The Hill on the cusp of healthcare

[Westernskies]

Gotta pipe in to note that despite the worries of the moderators this has remained a very respectful discussion. Given the rhetoric surrounding it in media land, that is a tribute to the population on this forum.

+1

...besides, I have been following this thread with the TV turned OFF.

 

[eridanus]

Do smokers and the obese get bigger SS and public pension checks to make up for the fact that they "save us money" by dying earlier? Do we place a tax on healthy choices because of the cost "the healthy" are putting on our SS and public pension systems by collecting more from those systems on average?

If not, then why not? Fair is fair. None of this picking and choosing, IMO.

clifp wrote that, as he recalls, the data on "smokers costing us less money" was flimsy. I haven't looked at that data so I have no idea. So it may well be that they DO cost less, or maybe they cost more because the lung transplant at the end of their life costs $700,000.

Obese men lose 5.8 years, on average (smokers lose 14 years). They have more health problems along the way. Diabetes, asthma, sleep apnea, heart problems, the list goes on. So, we could put it in dollars if we want and compare those 6 years of SS to the increased costs of being obese.

If we continue this trend of adjustments, the premium chart will eventually look like the IRS tax code.

 

[FIRE'd@51]

Seems like a lot of people around here are happy to have Medicare waiting for them to get a few years older. And no one seems to be proposing to abolish Medicare despite the fact that it will take a substantial influx in funding to fix.

Very true. Unfortunately, it was the Democratic party's 2000 VP candidate who essentially squashed the Medicare buy-in for 55 year-olds. IMO, that should have been part of the solution. After all, the over 55 crowd with pre-existing conditions is probably a risk pool with a similar makeup to that of the Medicare population (maybe even slightly better), so the cost/per person in the pool would probably be about the same. For those under 55, a buy-in to the FEHP could have been offered - again a risk pool with a not disimilar makeup. And the infrastructure is there. No need to set up an exchange in each state, so it could have been made available immediately. And it would allow the private insurance companies to compete for business as they do now, with no underwriting. There would still be many folks who would need subsidies but since the risk pools would be so large, the insurance cost/person would probably be minimized. And if down the road, we got rid of employer-provided insurance, it would only improve the situation, as more young and healthy folks would be added to the risk pools. Ron Wyden's plan built off this model and had quite a few Republican co-sponsors (I heard 15), but for some reason the Democrat leadership never brought that plan to the forefront.

 

[ziggy29]

Obese men lose 5.8 years, on average (smokers lose 14 years). They have more health problems along the way. Diabetes, asthma, sleep apnea, heart problems, the list goes on. So, we could put it in dollars if we want and compare those 6 years of SS to the increased costs of being obese.

I don't know that the reduced cost in SS and public pensions offset extra health insurance costs *entirely*, but I think it's pretty obvious that there is at least some offset. You die 10 years sooner, you probably collect less SS and government pensions than someone who lives another 10 years.

So if we want to impose "lifestyle taxes" on choices like cigarettes, beer and Doritos, we need to not only look at extra health care costs but also an offset for their reduced costs for SS and public pensions. After all, if the taxpayer is on the hook for lifestyle choices, they are across the board and not only for healthcare. So if we want to start taxing lifestyles, it needs to look at ALL public costs, not just cherrypicked ones because they impact "someone else."

 

[DeborahB]

Heck, if anyone really understands the bill and the implications, raise your hand. Not if you didn't read all of it.

I hope that it makes it easier or cheaper for me to get insurance for those exciting 17 - 18 months when COBRA has run out and Medicare hasn't kicked in.

 

[donheff]

Very true. Unfortunately, it was the Democratic party's 2000 VP candidate who essentially squashed the Medicare buy-in for 55 year-olds. IMO, that should have been part of the solution. For those under 55, a buy-in to the FEHP could have been offered - again a risk pool with a not disimilar makeup. And the infrastructure is there. No need to set up an exchange in each state, so it could have been made available immediately.

I far prefer that proposal to what "The Bill" does. In fact, my nephew ran for Congress in 1992 proposing essentially that (he was a Tsongas fan). I think the FEHB extension would prove more difficult than first appears but it would be something we could work with. I also liked the bi-partisan Bennett/Widen proposal that would have essentially abolished the employment based system. But we can't always get what we want.

 

[ChrisC]

Can anyone name a government/quasi-government program administered and/or funded by the federal government that isn't in financial trouble? Or that has performed to OMB budget projections?

And why we should think this Health Care Bill will be any different?

BTW, I don't see any of the folks who voted for this bill agreeing to sign themselves and their families up for it. Or am I missing something?

Hmmmm. Look no further than the Health Care Reform bill that just passed and you'll see an expansion of the direct student loan program administered by the US Department of Education, with projected multi-billion dollars savings over the next ten years. I think the case can be easily made that Federal direct student loan lending for the last decade or so has been a success story. It certainly will be an improvement over the Federal student credit and loan subsidy programs the American Banker Association and Sallie Mae, those captains of private finance, persuaded Congress in 1965 and later years to continue, while the captains were being feed at the public trough.

The federal deposit insurance program administered by the FDIC, with no depositor ever losing one penny, is unqualified success story. I don't really hear anyone suggesting that this program be privatized. If the metrics for success for this program were "public confidence" and depositor security, I can't see how this program is not successful -- all without any taxpayer financing!

Smithsonian also does a good job too, running a quasi-governmental program -- most of the operations there are self-sustaining/self-funded. A number of NAFIs (non-appropriated fund instrumentalities) like the Army-Air Force Exchange Service also aren't failures by any stretch of one's imagination.

 

[donheff]

CNBC just reported that health care companies were the market leaders today. Government takover, my behind. More like the Health Insurance Industry Guarantee Act.

