerging problems on their beats when the next mania begins.
That’s asking a lot, isn’t it?
Here’s a novel thought. Instead of creating more regulations to try to prevent this kind of mess from recurring, why not figure out how to hold regulators accountable when they perform as poorly as they did in recent years?
Edward J. Kane, a professor of finance at Boston College and an authority on the ethical and operational aspects of regulatory failure, has some ideas about how to do this and right our damaged system in the process. He outlined them in a recent paper titled “Unmet Duties in Managing Financial Safety Nets.”
This ugly financial episode we’ve all had to live through makes clear, Mr. Kane says, that taxpayers must protect themselves against two things: the corrupting influence of bureaucratic self-interest among regulators and the political clout wielded by the large institutions they are supposed to police. Finally, he argues, taxpayers must demand that the government publicize the costs of efforts taken to save the financial system from itself.
“That authorities and financiers could so callously violate common-law duties of loyalty, competence, and care they owe taxpayers and financial-institution customers is evidence of a massive incentive breakdown in industry and government,” Mr. Kane writes. “This breakdown cannot be repaired merely by replacing the governing political party or by changing the jurisdictions and mission statements of regulatory agencies.”
It’s tough, however, to assign responsibility to regulators who routinely fend off or stymie anyone attempting to scrutinize how the cops on the beat functioned in the years preceding the financial meltdown. So everyday Americans need to kick and scream if they want some light shed on this critical epoch in our financial history.
To bring accountability to regulatory performance, Mr. Kane suggests that financial supervisors take an oath of office in which they agree to perform four duties. First is the duty of vision, under which they would promise to adapt their surveillance practices to respond to the creative ways financial institutions hide their dubious practices. Regulators must also promise to take prompt corrective action, and to perform their work efficiently. Finally, there is what Mr. Kane calls the duty of “conscientious representation,” whereby regulators swear to put the interests of the community ahead of their own.
This last promise gets to the heart of a continued erosion of trust in our system, Mr. Kane argues. “If real world supervisors were perfectly virtuous, they would make themselves politically and financially accountable for the ways in which they exercise their discretion,” he writes. “Perfectly virtuous supervisors would fearlessly bond themselves to disclose enough information about their decision making to allow the community or interested outsiders to determine whether and how badly they neglect, abuse, or mishandle their responsibilities.”
Instead, our regulators refuse to produce complete documentation and accounts of the actions they took during the crisis. And keeping taxpayers in the dark isn’t exemplary ethical behavior. Rather, it is characteristic of what Mr. Kane calls an elitist regulator, one who uses crises to cover up mistakes and expand his or her jurisdiction.
“According to this standard,” Mr. Kane writes, “Fed efforts to use the crisis as a platform for self-congratulation and for securing enlarged systemic-risk authority sidetracks, rather than promotes, effective reform.”
To ensure that regulators live up to the promises they make, Mr. Kane suggests that inspectors general at each agency be charged with regularly auditing the performance of financial overseers. A crucial component of those reviews would be exploring attempts by regulated entities to influence the officials who oversee them. That’s because in financial crises, Mr. Kane explained, crippled institutions pressure the government to rescue them and force other parties (usually the taxpayers) to share their pain.
“We’ve got a very comfortable equilibrium here where Wall Street praises the authorities and the authorities give Wall Street more or less what it wants and they hope that the public really doesn’t understand the depth of the cynicism involved,” Mr. Kane said in an interview. “You keep reading about how wonderful it is that we didn’t have a Great Depression. Well, if they can sell that point of view, then nothing will change.”
Copyright 2009 The New York Times Company
Thursday, August 20, 2009
THE ECONOMY AND HEALTH CARE (what else is new?)
Mixed news on the US economy
1. http://www.ft.com/cms/s/0/cf328fb2-8d99-11de-93df-00144feabdc0.html
2. Greetings from RGE Monitor! Below you will find a preview of our views on the short- and medium-term outlook for the U.S. economy.
