Join Early Retirement Today
Closed Thread
 
Thread Tools Search this Thread Display Modes
Old 03-15-2010, 07:55 PM   #41
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Meanwhile, the current legislation looks an awful lot like something samclem once said "would work"

Quote:
Originally Posted by samclem View Post
Here's what I think would work to let everyone obtain care and keep things affordable. It's not what I think the country should do, but it is better than the alternative I believe we are headed for.

1) Mandatory Coverage: Everyone must buy a policy.
2) Government vouchers based on need. (Just as food stamps do for nutrition)
3) Private policies of four or five standardized types. A limited number of policy types greatly enhances price competition. Label them A-E and require that the insurers call them by that label.
4) No underwriting: If an insurer elects to sell a particular type of policy, the insurer must accept all applicants. Differences in price arr allowed based on geographic area. But--citizens can change policy types only once every 5 years (reducing the "hey-I've got a bad disease, I'm gonna go with the Cadillac policy now" syndrome)
5) All policies (of the 4 or 5 types) would cover preventative care that serves to reduce medical costs overall (Pap smears, immunizations, prenatal care, annual checkups, etc). Policies would differ by the co-pay amounts, private vs semi-private rooms, types of perscription drugs covered, degree of "doughnut-hole" that the insured would cover largely on his own, etc). All policies would feature catastrophic coverage based on the insured's household income--maybe all medical costs over 30% of income would be covered.
6) A government-run clearinghouse with with medical/consumer information. Provides info on customer satisfaction with various insurers by policy types, information on outcomes by procedures for various hospitals/centers, average out-of-pocket costs incurred by consumers in each state for each type of insurance, etc). This helps promote consumer knowledge and informed decisionmaking.
7) Individual purchase of medical care is allowed. Unlike some countries which prohibit individual purchase of medical care, it would be allowed in the US. In addition, if you want to purchase an additional medical policy to cover cosmetic surgery, experimental treatments, nursing home care, daily electroshock therapy, in-home aromatherapy, accupuncture, etc, that would be okay, too

There. The market helps provide cost controls (especially by giving consumers a stake in reducing their use of medical care and in picking insurers with the lowest costs). Provides consumers with feedback on medical care so they can make an informed choice. The "Cadillac" plans would be expensive because they cover a lot and because of adverse selection (that's the policy type the sickest people would choose), so people would be "incented" to select plans with higher co-pays, which helps drive down costs. Everyone gets the cost-effective preventative care provided in a cost-effective way, everyone is protected against catastrophic medical costs, the free market is preserved, medical costs are de-coupled from employment (which would be good for our economy as a whole), and the very poor pay nothing for their care (due to vouchers). And, if you want to take some risk by self-insuring to a larger degree, you are allowed to do it.
It's a nice plan sam, maybe you could come full circle and support it.
__________________

__________________
Retired early, traveling perpetually.
Gone4Good is offline  
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 03-15-2010, 08:06 PM   #42
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by Gone4Good View Post
Wow, talk about funny accounting.

The "Doc Fix" (which accounts for 2/3 of the presumed $600B hole) is part of the status quo. This isn't something that springs into being as a result of health care legislation and won't go away if the legislation fails.
Then it isn't going away if health care legislation passes either. So why count it as part of the 'savings'?

-ERD50
__________________

__________________
ERD50 is offline  
Old 03-15-2010, 08:10 PM   #43
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by Gone4Good View Post
Meanwhile, the current legislation looks an awful lot like something samclem once said "would work"
I didn't see anything about special deals for Nebraska ( and a dozen or so other special deals) in samclem's plan.

At any rate, samclem said: 'It's not what I think the country should do, but it is better than the alternative I believe we are headed for.'.


-ERD50
__________________
ERD50 is offline  
Old 03-15-2010, 08:13 PM   #44
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Quote:
Originally Posted by ERD50 View Post
Then it isn't going away if health care legislation passes either. So why count it as part of the 'savings'?

