How Weird Is HR-3200?
CNN reports that Health-care bill could mandate insurance for illegal immigrants, report says
(CNN) — Immigrants living illegally in the United States could be mandated to have health insurance under the proposed health-care reform bill, but would be ineligible to receive subsidies to afford such coverage, a report released Tuesday by the Congressional Research Service says.
And how are they supposed to buy this insurance? They already pay FICA withholding taxes that they can’t benefit from because they aren’t legal residents, so now they are going to be required to pay for insurance they can’t use, or afford, because of this current illogical mishmash of a bill.
I haven’t seen a mess this bad since MS-DOS 6.0. Someone should have told Congress that if you’re going to make sausage, you shouldn’t throw the casing in the grinder.
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treat everybody the same, whether they’re here legally or not, and without asking them for their papers.
.-= last blog ..Fortunately, =-.
“treat everybody the same, whether they’re here legally or not” – hipparchia
After all, that’s what viruses do… I have yet to meet the infectious disease that can distinguish someone here legally from someone who is not. For that very reason, any sane healthcare plan must do the same
.-= last blog ..Friday Scoot-Over-Damn-You Blogging =-.
That’s makes entirely too much sense in economic and public health term, so it is totally beyond the pale.
It would give the Republicans vapors and make Lou Dobbs have a conniption. What would the leaders of the Repubs, Rush and Glenn say about that kind of “give-away”.
You’ll have to forgive me if I’m not particularly worried about this “problem”. All that would happen would be that a 4% penalty would be applied when they file their income tax return. Oh wait, you say that they don’t file an income tax return because they work for cash only and can’t legally file one? Or they’re working with a social security number and card that “proves” they are a U.S. citizen so they can just buy insurance (or have it provided by their employer) and use it just like any U.S. citizen? Problem solved!
HR3200 sets up a bizarre mashup of the German and Swiss systems, both of which rely upon insurer mandates and insurance mandates and subsidies to obtain universal health care, but it’s not as out-of-this-world as you seem to think. It’s not the ideal system I would prefer — which would be Medicare For All — but if it became law, I wouldn’t shed tears of sorrow. It does seem to work reasonably well for the Swiss and Germans after all, their outcomes are quite good and access to health care is so close to universal there that it doesn’t really make a big difference. It’s not as cheap as the French system (which is closest to Medicare For All), and not as universal as the British PHS, but it’s close enough for our purposes.
– Badtux the Health Care Penguin
.-= last blog ..Priorities =-.
The problem is that the bill is a mess and self-contradictory. We know that the requirement is silly and meaningless, but idiots on the right will claim that it is a benefit for undocumented workers.
The whole thing has degenerated into a screaming match.
HR 3200 won’t solve anything. The Swiss and German systems are dependent on regulation, and we don’t have the structure to regulate health insurance. To the limited extent that insurance is regulated, it is by the individual states. A lot of money will be spent with no benefit for anyone except the insurance companies and bankruptcy lawyers.
A huge part of HR3200 is spent setting up just such a regulatory mechanism. And the law itself is not self-contradictory for the most part — just the bizarre interpretations of the clear legal language of the law, which are akin to people boldly proclaiming that water is dry and the sky on a sunny day at noon is a fine shade of lime green.
The biggest reason HR3200 is so complex is that it attempts to patch the current set of laws governing health insurance, laws going back 60+ years in some cases, rather than just wipe them all aside and have a simple two-page law that says “All Americans with an employee identification number or social security number are now covered by Medicare, to be funded by a 4% payroll tax surcharge on both employee and employer and a 2% hike in top tax rate for those in top 5% income bracket”. You and I both know that this would be a much simpler system. But I look at the polls that KFF etc. are conducting and it appears that while this is supported by a majority of Americans, a majority of Americans favor the mechanisms of HR3200 even more. The prunes don’t want to have to share their Medicare with sprouts (“My pressshush! Mine! Mine!”), people who have insurance via their employers don’t want to see an extra payroll deduction on their paycheck, and of course the insurers don’t want Medicare For All either even though it would still leave them a major market for Medigap. Politicians have all the spine of jellyfish, when they read these polls they go for the one that seems most painless. The fact that the right wing went ballistic at that point is just what the right wing does, and utterly unrelated to the content of the bill, which is rather ordinary, consisting of concepts that in some cases date back to the 1880’s Bismarkian system of German universal healthcare (i.e., the employer mandates part of the bill).