Rebalancing Growth
A number of economic and financial variables have exhibited signs of improvement recently even if macro indicators are still mixed. The pace of economic deterioration has slowed significantly, and after four quarters of severe contraction in economic activity, RGE Monitor now forecasts that the U.S. will display positive real GDP growth in the second half of 2009. As discussed below, however, that does not mean that the recession in the U.S. is already over, as many analysts have argued. Indeed, all the variables used by the National Bureau of Economic Research (NBER) to date recessionary periods will continue to contract or display sub-par growth. However, RGE Monitor now anticipates that policy measures and other factors will boost real GDP growth, albeit in a temporary manner, in the second half of 2009. Yet the shape of the recovery (will it be V, U or W?) and other challenges will influence the U.S. economic outlook going forward. According to RGE Monitor, growth will remain well below potential in 2010, while the shape of the recovery will be closer to a U. Some of the so-called “green shoots” observed in the economy in recent months can be defined as green shoots only if compared with the economic picture painted at the beginning of the year. The contraction in some indicators, such as industrial production, is still comparable to the recessions in the 1970s and 1980s. The July 2009 employment report displayed “only” 247,000 non-farm payroll losses—hardly qualifying as a green shoot in any other post-war recession. (See Easing Job Losses Don’t Change Weak Prospects for U.S. Recovery).
However, given how close the U.S. was to entering a depression, even 250,000 payroll losses seem capable of cheering up investors. H2 2009 Pick-Up in GDP Growth a Temporary Phenomenon In H2 2009, as the economy bottoms out from a record contraction (the worst in the last 60 years), adjustments, such as slower inventory destocking, will occur, while policy measures such as “cash for clunkers” will boost auto production and induce continued spending brought on by the stimulus. According to RGE Monitor, these factors will likely bring U.S. real GDP growth back to positive territory in Q3 2009. However, the NBER is not likely to call the end of the recession until at least late 2009 or early 2010.
In addition to GDP growth, the NBER looks at four variables in making recession calls: real personal income less transfer payments, real manufacturing and wholesale-retail trade sales, industrial production and payroll employment. While all of these indicators might perform better in H2 than in H1 2009, they are likely to remain in contraction or register sub-par growth. With the labor market now a leading indicator for the recovery in private consumption and the wider economy, trends in payrolls will definitely influence the NBER's call. Lower Trend Growth Will Characterize the Recovery The inventory adjustments will largely be over by the middle of 2010 as will the impact of the stimulus. But since the recovery in private demand will be weak, the economy is poised to slip back to anemic growth (well below potential) in 2010, posing the risk of a double-dip recession. Exhausting most policy measures now means that there will be little room for additional fiscal and monetary stimuli in the future. Policy measures entailing long-term fiscal costs can only provide temporary stimulus to growth. Any sustained economic recovery will ultimately have to come from the revival in private demand—i.e. through consumption and investment—both of which will be constrained by structural factors. Preceded by a financial crisis, this is the most severe and prolonged recession since the 1930s. Avoiding the short-term pain of private-sector deleveraging by socializing private losses and re-leveraging the public sector with large deficits and debt accumulation will spur long-term costs and crowd out private spending. The drivers of the previous economic boom—consumers, the housing sector and easy credit—will remain under pressure even after the economy is out of recession. Structural weaknesses will persist. Until the economy finds new sources of growth, it will grow below potential for several years. Potential GDP growth might also take a hit, falling from around 2.8% during 1997-2008 to around 2.25% in the coming years. Productivity growth has held up—on a temporary basis—during the current recession, not due to innovation or productive investment, but due to aggressive cuts in labor and labor hours by firms. In the coming years, productivity growth will remain under pressure as workers age, structural unemployment rises, labor skills deteriorate, and investment and innovation slow.
3. Brighter signs in Europe
http://www.ft.com/cms/s/0/52947306-8cdd-11de-a540-00144feabdc0.html
4. Long-term (and scary) view of the crisis, comparing the Great Depression to the Great Recession -- long article, but very interesting
http://www.voxeu.org/index.php?q=node/3421
ON HEALTH CARE
Have the Republicans pushed the envelope too much?
