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Has Anyone Thought This Through?

McClatchy reports that Democrats may drop public option from health bill, which means the whole process was a waste of energy and time.

The “half dozen half-wits” in the Senate, Max Baucus [dR] of Montana, Kent Conrad [dR] of North Dakota, Jeff Bingaman [DD] of New Mexico, Susan Collins [rd] of Maine, Mike Enzi [RR] of Wyoming, and Chuck Grassley [RR] of Iowa, have lost the reason for the effort and think there is some way of getting health insurance reform without actually reforming anything.

There is talk of mandates for people, but no explanation as to exactly what authority the government has that can force people to buy anything from a private business, like an insurance company. You don’t have to buy auto insurance unless you want to drive, and driving is a privilege, not a right. If the government supplies health insurance, you can be taxed to pay for it, but you can’t be ordered to buy it from a private insurance company, no matter what Congress may think. This mandate garbage is nonsense. Where does this power come from?

10 comments

1 Badtux { 07.29.09 at 10:57 pm }

The current bill taxes you 4% if no insurance company sez you have insurance with them. Big fuggin’ deal, I did the math for my company and discovered that we on average spend 7.8% of our payroll on health care — and our payroll is entirely well paid senior people (all our junior engineers are overseas). Folks making half what we make would be spending over 16% of their income on health insurance.

So anyhow, I would suspect it’d be like MassCare — most people will jump at the opportunity to buy subsidized health insurance (the bill caps the amount you pay at various levels based on income, low income pays small percent of income and 400% poverty level pays 10% income) even without the mandate. Most surveys of MassCare show that the subsidies, not the mandate, is what got people to buy health insurance, though they’re aware of the mandate. MassCare has achieved 97% coverage with that mandate + subsidy approach. But the subsidies have proven to be horrendously expensive because the insurers just don’t care, they simply hike premiums just for the hell of it with no real attempts to rein in costs.

BTW, it is not necessary to go single-payer to have single-point-of-contact between physicians and insurers. All you need is a central insurance clearing house, much like the Federal Reserve has set up a central check clearing system, that has one set of data entry procedures, one set of forms, one set of approval and appeals processes that providers go through. Then it works like single-payer as far as providers are concerned, they just don’t have to deal with the horrible mess of thousands of payers each with its own set of forms, procedures, appeals processes, coverages, etc. that must be navigated to get paid for service. This is pretty much what the Swiss and the French do (France actually isn’t single-payer — various industries are covered by different sickness funds — but the Ministry of Health serves as the central point of contact that negotiates all payment levels and payment policies and so forth for them). That said, I would expect the insurers to squeal like stuck pigs if we tried imposing this on them, because it removes their ability to just arbitrarily deny claims for no reason other than because they can…

2 John B. { 07.30.09 at 8:51 am }

I want a simple to understand, effective, one-sentence national health care bill. it would read, “Every resident of the United States who applies can join the same cost-free health care system available to U.S. senators and congress persons.”

3 Bryan { 07.30.09 at 12:58 pm }

Another feature of the multiple forms and codes system, Badtux, it that if there are any errors, it’s another reason to reject the claim. The forms and codes crap is a major reason behind group practices, because an individual doctor can’t keep up with the paperwork and administrative overhead. It is an additional cost that jacks up the price of health care. Two of my Mother’s doctors have had to surrender and join group practices in order to make a living, even though they hate the working conditions.

Good luck on the cost of verifying membership so people can be taxed. That will cost major bucks and create a new bureaucracy.

John, I prefer Medicare for all because if you have a Social Security number you are enrolled, and nothing else is required. If you want something more, you are free to buy it from an insurance company.

4 cookie jill { 07.30.09 at 2:32 pm }

Medicare for all. Simple. But our Congresscritters still prefer the current “pay or die” health plan.
.-= ´s last blog ..Hidden amongst the draconian cuts signed by The Governator =-.

5 Badtux { 07.30.09 at 3:32 pm }

Oh I absolutely agree that Medicare For All would trump any/all of the current proposals. And I understand why insurers like their current way of handling things, it gives them the ability to arbitrarily deny things for no real reason. Just was dashing water onto the notion that it was the only way to eliminate that administrative overhead for providers — other nations w/o singlepayer do it via creating a central insurance clearinghouse that handles all that stuff.

Meanwhile, how’s this for fun? Florida legislators want to keep Florida out of ObamaCare by… banning Medicare?! Of course, that wasn’t exactly what they thought they were doing. But wait. Thought. Florida legislator. Never mind.

– Badtux the Snarky Penguin

6 cookie jill { 07.30.09 at 3:54 pm }

Fun state you live in, Bryan. Almost as fun as we’re having in CA right now.
.-= ´s last blog ..Hidden amongst the draconian cuts signed by The Governator =-.

7 Bryan { 07.30.09 at 4:38 pm }

I know, Badtux, and I have done some work with doctors over a system that would do it, but you can’t get any of the health insurance companies to agree – actually, they put it as , we’ll do it if everyone else does it, knowing that someone won’t so they can ignore it without actually saying no.

The Lege doesn’t meet until March of next year, so individuals come up with all kinds of crap. The proposal would pass in the house and fail in the senate, although both are 65% Repub. The state senators want to run for Congress when they get term-limited out, and will need some votes from sane people to do that.

We suffer from the same problem as California, Jill, government by initiative. It is destroying the state, now that growth is slowing.

OT: Badtux, your comment system ate my comment for some reason, but you need to remember that Jefferson Davis did design a nice hat for the Army when he was Secretary of War, and we all know how important hats are.

8 hipparchia { 07.30.09 at 10:40 pm }

(the bill caps the amount you pay at various levels based on income, low income pays small percent of income and 400% poverty level pays 10% income)

that’s only sorta true, as i read it anyway. the 10% cap [now upped to 12%] appears to apply to premiums only, and you can have up to an additional $5000 in out-of-pocket expenses, but the oop expenses are defined as co-pays, deductibles, etc. i can’t remember if it’s in the senate bill too, but in the house bill that out-of-pocket definition explicitly does NOT include any out-of-network fees you may rack up.

9 hipparchia { 07.30.09 at 10:49 pm }

BTW, it is not necessary to go single-payer to have single-point-of-contact between physicians and insurers. All you need is a central insurance clearing house, […] That said, I would expect the insurers to squeal like stuck pigs if we tried imposing this on them, because it removes their ability to just arbitrarily deny claims for no reason other than because they can…

yep.

but since we already have medicare, and since it works, and since the insurers are going to scream anyway, no need to set up a whole new bureaucracy just for them. just open up medicare to everyone and let the insurance industry sell supplemental insurance.

10 Bryan { 07.30.09 at 11:16 pm }

The problem is that Congress is working for the insurance companies and no one is working for the people who need help.

LBJ would have had this sucker enacted by now. There was a guy who knew how to get a bill through Congress if he had anything that approached a majority.

I hope Obama isn’t expecting a second term, because if he doesn’t get his act in gear and start acting like a leader, instead of a mediator, he will be a lame duck before the end of year.