So about these health plans...

[Jed Dilligan]

I admit I've never paid much attention to the politics of healthcare. The main reason for this is that when I've had health insurance it has been basically useless. It either goes unused or there is a catastrophic incident of some kind, in which case the co-pays are enormous. Every time I've bought into health insurance I've ended up way behind, in the long run. This makes perfect sense, of course: private-sector businesses would not exist if this was not usually the case.

That being said: is it true that the Clinton plan might actually force me to buy insurance from a private company? To me, that's totally unacceptable. Either cover me or leave me to make up my own mind. The day the government forces Americans to buy a product from a corporation will be a sad one for democracy.

There are so many other ways to do it. Why not make medicine affordable by subsidizing doctors, clinics, and hospitals?

[FormerDittoHead]

1. Well, in NJ and a lot of states you have to have auto insurance...

I'm not defending it. I think it stinks, but there you go. It can be done...

[Jed Dilligan]

2. I have to have auto liability insurance

That's part of the privilege of driving. It's to protect others, not you. It's not a mandate for all people. I've lived carless, too, and while it's hard to do some things, I was happier and healthier all in all.

Note that it's also basically impossible to buy a car without doing business with a corporation.

edit for typo

[Warpy]

3. You are already forced to buy car insurance

and the Clinton plan treats your health care the same way.

That would be fine if health insurance companies were dedicated to providing care instead of maximizing profit, something her plan does not address.

My hope is that Edwards has enough delegates to force one or the other to adopt his sensible plan that allows us to opt into Medicare instead of fattening insurance company executives.

However, reality is setting in and I'm pretty much committed to start finding a place outside this country to live. I can't last another 6 years with no health insurance.

[Jed Dilligan]

4. I don't consider "driving" and "being alive" equivalent

I know that's true for most Americans, but to me the difference is glaring.

[Warpy]

7. Funny thing about that, most of us don't.

I guess your perspective changes when you get into the Senate and a lot of your reelection war chest comes from Big Insurance and Big Pill.

I only hope she remembers how they stabbed her in the back in 1994 when she changed her plan from single payer to that monstrosity she's still pushing and stabs THEM in the back for a change and goes back to single payer.

[Serial Mom]

5. No, not from a private company

this is incorrect... is it true that the Clinton plan might actually force me to buy insurance from a private company? To me, that's totally unacceptable. Either cover me or leave me to make up my own mind. The day the government forces Americans to buy a product from a corporation will be a sad one for democracy.


from Clinton from the transcript of the debate...
And the reason why I have designed a plan that, number one, tells people, "If you have health insurance and you're happy with it, nothing changes," is because we want to maximize choice for people.

So if you are satisfied, you're not one of the people who will necessarily at this time take advantage of what I'm offering. But if you are uninsured or underinsured, we will open the congressional health plan to you. (Applause.)

on edit: clarified it was Clinton who said above

[Jed Dilligan]

6. What is the congressional health plan?

And how poor do you have to be to qualify for it?

[Serial Mom]

9. Who says you have to quality for it??

And she never said you had to be poor! Read the words

[Jed Dilligan]

14. I just assumed there would be some red tape

it's a government program, right?

:shrug:

I'm supposed to trust a politician on campaign over my own sense of how these things tend to go? She will never push a plan like that through Congress without a very stringent income cap on the people who don't have to pay.

[Maven]

10. You don't have to be poor to qualify for it.

It will be another choice available to anyone under her plan.

Very low-income people are already covered by Medicaid, and her plan would improve the quality of coverage under Medicaid and close loopholes that left certain groups of people without coverage.

[Jed Dilligan]

15. So it will cost money

Is it a non-profit? Operated by the government?

[Maven]

18. It will cost money, but the cost will be geared progressively to income

via tax credits.

The public plan would be similar to Medicare, but with benefits at least as good as those offered to members of Congress.

In addition, people would be allowed to choose from a menu of private plans that are currently available to federal employees, including members of Congress.

By forcing private insurers to compete against the public plan, the plan would use market forces to drive premiums down while imposing strict requirements to keep the quality of coverage high.