-ERD50
It's not part of savings. Nor is it part of its cost. It simply isn't included at all, which is appropriate because it is a cost that pre-dates the current legislation. Samclem's post says as much. Including it as a "cost" to new legislation makes as much sense as including costs associated with the Iraq war, or existing Medicare obligations.

But what opponents want to do is take this existing cost and apply it to the new legislation to make it seem more expensive than it is.
__________________
Retired early, traveling perpetually.
Gone4Good is offline  
Old 03-15-2010, 08:18 PM   #45
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Quote:
Originally Posted by ERD50 View Post
I didn't see anything about special deals for Nebraska ( and a dozen or so other special deals) in samclem's plan.
Then I'm sure he supports the work the House is doing to strip that out (via reconciliation, if needs be).


Quote:
Originally Posted by ERD50 View Post
At any rate, samclem said: 'It's not what I think the country should do, but it is better than the alternative I believe we are headed for.'.
Yup he sure did. And it sounds an awful lot like something someone says about any compromise. This isn't the legislation I would have written either, but its better than the alternative.

One is left to wonder though, if it were so awful and so deserving of defeat 12 months ago, why would he put it out there as a plan that "would work". The answer, if I may, is that 12 months ago he was afraid single payer might be the plan and was willing to accept this as a "better alternative". But now that single payer is off the table, this compromise is no longer good enough. He wants further compromise to the compromise . . . that, by the way, is what's required these days to garner a "bi-partisan" solution (keep conceding your position until the opposition gets everything they want).

The answer to that, of course, is not to keep conceding to ever-changing demands. But to create a compromise that has just enough support so that it can be "rammed through".
__________________
Retired early, traveling perpetually.
Gone4Good is offline  
Old 03-15-2010, 09:27 PM   #46
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,616
Quote:
Originally Posted by Gone4Good View Post
It's not part of savings.
Well--the CBO included savings to be had from reduced Medicare payments to doctors (since that's what the new legislation claims will be done). Except that there is current legislation that is supposed to do the same thing, and for 8 years Congress has chosen not to make these cuts. Everyone knows they won't be made in the future. So, including them as future cost savings is just not realistic. What would be realistic (and honest) is to build the cost of the "Doc Fix" into the pending legislation rather than put it elsewhere.


Quote:
Originally Posted by Gone4Good
The answer, if I may, is that 12 months ago he was afraid single payer might be the plan and was willing to accept this as a "better alternative". But now that single payer is off the table, this compromise is no longer good enough.
Your point is well taken. Single payer is worse than even the presently proposed legislation.
But I disagree that the "plan" I outlined bears any resemblance to the present legislation (any more than a piano resembles a calliope).

Element by element:
1. (Mandatory coverage): This plan does little to mandate coverage. The penalties are so low that individuals would be foolish to buy coverage in advance if guaranteed issue is in place. On another note: It will be interesting to see if the SCOTUS finds this unconstitutional. If so, I hope we'll do the honest thing and amend the constitution. Under the present environment, I'm afraid Congressman Slaughter will be asked to come up with a workaround whereby Cub Scout Pack 734 can accomplish the same thing via secret ballot.
2. (Government vouchers based on need). I suppose this is only a tiny matter of degree. The huge transfer payments under the proposed legislation are nowhere near what I'd envisioned. The whole concept of a market only works if customers/patients have some of their own skin in the game. The Senate plan gives subsidies to families with incomes well into the middle class (family of 4 with incomes over $88,000). Only when most people are paying a considerable amount of their own money for insurance will they demand inexpensive policies.
3. (Standardized types of private insurance). Nothing like this in the presently proposed legislation.
4. (Elimination of underwriting): Yep, that's here. But, without effective "teeth" in the individual mandate to buy insurance, this becomes a liability rather than an asset.
5. (Coverage of preventative care): Yes, it's in the Senate plan. But there's no market-based mechanism to halt the expansion of mandates (gender reassignment, unlimited fertility treatments, etc, etc) that has plagued many State plans. Again, this happens only when people can buy their own policies and must do it with mostly their own money. Then they'll tell their legislators to quit with the add-ons.
6. (Govt clearinghouse for medical treatment result info): It does sound like there's some of this in there, along with worrying early indications that the government will be using the findings to deny coverage. Again--the intent is to allow the market to work, not to introduce more top-down "we'll tell you what's best" action.
7. (Individual purchase of care still allowed): I haven't heard of any new proposed restrictions in this area. If the government would free up the private market by allowing Medicare providers to charge non-Medicare patients whatever the two agree upon, that would be a step in the right direction. I don't think that's in the Senate plan.