1. Senator Grassely and townhall meetings
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/19/AR2009081004125.html?wpisrc=newsletter
2. The end of bipartisanship?
http://www.nytimes.com/2009/08/19/health/policy/19repubs.html?_r=1&ref=health
3. The Health Insurance Industry according to a free-market supporter
Health Care War! by Martin D. Weiss, Ph.D.
Dear Subscriber,
What you're witnessing in the U.S. today is not a health care debate. It's a health care WAR.
But it's too soon to take sides: Neither has defined its territory; both are escalating the battle with weapons of mass disgrace. In the meantime, millions of Americans are potentially innocent victims of the collateral damage — both financially and physically. But if you're among those upset at the Obama administration for trying to ram through a health reform bill, wait till you see what most health insurance companies are doing — and have been doing for many years!
They routinely overcharge you on premiums when you're healthy and deny your claims when you're sick.
They welcome your policy when you don't need it and shred it when you do.
Adding financial insult to personal injury, they take the savings you've worked so hard to earn and throw it into high-risk investments you'd never touch with a ten-foot pole.
.....
How Americans Are Routinely Bullied, Cheated, And Abused by Their Health Insurance Companies
The business battles I fought with insurers are inconsequential in comparison to the life-and-death struggles fought by millions of Americans with their insurance companies every day.
All I lost was time and money. In contrast, a young mother with bone cancer who fought against the same company that sued me lost a lot more: her life.
In a trial after her death, the jury read internal memos that revealed a sinister plot: To reduce their costs, not only did the company's executives pursue extreme measures to deny her the treatments that could have saved her life ... they also discussed the cost benefits of hastening her demise. The jurors were so outraged, they awarded her family the largest punitive damage award in the history of health insurers. Think these are just isolated cases? Think again!
Here are just a few of the rampant abuses that continue to this day:
Abuse #1Denial machines ...
Most health insurers spend substantial sums in order to develop computer programs and systems that automatically and repeatedly deny and delay claims payments;
hire doctors specialized in poking holes in legitimate claims; and give extra bonuses to employees who can successfully deny the most claims. In sum, health insurers build massive machines designed with the sole purpose of denying and delaying your claims. They know that few policyholders will take legal action. Plus, even though policyholders do win judgments, the companies can earn a lot of extra income on the funds they hold back with delayed claims payments. The longer you or your doctor has to wait for reimbursement, the more income they can make on your money.
And unfortunately, this is not just about a few bad apples in the industry. According to the National Association of Insurance Commissioners (NAIC), in 2008 alone, policyholders filed 195,669 complaints against insurance companies. That excludes complaints in many states which do not compile comparable data and, needless to say, it also excludes the millions of Americans who do not file a formal complaint.
The two most common types of complaints of all: delays and denials.
"All too often," says New York Attorney General Cuomo, "insurers play a game of deny, delay, and deceive." And, I might add, all too often, people are bankrupted by the expenses or die waiting for the care.
But it gets worse ...
Abuse #2 After-the-fact policy cancellations ...
Just last Tuesday, the U.S. Department of Health and Human Services released a study demonstrating that, in most states:
Insurance companies can retroactively cancel individual policies if any condition was not disclosed when the policy was obtained. More to the point, insurers can cancel the policies even if the medical condition is unrelated and even if the person was not aware of the condition at the time. (Italics are mine.)
Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition.
And again, companies institute sophisticated systems and procedures that maximize the savings with these underhanded tactics, including special compensations for employees who can deploy them most effectively.
Two major insurers have admitted to Congressional committees that they automatically investigate the medical records of every policyholder with certain conditions, including leukemia, ovarian cancer, brain cancer, and becoming pregnant with twins.
For example, in one case, after a Texas resident was found to have a lump in her breast, the insurance company investigated her medical history and concluded that she had been diagnosed previously with osteoporosis. Although that condition was unrelated to breast cancer, the company used it as an excuse to cancel her policy.