 

[Westernskies]

If we continue this trend of adjustments, the premium chart will eventually look like the IRS tax code.

with 16,000 new federal employees monitoring compliance.

 

[ChrisC]

with 16,000 new federal employees monitoring compliance.

Attention, federal annuitants submit your applications promptly.

 

[Gone4Good]

So we need some sort of involvement - But that does not mean that I should be 'happy' with what passed.

Nobody is completely happy with what passed. That is why everyone is talking about "fixing" it. But not every one agrees with what "fixing" it entails.

But the problem goes deeper. And I really, really, wish people would stop and think this through. Because when you say "some sort of involvement" is needed, it actually turns out to be a lot of involvement when you work through the details. And that large degree of government involvement is precisely what this whole debate is about. People were opposed to this bill long before there was a bill to oppose (you can go back to the early debates on this forum and see the same people on exactly the same side of the issues. Nothing has changed, only people picked out pieces of the bill to support the arguments they carried in with them). What they opposed was the "big government" approach. But nobody has put forward a "small government" alternative that solves the core problem. And without that alternative, the opposition is just serving to make a bad situation worse.

And like I said initially. I'd really like everyone who favors a "small government" alternative to think through the complexities of insuring a chronically sick person. When they work the problem from that direction, you come to the conclusion that something similar to the current bill is about the least invasive way possible to actually solve the problem.

 

[Westernskies]

... the opposition is just serving to make a bad situation worse.

...the opposition passed the bill that put us in this "bad situation'?

 

[FinanceDude]

he said it's in 2007 dollars, read the post before you talk

You have 24 posts? I guess that's what the ignore button is for..........

 

[Gone4Good]

...the opposition passed the bill that put us in this "bad situation'?

It is my view that if we had two grown up parties that each wanted to solve the same problem we would now have a far better bill.

 

[Westernskies]

. Both Rs & Ds opposed it, but only Ds supported it.-ERD50

I bet many of them are lined up to see the House Chiropractor this AM, needing help for twisted arms. Thank goodness they have a great health care program.

 

[FinanceDude]

I wonder if our local school system needs any teachers. I think I can teach a few business courses to high school students and grab a pension and almost free health care................gotta few favors I can call in.......

Wish me luck.......

 

[Westernskies]

It is my view that if we had two grown up parties that each wanted to solve the same problem we would now have a far better bill.

you left out transparency... and a roll-call vote... and all the special-interest side deals.. and a last-minute executive order... and forcing a last-minute vote on a weekend before anyone could confer with their constituency on the final product.

IMO, in the end, the passage of this bill had nothing to do with the bill itself. Maybe it was just me, but while watching the coverage of the proceedings last night, neither side gave me the impression they really gave a sh*t about health care reform- this was pure partisan politics at it's worst.

 

[Westernskies]

I wonder if our local school system needs any teachers. I think I can teach a few business courses to high school students and grab a pension and almost free health care................gotta few favors I can call in.......

Wish me luck.......

Nope, sorry, your curriculum viewpoint is no longer in vogue. Please try your call again later.

 

[FinanceDude]

It is my view that if we had two grown up parties that each wanted to solve the same problem we would now have a far better bill.

I really can't tell who the grown-ups are. Seems like one party is the playground bully and the other doesn't tattle enough........

 

[Gone4Good]

you left out transparency... and a roll-call vote... and all the special-interest side deals.. and a last-minute executive order... and forcing a last-minute vote on a weekend before anyone could confer with their constituency on the final product.

IMO, in the end, the passage of this bill had nothing to do with the bill itself.

Yes, that is all bad stuff. But to me, the substance of the bill is far more important. I think this quote from above also applies to people who now express overwhelming concern about the legislative process . . .

People were opposed to this bill long before there was a bill to oppose

 

[FIRE'd@51]

In fact, my nephew ran for Congress in 1992 proposing essentially that (he was a Tsongas fan)

Interesting - did he, by chance, run against Connie Morella? My in-laws were very active in Democratic Party politics in Montgomery County back then.

 

[youbet]

Seems like a lot of people around here are happy to have Medicare waiting for them to get a few years older. And no one seems to be proposing to abolish Medicare despite the fact that it will take a substantial influx in funding to fix. As to the public option, if no one would sign up for a public option why is the insurance industry so frightened of it? And don't pile on with the canard that it's losses would be covered by tax dollars. It was to be structured as a stand alone program that had to rely on on premiums to fund its costs. It ain't rocket science to make that an iron clad requirement.

You quote me as agreeing that it's not a good sign when the authors of the new "reform" aren't impacted by it themselves. Then you make the above post. I don't see the connection. Perhaps you quoted one thing and inadvertantly responded to another?

 

[youbet]

I hope that it makes it easier or cheaper for me to get insurance for those exciting 17 - 18 months when COBRA has run out and Medicare hasn't kicked in.

It will likely make it easier (no pre-existing conditions issue) but not cheaper unless your timing is right and your income is low enough to qualify for a subsidy. (I'm assuming you're healthy.) If you don't qualify for a subsidy, it is likely to be more expensive but will have more expansive coverage and fewer limitations or exceptions.

If I needed to buy an individual policy to cover the gap to Medicare, I'd like this bill. I have medical issues and having guaranteed access and paying the same rates as healthy folks would be a good deal. Thanks healthy folks!

 

[DeborahB]

It is my view that if we had two grown up parties that each wanted to solve the same problem we would now have a far better bill.

Yes. YES.

 

[eridanus]

And like I said initially. I'd really like everyone who favors a "small government" alternative to think through the complexities of insuring a chronically sick person. When they work the problem from that direction, you come to the conclusion that something similar to the current bill is about the least invasive way possible to actually solve the problem.

The crux of the problem: Who wants to insure a chronically sick person?