Eliminate the Cornhusker kickback from the present legislation? Why? Leave it there as a testament to a disgusting process. In my book, Senator Nelson has done more to highlight the integrity deficit characterizing the whole mess than any other individual. Removing it is like removing the warning signs from around the open cesspool in order to clean things up.
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is online now  
Old 03-15-2010, 09:27 PM   #47
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by ERD50 View Post
Then it isn't going away if health care legislation passes either. So why count it as part of the 'savings'?

-ERD50
Quote:
Originally Posted by Gone4Good View Post
It's not part of savings. Nor is it part of its cost. It simply isn't included at all, which is appropriate because it is a cost that pre-dates the current legislation. Samclem's post says as much. Including it as a "cost" to new legislation makes as much sense as including costs associated with the Iraq war, or existing Medicare obligations.

But what opponents want to do is take this existing cost and apply it to the new legislation to make it seem more expensive than it is.

I guess it depends on what the basis is for comparison. But earlier, you said (bold mine):

Quote:
That $600B is an estimate of how much less the country, in total, will spend because of the cost saving initiatives in the current legislation.
The "Doc Fix" increases spending every year. So if they don't count that as a cost, it underestimates costs compared to real life. It sounds like the mere act of submitting it to the CBO creates a 'savings' that does not exist in real life, since they cannot count the "Doc Fix" as it is not part of the legislation.

OTOH, if these 'savings' are strictly calculated by deltas from specific programs (which may be what you meant by the 'because of cost savings'), that *might* be different. But the "tax us now" and "don't provide all the benefits for 4 years" is certainly a dishonest way to present the numbers. Couple that with "we need to pass this NOW to help people", and I think that is one of many reasons why people who learn a bit about the bill are so skeptical. Multiply that by 1000x when Speaker Pelosi tells us “But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy."

Yep, we don't want to address any of that pesky 'controversy' when Congress is trying to pass a bill that affects every US citizen.


-ERD50
__________________
ERD50 is offline  
Old 03-15-2010, 11:01 PM   #48
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,616
Quote:
Originally Posted by Gone4Good View Post
That $600B is an estimate of how much less the country, in total, will spend because of the cost saving initiatives in the current legislation. Not shifted from one person to another, but lower total outlays.
Somebody should pass this news about overall cost savings to the Centers for Medicare & Medicaid Services (which, of course, is part of President Obama's executive branch and unlikely to be understating the costs of this plan). In January they wrote about the Senate plan (Link to coverage of their report):

Quote:
"Overall national health expenditures under this bill would increase by an estimated total of $222 billion (0.6 percent) during calendar years 2010-2019."
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is online now  
Old 03-15-2010, 11:25 PM   #49
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
haha's Avatar
 
Join Date: Apr 2003
Location: Hooverville
Posts: 22,387
Chances of passage are looking strong.

Intrade Prediction Markets
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
haha is offline  
Old 03-15-2010, 11:34 PM   #50
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,616
Quote:
Originally Posted by haha View Post
Chances of passage are looking strong.

Intrade Prediction Markets
At least a random group of people think so. Meanwhile, another Democratic congressman (John Adler) formerly in the "undecided" column has indicated he won't support this thing.