No, I don't support the notion that underwriting — the process of denying coverage or charging higher premiums due to known risks — is somehow evil. Quite the contrary, if insurers do NOT protect themselves from those risks, they may not be financially capable of fulfilling their promises to all other policyholders. But systematically leveraging contract loopholes to cancel policies after a condition is diagnosed fails to pass the most basic of smell tests.
The most insidious abuse of all: Direct interference with medically recommended procedures ...
"One of our big frustrations with insurance companies," says GOP Congressman Tim Murphy, "is they control the market place, they control what's done," and what doctors decide.
Indeed, in 50 out of 300 U.S. metropolitan areas, a single health insurer controls at least 70 percent of customers. And in many more areas, just two health insurance companies dominate the market.
That puts both you and your doctor at a great disadvantage.
End result: Your doctor's decisions about what's best for your health are frequently overruled by the insurer's decisions about what's best for its bottom line.
Most patients don't realize how widespread this is and how deeply it can impact the quality of care. Most doctors, meanwhile, are so sick and tired of insurance company interference, they've given up complaining.
Which Companies Are the Worst Offenders?
For the most part, government officials are loathe to give you straight answers. But I do. Based on my review of customer complaint data compiled by key states, here's my partial list:
Some Major Health Insurers and HMOs WithThe MOST Frequent Customer Complaints American International GroupAtlantis Health Plans, Inc.Celtic Insurance CompanyCIGNA Healthcare of NY, Inc.Fortis GroupGHI HMO Select, Inc.Mutual of Omaha GroupOxford Health Plans of NYUnitedHealth Group
Not all insurers routinely resort to bad business practices. In fact, some bend over backwards to pay claims promptly and avoid customer complaints ...
Some Major Health Insurers and HMOs WithThe LEAST Frequent Customer Complaints CNA Insurance GroupMass Mutual Life Ins. Co.Northwestern MutualSun Life Assurance Company of CNUniversal American FinancialUNUMProvident Corp. Group
My Recommendations Are Very Straightforward ...
First and foremost, do everything within reason to avoid the worst providers and stick with the best. My lists above are not complete, but I'm confident in my conclusions for each company cited. Second, be sure to keep all your medical records and correspondence with insurers.
Third, if your insurer tries to stiff you for bills you feel should be covered, file a formal complaint. Some states let you file your complaint online. Others require you do it via mail. Either way, do not let insurance companies get away with behavior that you feel is unfair or abusive.
Fourth, if you can't get satisfaction, seriously consider legal action. The good news: Most of the time, plaintiffs with good documentation do win.
Tuesday, August 11, 2009
What Health Reform Will Do For You -- And Why
blog.healthcareforamericanow.org/2009/08/04/what-health-reform-will-do-for-you-and-why/
The below is based on the House version of health care reform, HR 3200 - America's Affordable Health Choices Act, which is the strongest bill being discussed to date. In short, it will provide a guarantee of quality, affordable health care to everyone.
1. If you receive health insurance from your employer (or your spouse's or parent's employer):
The big things will not change - you will keep your current health insurance, keep your current doctor, and keep your current benefits. All the health reform plans being proposed allow people to keep their health insurance if they want to, and that means keeping their current benefits and choice of doctor. So if you get your coverage through work, or if your spouse or parent covers you on their health insurance through work, these big pieces will not change unless you want them to.
Your health insurance will get better and more stable. Health reform gives your employer a strong incentive to retain your health insurance or make it better. They will have to offer you at least standard, comprehensive package of benefits and your employer will not be able to continue shifting additional costs of insurance to you - they will have to pay at least about 70% of the cost of your coverage.
Your health insurance will get cheaper. As the public health insurance option forces insurance companies to compete, prices of private health insurance will fall. Your costs, even if you keep your current health insurance plan, will go down.
If you lose your job, you will always be able to get affordable insurance. If for any reason you lose your job and your employer based coverage, you will be eligible for affordable health insurance that meets your needs, as described below, with the government helping you pick up the tab until you get back to work, and expenses will be capped to make sure you can't go bankrupt due to medical costs. You will always have a guaranteed, affordable backup to rely on if you need it.
