I Wish It Had Been An April Fool's Joke

[howeird]

Every time I hear something about Obamacare and this debate about mandatory health insurance, I want to throw a shoe at the TV/radio/person.

Pardon my screaming, but Obama and Pelosi promised

National Health Care

Not insurance.

Like all the other countries which have socialized medicine, the plan was for the insurance companies to leave the medical world and try to make ends meet gouging us on car, home, life and flood insurance. I know they could eke out a tiny profit from those. The government would pay the doctors and hospitals directly, there would be no co-pay, no insurance premium, it would all come from taxes.

Very early in the debate the GOP cleverly flooded the media with crap about single-payer insurance, and the media obligingly changed the vocabulary from health care to health insurance.

All Obamacare does is encourage the insurance companies' gouging by forcing everyone to buy insurance. It's a 1% plan - with one hand give a small number of people with pre-existing conditions the chance to pay exorbitant prices for insurance, and on the other hand take away $$ from those who can least afford it by requiring them to BUY insurance.

Comments

[lemmozine.livejournal.com]

I somewhat agree and somewhat disagree.

The only way it will work is if everyone who has the means to pay for it does. Whether this is through taxes or insurance premiums is the question. Of course, the only way to keep costs down is to eliminate the insurance companies from the formula, so there I agree.

Sadly, the insurance company lobbyists got in there and messed everything up, bigtime. As it is, this new mess is a slight improvement over the mess it replaces, despite the fact it doesn't go very far to solve the underlying crisis.

Those who can least afford to pay for health insurance - the Medicaid crowd, the people who qualify for assistance of various types, will probably not have to buy anything. This includes those on Medicare who qualify for a subsidy to pay their monthly Part B premium. It's the next level up - where I'm at - that has to worry. My retirement subsidizes a percentage of my health care premium, but because I retired early, they're still taking about $300 out every month for health insurance, from the $1889 that I make, gross. My mortgage, at the moment, is $1119 a month. Do THAT math!

In theory, if everyone who could afford health insurance was buying it, my premium would drop substantially. No, my glasses aren't so rose-colored that I actually believe this will ever happen. I do qualify for a state program for the medically indigent, and I could rely on that and drop my health insurance, but there's no guarantee I could get it back, and I like the doctor on my plan. Also, I've met countless people who did rely on that state program, and were victims of the loopholes. It only covers a very short list of public hospitals. If one is taken by ambulance to a private hospital, one can get stuck with some gigantic medical bills and lose everything. Perhaps it might be worth taking that risk in 5+ years when I turn 62, if I do a reverse mortgage and I'm not risking my house in a bankruptcy. I'm uncertain of the bankruptcy law on that one.

Bottom line (my opinion) this thing shouldn't be tossed out, but there are a few things that could be done to improve it. (1) Eliminate profit from the picture. (2) Cap salaries for those who derive income from it. The CEOs of non-profit HMOs are making way too much money. (3) Up to 250% of the FPL, base premiums on a percentage of net (not gross) income. With zero premiums for those at 100% and below. So, for instance, someone like me whose entire gross income is eaten up by mortgage and utilities could slide by without paying a premium. (4) Add mental, dental, chiropractic and other non-covered stuff to the plan. (5) Cap copays at some ridiculously small amount. 25 cents would be good. (6) Guarantee access in terms of being able to get any kind of appointment within a reasonable period of time. (7) Establish a simple process for waiving copays (if any) for those seeking care who are actually ill or injured and have no money. (8) Require all caregivers and facilities to accept all patients regardless of income or financial status. (9) Guarantee reasonable payment to caregivers for services; this should be considerably more than is now guaranteed, for example, by Medicaid. (10) Establish a government malpractice insurance program to replace private malpractice insurance, and substantially lower the premiums paid while simultaneously requiring caregivers to lower their charges proportionally. (11) Simplify the billing process, reduce costs for clerical workers, and at the same time increase the penalties for caregiver fraud by making it a federal crime with a gigantic minimum sentence on conviction.

The plan as it is is not a solution to the problems we have, but neither is going back to square one.

[howeird]

Your eloquent response does not address the issue. We need national health care.

[lemmozine.livejournal.com]

I agree 100%. Here's the problem: we're probably not going to see it happen in our lifetimes. Second problem: we are currently dealing with opposition that, unlike the opposition when the current bill was passed, is unified and completely unwilling to compromise to get anything done. The only way we'll get what we want is with a president + 2/3ds of house and senate gone to liberal democrats & progressives.

Work on that.

By the way, we do have national health care for certain people. Medicare, Medicaid, CHP, the VA and I think there's one other are all single-payor plans. My simple fix is to make everyone eligible for Medicaid. Period. This would eliminate the need for Medicare and CHP altogether. It would also eliminate most private health insurance. It would not, unfortunately, get rid of HMOs.

[howeird]

Thanks. The original suggestion from Pelosi was to extend medicare to everyone. Medicaid varies too much from state to state to make it viable. VA type coverage would be good, and I think it would have to start with the Feds taking over all the hospitals.

Of course we won't see this in our lifetimes. The window was open from 2009-2010, and Pelosi, Reid and Obama blew it. It will be at least another 12 years before the dice fall like that again.

[lemmozine.livejournal.com]

As I recall the situation back then, the problem was with the blue dog democrats.

The HUGE problem with Medicare is the bill, as proposed by LBJ back in - was it '65, was pretty much universal single payer coverage, and the "compromise" worked out with the opposition was to only give partial coverage, requiring a complicated and expensive multiple-billing system, with no coverage for dental or pharmacy. Medicare only covers 80%, and most people have to buy private health insurance to cover the other 20%. W's much-touted prescription drug plan is like something Chico Marx was selling with his tutsi-frutsi ice cream in A Day at the Races. You're covered, for a while. Then there's a doughnut hole, where you get to choose between death from no medications or death from starvation, unless you have money for insurance to cover the doughnut hole. If the act is repealed, this is what a lot of folks will go back to. Then, after you're dead, you're covered again. Brilliant! I wonder if they ever counted the bodies.

Medicare is actually a combo of about 5 or 6 insurance plans, some private and some not. A and B are inpatient and outpatient, 80% covered. C is of little importance except to 75 year old workaholics. D is usually private insurance, and often part of an Advantage plan. Medigap is normally private health insurance that covers the 20% not covered by Medicare. Medicare includes no dental coverage, but some Advantage plans include dental. Some low-income Medicare people get Medicaid or other state programs that pay for the part B premium, copays, and the gap. Advantage plans, usually private, combine part D, medigap and sometimes dental. Some also offer other benefits. Trying to shop for a part D plan is a common cause of mental deterioration - it's a very confusing and frustrating experience, and one's chances of getting the best plan for them are about 1 in 19. I don't think inflicting Medicare on the entire population is a wise or well thought out scheme. Which is why I favor combining all the various public and private health insurances, benefits, health plans and whatevers into one - the same policies would apply to all states, the overhead and administrative costs would shrink considerably, a lot of insurance company employees would be looking for more useful occupations (but at least they'd have health care while out of work), and the health care money would actually be going for health care and not lining the pockets of rich creeps.

[bovil.livejournal.com]

On the nose. We got health insurance reform (and weak reform at that), not health care reform.

It's still an improvement over what we had.