There's no doubt this will be very close.
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is online now  
Old 03-16-2010, 09:23 AM   #51
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,613
Quote:
Originally Posted by haha View Post
Chances of passage are looking strong.

Intrade Prediction Markets
Interesting. I thought this might happen, but not until after the election. If it's not popular in its current form, I wonder how many people in Washington will willingly fall on their swords to support it. After all, no matter what almost all of them talk about wanting, all they *really* want is to be re-elected.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline  
Old 03-16-2010, 10:30 AM   #52
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,291
Quote:
Originally Posted by Gone4Good View Post
It's not the CBO projection. It's from a Harvard Economist, David Cutler.
Sorry.... can not read the article as it is cut...

Is there anybody else that agrees with his number Has anybody checked it?
__________________
Texas Proud is offline  
Old 03-16-2010, 10:44 AM   #53
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by Texas Proud View Post
Sorry.... can not read the article as it is cut...

Is there anybody else that agrees with his number Has anybody checked it?
I wanted to check it, but I also found the article cut off, could not get to the meat of it to check.

Maybe GTG has a subscription that allows reading (it didn't ask, so I don't think that's it)? I dunno, but I'm curious.


-ERD50
__________________
ERD50 is offline  
Old 03-17-2010, 03:14 AM   #54
Thinks s/he gets paid by the post
ls99's Avatar
 
Join Date: May 2008
Posts: 4,792
Quote:
Originally Posted by haha View Post
Chances of passage are looking strong.

Intrade Prediction Markets
Woke up too darn early. Just checked intrade, collapsed to 35. Do some insiders know stuff no one else does?
__________________
There must be moderation in everything, including moderation.
ls99 is offline  
Old 03-17-2010, 08:01 AM   #55
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by ls99 View Post
Woke up too darn early. Just checked intrade, collapsed to 35. Do some insiders know stuff no one else does?
It is back up on very thin trading, 2 trades. I do wonder what that was about. Someone got a wire on Pelosi?

also, this might give you a better view: Time and Sales Chart - 'Obamacare' health care reform (see contract rules) to become law before midnight ET 30 Jun 2010

then manually set the time to last day, that does not seem to carry in the url.

from the 'download' button on intrade (if this pastes):

Mar 16, 2010 10:34 PM CDT 65 20
Mar 16, 2010 10:49 PM CDT 65 1
Mar 16, 2010 11:49 PM CDT 64 3
Mar 16, 2010 11:58 PM CDT 63.5 1
Mar 16, 2010 11:58 PM CDT 63.5 9
Mar 16, 2010 11:58 PM CDT 62.1 1
Mar 16, 2010 11:58 PM CDT 62 1
Mar 16, 2010 11:58 PM CDT 60.7 1
Mar 16, 2010 11:58 PM CDT 60.6 10
Mar 16, 2010 11:58 PM CDT 60 1
Mar 16, 2010 11:58 PM CDT 60 9
Mar 16, 2010 11:58 PM CDT 60 9
Mar 17, 2010 12:08 AM CDT 60 8
Mar 17, 2010 1:09 AM CDT 60 8
Mar 17, 2010 1:09 AM CDT 59 8
Mar 17, 2010 1:10 AM CDT 58 4
Mar 17, 2010 1:10 AM CDT 57.1 1
Mar 17, 2010 1:10 AM CDT 57 5
Mar 17, 2010 1:10 AM CDT 53 1
Mar 17, 2010 1:16 AM CDT 50.5 10
Mar 17, 2010 1:16 AM CDT 50 1
Mar 17, 2010 1:16 AM CDT 50 1
Mar 17, 2010 1:16 AM CDT 47.3 1
Mar 17, 2010 1:18 AM CDT 46 10
Mar 17, 2010 1:18 AM CDT 41 1
Mar 17, 2010 1:18 AM CDT 40.6 1
Mar 17, 2010 1:18 AM CDT 36.5 4
Mar 17, 2010 1:18 AM CDT 35.1 1