2. If you are employed but do not receive health care benefits from your employer:
Your employer will have to offer you good, affordable health insurance. Under the bill proposed by the House, employers will have to offer you health benefits. Those benefits need to meet a standard for coverage, so you can't be offered sub-par insurance that doesn't meet the needs of you and your family. And your employer will have to cover a large percentage of your health care costs (65% for families and 72% for individuals), ensuring insurance is affordable and your employer can't shift more costs to you. Small businesses are exempt from this regulation.
If you work for a small business that is exempt from regulations asking employers to provide health benefits you will always be able to get affordable insurance. You will be eligible for affordable health insurance that meets your needs, as described below.
3. If you buy health insurance on your own, or if you or your family are uninsured:
You will be able to find coverage. You will have access to a new health insurance "exchange," where both public and private health insurance will be offered. You will be able to compare these plans side-by-side and choose what's right for you and your family. None of these plans will be able to reject your application for pre-existing conditions or for your gender. You will have guaranteed access to health insurance.
You will be able to afford coverage. Any health insurance plan in the exchange will be subsidized if you qualify. Subsidies will be available up to 400% of the federal poverty level, or $88,000 per year for a family of four. These subsidies will ensure that you will only pay a certain percentage of your income in health care costs (that percentage varies depending on how much you make). Bottom line: Health insurance through the exchange will be affordable to you.
You will save money. Even if you do not qualify for subsidies or choose the public health insurance option, competition from the public health insurance option will force prices for insurance to fall across the board.
Your coverage will be good coverage, stable and secure. All plans in the exchange will have to conform to federal regulations, making sure that the plan you purchase covers things that you and your family need - things like preventative medicine, regular checkups, and prescription drugs. And, under health reform, your health insurance company will no longer be able to deny you coverage or care for pre-existing conditions. Your insurance company will no longer be able to drop your coverage if you become sick, or charge you more if you're a woman. There will be no more annual or lifetime caps on coverage, so you won't be stuck with tens of thousands in uncovered medical bills. And if you pay your premiums, your insurance company won't be able to reject a renewal of your insurance plan.
Your expenses will be capped. Deductibles, co-pays, premiums, and other expenses will be capped at a percentage of your income (between 1.5% and 11%, depending on how much you make), so you no longer face exorbitant health insurance costs.
4. If you are on Medicare or Medicaid:
Your health programs will not be touched. There will be no eligibility or benefit cuts to Medicare and Medicaid. Health reform will be financed partly by finding savings in these programs. These savings will come from eliminating portions of Medicare and Medicaid that are no longer needed once we've passed health care reform for everyone. For example, right now, Medicaid pays hospitals a reimbursement for people who come to the hospital without health insurance, and thus stick that hospital with the bill. Under health reform, most people will have health insurance, making these reimbursements unnecessary.
The Medicare "Donut Hole" will be closed. The "donut hole" in Medicare's prescription drug program that leaves seniors with thousands of dollars in drug costs when their coverage runs out partway through the year will be gradually closed under health care reform.
5. Is this all paid for?
Yes. Health reform will be fully paid for, and will not increase the deficit. It will not increase your taxes, either. The House has proposed increasing taxes on those that make more than a quarter of a million dollars per year to pay for health reform. The middle class will not be affected.
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There is a short answer to the question of what health reform will do for you: Better coverage, lower costs, and the security of knowing you're not at the mercy of private insurance anymore. This is what health care reform will do for you.
The cost of doing nothing - the conservative plan for health care - is staggering: The average family will pay $10,000 more in premiums by 2019 if nothing is done. We can not afford the conservative health care plan. We must reform health care now, for you and me and our families.
For a lot of you, this information is not news. However, you must know someone who needs to be educated. Copy and paste this post into an email and send it to someone who needs to know exactly how this bill works. Send around this link. Whatever you need to do, get that information out there. Fear can stop health care reform from happening, we need to fight back with the truth.
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The Obama Caucus of Ann Arbor is part of Organizing for America.
obama.caucus@gmail.com ObamaCaucus.blogspot.com