From the plan:

A Choice of Health Plan Options: Businesses, employees, and the uninsured will have the
option of buying group insurance through a new Health Choices Menu. This Menu will
give all Americans the same set of insurance options that their Member of Congress has.
Without creating new bureaucracy, the Menu will be part of the Federal Employee Health
Benefit Program (FEHBP), which includes numerous, high-quality private health insurance
options. The Health Choices Menu will have the purchasing power of millions of
Americans in securing high-quality and affordable insurance. States will also have the
option of banding together to offer the same type of choices in a region of the country if
they wish. The benefits will be as good as those offered to Members of Congress. Such
coverage includes mental health parity, and many plans offer dental coverage. In addition,
as a condition of doing business with the federal government, insurers must cover highpriority
preventive services that experts agree are proven and effective. This focus on
prevention will improve health and lower costs in the long run.

3) A Choice of a Public Plan Option: In addition to the array of private insurance choices
offered, the Health Choices Menu will also provide Americans with a choice of a public plan
option, which could be modeled on the traditional Medicare program, but would cover the
same benefits as guaranteed in private plan options in the Health Choices Menu without
creating a new bureaucracy. The alternative will compete on a level playing field with
traditional private insurance plans. It will provide a more affordable option, in part through
greater administrative savings. It will not be funded through the Medicare trust fund.

[napi21]

8. You would have the option of buying into a private ins, or into Medicare.

I hear what you're saying about the co-pays! I've had health ins my whole life, and until the last 2 years, the only time I ever used it was back in the 60's when my boys were born. Back then, you didn't have to pay ANY copays, but Dr. visits & drugs weren't covered. Dr. visits were fairly inexpensive ($7.00) and it was RARE that a prescription cost more than $10.

Last year I broke my ankle. I went to the ER, they did their thing, made arrangements for surgery in 2 days, and I stayed 1 day in the hosp. Between all the different bills I received from the hosp, Drs, anesthetist, and followup visits to the Dr. my co-pays were $2,500! The only reason they weren't more than that is because the cap on out of packet expense on our ins. is $2,500. If I hadn't had ins. I don't know WHAT I would have done! I can't recall the total charges before the ins. reimbursements, but I know it was over $30,000!

The reason Hillary's plan requires ALL to get ins. is because the cost of paying for treatment of the uninsured is passed on to everyone else! Remember what insurance is! You have auto ins. but you HOPE you won't ever need it. The same with ins. on your house!

I know Wolf aske Barack what he would do about the people who could afford ins, but just decided they didn't want to, but then got injured. Some injury that wasn't anyone's fault, like getting hurt while bungie jumping. Barack said there would have to be some kind of penalty like paying back permiums or something.

If EVERYONE is in some plan, EVERYONE'S premiums would go down!

[Jed Dilligan]

12. Can you explain Medicare to me?

I thought it was only for old folks. I know they already take money out of my paychecks for it, but I never thought of it as something I could use myself. (I don't mind paying into care for elders, btw.)

The car/house analogies don't cut it for me. I never plan to own a house and have spent many years of my life happily carless. There's nothing wrong with requiring insurance for optional activities--I am all for businesses carrying liability insurance, for instance, and it would be nice if more drivers complied with that mandate! I'm actually thinking about getting renter's insurance--having had a steady income for three years now, I have recently come to realize my book and DVD collection is worth quite a lot.

I guess an internal injury like that can get expensive. Like most uninsured people, I don't do a lot of bungee jumping... I've been in the ER for a skin infection (abscess), but that was simple--no tests, no x-rays, just a shot of anesthetic, a knife, and lots of screaming on my part--it was in a bad spot! The whole bill was only a few hundred bucks.

[nbsmom]

23. Medicare

Who does it cover?
People over 65 and people with certain qualifying conditions (end stage renal disease.)

What does it cover?
There are different parts of U.S. Medicare, and the government (quite cleverly) has assigned letters of the alphabet to each type of coverage.
Part A primarily covers care in a hospital
Part B primarily covers doctors' visits
Part D covers drugs

How and how much do you pay for it?
Well, right now, people who are collecting Social Security pay their Part A premiums out of their checks. Depending on the type of supplementary coverage they opt to take, they may or may not pay a Part B and Part D premium as well. Depending on where they live and how much their drugs cost, they may or may not run into what's called a 'donut hole' around August or September, which means they have to pay for the entire cost of their prescriptions for the balance of the calendar year or until they have spent $4,000 or more on their drugs, and then their Part D plan will kick in again.

When will Medicare become unfunded?
Most estimates peg 2018 as the year that Medicare funding will be exhausted. Some really conservative estimates say 2016.

[napi21]

25. I don't know if the cost of medicare is the same countrywide, but

here in Ga. it's about $100 a month. There are deductibles, like $20 for Dr. visits and I think it's $300 for hospitalization. Medicare alone does not cover drugs unless they are dispensed while you are hospitalized. I haen't checked real close, but it appears they cover most emergencies and ailments, but no eyeglasses or hearing aids.