I would say that we have developed better ways of handling health care funding since the 1880’s, but neither of us get to decide, alas…
– Badtux the Health Care Penguin
The prunes don’t want to have to share their Medicare with sprouts
they don’t want to share medicare [i doubt this] or they’re afraid of the unspecified ‘cuts’ in medicare that will be [ostensibly] used to ‘pay’ for ‘care’ for younger people?
i’m betting it’s the latter. the cuts in medicare and medicaid are essentially going to be given to the insurance companies [via subsidies] and an awful lot of people on medicare are relieved to have finally escaped from private insurance. i can’t blame them for not wanting to ‘share’.
people who have insurance via their employers don’t want to see an extra payroll deduction on their paycheck,
this is specious. most people already have their insurance deducted from their paychecks.
The biggest reason HR3200 is so complex is that it attempts to patch the current set of laws governing health insurance, laws going back 60+ years in some cases,
~200 pages are devoted to ‘fixing’ private health insurance. the other ~800 pages are devoted to ‘fixing’ medicare [~550 pages] and medicaid [the remaining ~250 pages]. the poor people are probably just as worried as the old people, but nobody listens to poor people so it becomes easy to blame ‘prunes’ for being ‘selfish’.
the poor people should be worried [and probably the old folks too]. both the massachusetts experiment and the netherlands experiment have resulted so far in rips in the safety nets for the poor to achieve greater insurance coverage among the better off.
the proposed legislation would only be a mashup of the german and swiss systems if it included the much lower prices for drugs, doctor visits, hospital stays, etc, and would need much more generous subsidies than presently proposed to approach the swiss system. not to mention that what is going to be a gold or premium or platinum or whatever plan in the health insurance exchanges is going to resemble a basic plan in europe. the proposed basic plans for here are going to be junk insurance by comparison.
.-= last blog ..Fortunately, =-.
I would say that we have developed better ways of handling health care funding since the 1880’s, but neither of us get to decide, alas…
agree with you about the funding, but as to who gets to decide, that’s what votes [in election years] and protests [the rest of the time] are for.
.-= last blog ..Fortunately, =-.
Yes, but Hipparchia, when the polls say that the approaches used by HR3200 to achieve universal coverage are more popular than Medicare For All, it is the majority who decides, not you and I.
Regarding whether Germany+Switzerland have universal coverage or not, yes, they do, for the most part. Masscare had/has a problem in that the funding sources identified for subsidies for the uninsured turned out to be inadequate, and Massachusetts cannot print money. The U.S. government has no such limitation, for better or for worse :}.
– Badtux the Democratic Penguin
.-= last blog ..California Pizza Kitchen Crispy Thin Crust Signature Pepperoni =-.
the polls say that the approaches used by HR3200 to achieve universal coverage are more popular than Medicare For All,
an awful lot of people who want medicare for all are in favor of hr3200 because they think it will eventually lead to medicare for all, not because they actually want some kind of public/private hybridized bastardized bismarckian nonsystem, which is what the powers that be want us to end up with. not that i’ve seen any polls that ask that. the majority is either being misled or misread, or very likely, both.
The U.S. government has no such limitation, for better or for worse
🙂
the proposed subsidies are going to be hugely inadequate, and while the govt can print enough money to give out generous subsidies, the congress that’s bringing us hr3200 isn’t going to allow those generous subsidies.
yes, they do, for the most part.
i know all the numbers for all the oecd countries. you aren’t going to sell ME on the universality of hr3200.