Mar 17, 2010 5:02 AM CDT 66.6 1
Mar 17, 2010 6:10 AM CDT 66.9 1 < but then back up? Odd
__________________
ERD50 is offline  
Old 03-17-2010, 10:50 AM   #56
Thinks s/he gets paid by the post
FIRE'd@51's Avatar
 
Join Date: Aug 2006
Posts: 2,322
Quote:
Originally Posted by ERD50 View Post
Mar 17, 2010 1:18 AM CDT 36.5 4
Mar 17, 2010 1:18 AM CDT 35.1 1

Mar 17, 2010 5:02 AM CDT 66.6 1
Mar 17, 2010 6:10 AM CDT 66.9 1 < but then back up? Odd
I think this was due to the announcement that Dennis Kucinich would be holding a press conference this morning, in which he subsequently switched his NO vote to YES.
__________________
I'd rather be governed by the first one hundred names in the telephone book than the Harvard faculty - William F. Buckley
FIRE'd@51 is offline  
Old 03-17-2010, 01:58 PM   #57
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by FIRE'd@51 View Post
I think this was due to the announcement that Dennis Kucinich would be holding a press conference this morning, in which he subsequently switched his NO vote to YES.
That explains the rise back to 60-70, but what about the drop in the first place?


OK, I just checked their forums, and the regulars there seem perplexed as well. Hard to say.


-ERD50
__________________
ERD50 is offline  
Old 03-18-2010, 07:38 PM   #58
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Quote:
Originally Posted by samclem View Post
Somebody should pass this news about overall cost savings to the Centers for Medicare & Medicaid Services (which, of course, is part of President Obama's executive branch and unlikely to be understating the costs of this plan). In January they wrote about the Senate plan (Link to coverage of their report):
Wow, you really like to selectively read things. If you continue just one sentence beyond the part you quote it says this . . .

Quote:
The estimated effects of the bill on overall national health expenditures is that the share of GDP is projected to be 20.9 percent in 2019 compared to 20.8 under current law -- "primarily as a net result of the substantial expansions in coverage."
So we're covering far more people and spending roughly the same share of GDP and you're claiming that health care isn't less costly under this bill?

So if the store is running a 50% off sale on bread and you come home with two loaves instead of your typical one do you look at the bill and say "boy they didn't lower the price at all because I spent the same amount as I did before"?
__________________
Retired early, traveling perpetually.
Gone4Good is offline  
Old 03-18-2010, 07:53 PM   #59
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,616
If the question is "will we as a nation save any money on our medical costs as a result of this legislation" the answer, from the Centers for Medicare & Medicaid Services is "No, there are no cost savings." It might do a lot of other things, but apparently it doesn't save any money.
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is online now  
Old 03-18-2010, 08:01 PM   #60
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Quote:
Originally Posted by samclem View Post
If the question is "will we as a nation save any money on our medical costs as a result of this legislation" the answer, from the Centers for Medicare & Medicaid Services is "No, there are no cost savings." It might do a lot of other things, but apparently it doesn't save any money.
Well, gee, my two loaves fed twice as many people at the same cost but the program is worthless because we didn't spend less (meanwhile my original argument was that it was worthless because it would drive up the price of bread, but forget I said that).
__________________

__________________
Retired early, traveling perpetually.
Gone4Good is offline  
Closed Thread


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Double Coverage Health Insurance mark500 Health and Early Retirement 3 02-04-2008 03:07 AM
Universal health care - best I've seen Rich_by_the_Bay Health and Early Retirement 21 12-13-2007 11:38 AM
Universal Health Coverage in MA firewhen Health and Early Retirement 25 07-01-2007 09:24 PM
New Health Care Proposal -- If it happens what does it mean? chinaco FIRE and Money 9 06-11-2007 04:04 PM
Americans want universal health coverage REWahoo FIRE and Money 162 06-21-2006 12:29 AM

 

 
All times are GMT -6. The time now is 05:19 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.