The reason I used the bungee jumping example is because my nephew (at age 17) had just such an accident. He wasn't expected to live. He had almost 100 broken bones, damaged organs, and was on a ventilator for almost 60 days! He's now 23. He will never be able to walk, but he has a motorized wheelchair, a van that has that platform than lowers so he can drive onto it, and drive the van. He has a job teaching Archery skills somewhere in eastern Pa. I don't even want to guess how much his med. bills were! You could use any example of any accident. It's NevER something we anticipate, and certainly when we're young, we don't think anything will ever happen to us. Hell, I believed THAT until the one night I was spending too much time on DU and it was about 1AM. I got up to go to the kitchen and didn't realize my foot had fallen asleep. BANG! Down on the floor I went, and I knew as soon as I hit, that pain in my ankle was something I had never felt before!

All I'm trying to tell ya is that we all do dumb things, and we all have SOME things that we value and wouldn't want to lose. For some it's a car, for some it's a house, and for you, it's at least your collection.

FWIW, Hillary's plan retains Medicaid for the poor, and grants subsidies to those who make too much $$ to qualify for Medicaid but still can't afford to pay for ins. I don't think she has said the specifics of how much those grants would be or what levels of income would qualify for the grants.

[Jed Dilligan]

26. I know I couldn't take on another $100 a month

My student loan payment is going up by about that much soon, and that's going to be a pinch.

[napi21]

27. Maybe you'll qualify for a subsidy. All I can tell you is that my

hisband & I don't have a choice! He's 65 & I'm 64. Medicare comes out of your SS check every month whether you like it or not!

[old guy]

11. Affordable?

I have read many articles and listened to campaign speeches and I even asked this on DU and still don't have an answer. What does affordable mean and more importantly who decides what the figures are? Just askin'.

[Jed Dilligan]

13. As long as I can remember,

I'm the person who has decided what I can afford!

[old guy]

16. I agree with you. However,

If insurance is mandated someone else is going to take that decision away from us and we don't know whom that will be.

[Jed Dilligan]

17. What would be so wrong with

a progressive tax covering everyone in the country?

[Maven]

20. That is essentially what "mandates" accomplish, just in a roundabout way

Single-payer systems essentially force everyone to pay into the system, which covers everyone and can operate efficiently because no one is a "free rider." Similarly, Clinton's and Edwards' plans eliminate free rider problems that drive up costs, while subsidizing premiums via tax credits geared to income. In other words, it's like a progressive tax that allows everyone to receive high-quality coverage because costs are driven down while standards are kept up.

[Vinca]

19. The "health plans" should not be an issue between Clinton and Obama

because neither is what the majority of people in this country want. Both are offering universal health INSURANCE and, in the end, the details would be worked out in Congress and not by them so it's almost a waste of time to talk about it. Everyone agrees we want universal health CARE, few of us agree we want universal health INSURANCE. What pains me most is that of all the viable candidates, John Edwards could have made a case for single payer, universal, health CARE (Kucinich/Conyers bill), but he did not. I think if he had, John Edwards would have been far ahead of either Obama or Clinton.

[Maven]

21. Edwards' plan is essentially identical to Clinton's.

Both do more than Obama's plan to get us toward single payer by repositioning health coverage as a "standard" feature of American citizenship and by apportioning premiums progressively through taxes. The only difference is that instead of paying taxes into the system to get coverage, you're paying into coverage and getting taxes paid back to you according to what you earn.

When people start to see health coverage as a benefit that every individual enjoys and contributes into, rather a privilege tied to employment, it will be much easier to transition to single-payer for everyone.

[Vinca]

22. I know what Edwards' plan is. When he came out with it, I dropped

my support of him and went to Kucinich. Now I'm between a rock and a hard place. Either I gleefully contribute to insurance company profits or I have a gun held to my head to force me to contribute to insurance company profits. I'm dismayed and disappointed that neither candidate has the courage to tell the insurance companies to go to hell . . . because that's where they belong.

[Maven]

24. Well, I hear you - one of the big reasons I supported Kucinich was his action on single-payer

However, neither Clinton's nor Edwards' plan require you to pay insurance companies anything. Both allow you to subscribe to a public plan which would offer similar coverage but be more affordable. This is how they intend to squeeze private insurers, and probably make them an endangered species in the long run. Of the two types of plans, Clinton/Edwards is more likely to push us toward single-payer than Obama's plan.