Subsidies. Health Care Reform must provide real subsidies.

[sandnsea]

They must be implemented on a sliding scale because low income people can't pay 10% of their income to a premium.

Nothing else - absolutely nothing else - really matters.

If the subsidies become too expensive, they will implement all the other cost containment because people will want to keep their health care. If they never get health care at an affordable cost, they'll never rise up to fight to keep it.

Subsidies. That's the important issue. Not for profit or non profit or co-op or bargaining or anything else.

Subsidies.

Geesh. Isn't that what you really need? Help paying the premium??

[NYC_SKP]

1. So, mandated purchase of private healthcare plans with subsidies, that's all?

Nope, I disagree.

We need to reform the system and offer an efficiently operated public health insurance plan as an alternative.

Subsidies will be provided to help those who cannot afford it.

:patriot:

[sandnsea]

2. Not all. Most important.

I am sick of these threads with obscure demands in the health care bill when nobody is advocating for the most important thing - the subsidies.

NOTHING will work if the end result isn't affordable.

[dflprincess]

4. In HR3200 the subsidies cut off at 4x the poverty level

that's $43,000 for a single person and $80 some thousand for a family of four. This is gross income, not after tax income. And, Pelosi has indicated that lowering those income caps might be okay.

Personally, I don't think they're high enough as they don't take into account any other expenses or where you live. A single person making $43,000 could be charged 12% of their income in premiums (though hopefully some of that cost would be made up by their employer) and could have out of pocket expenses of $5,000 in copays & deductibles as well as any other costs not covered by insurance. The bill also allows for premiums and and out of pockets to increase each year. If you're someone dealing with a chronic condition you're looking at some hefty expenses every single year.

This bill a gift not only to the insurance industry but to the credit card companies as well because many people will continue to use their credit cards to cover medical expenses.

Not only will nothing work if it isn't affordable, it won't work if it doesn't actually improve access to care. We need a system that does not demand payments at point of service.

[sandnsea]

8. That's why subsidies are the most important issue

If we don't get the premiums low enough, you can forget anybody caring how doctors are paid or any other cost cutting reform. They'll fight for repeal from the second they get the first premium bill that they can't afford.

[dflprincess]

10. Not just the premiums - the out of pockets are way too high

and the current income caps for subsidies too low.

[sandnsea]

12. Nothing else will matter if the premiums are too high

The first thing people without insurance are going to have to deal with is a premium. Health care reform can be completely lost long before anybody even makes a claim and has to worry about out of pocket expenses. If we bring the premium in at an affordable level, the people with that health care will switch sides and start helping in the fight for the rest of it.

[dflprincess]

19. If premium costs come down and people still can't access care

because they can't afford the out of pocket they still won't be any better off than they are today. Paying for a policy you still can't use isn't "coverage".

[sandnsea]

21. If you get the first bill and can't pay it

You won't ever find out that the out of pocket is too high.

[grantcart]

26. You are correct - it is the restructuring that is more important

universality cannot be achieved with subsidies there has to be a public option to control future costs.


Subsidies can be increased but you cannot increase a structural change that is what is going to happen now.


Frankly if we could get to Eurpean standards we could lower the costs and use part of the savings for the subsidy.

[NYC_SKP]

3. I think it's equally important to bring costs down, We need both. But I see your point. nt

[OHdem10]

5. To give adequate subsidy fewer people will be covered.

Right now they under pay Doctors. Many Doctors in our state
refuse to take Medicare Patients because of this.

As long as the Insurance Companies are getting the largest
boatload, others take the cuts.

[sandnsea]

7. Subsidies are part of the plan already

How else do you think they're going to make this affordable? The question is whether the subsidy is enough to keep people out of poverty.

[quakerboy]

29. The answer is no

It is not, and it will not. Not without something to contain the cost.

I understand your argument, but I strongly believe you have missed an important aspect. When it comes to a mandate that slams a lot of people, myself included, without any chance at a subsidy, that's hitting me where I live. I will not be moving to the right in response, my tendency is to go left. But a lot of my less politically aware friends in similar circumstances will move right. They will start to buy the "government is bad" meme, when it starts to hurt their pocketbook directly.

It wont take an awful lot of them turning to put the R's back in charge of things. And they will ensure that the program meets an ignominious demise, thus "proving" their "government is wasteful and incompetent" meme.

[Jakes Progress]

6. Of course we can't consider

a plan that would same millions a day in health care costs. We know the insurance corporations are spending what, 1.4 mil per day, for lobbying. Then there is the lobbying for pharma and the doctors. Now we add in the advertising for insurance and pharma. Then you could subtract the multi-million dollar bonuses and salaries. Oh yeah. The cost of the thousand dollar and hour lawyers that these corps have on call by the hundreds.

Now how could we just not have to pay for that? How, oh how, could we eliminate those costs and make universal coverage easily affordable? If only there were some way.

[sandnsea]

9. That would reduce premiums by 90%?

That's all some moderate income individuals and families can pay.

[Jakes Progress]

14. With their taxes

they already pay that. We pay twice as much for half as much heath care as other countries. If England can do it, and France, and Italy, and ......, why can't we. The poor in England aren't any poorer than we are.

It's called single payer. And it works everywhere else. Rich and poor.

[sandnsea]

17. And until that gets passed?? People just die???

Why can't you let go of single payer until we at least get something that will pass Congress? What good does it do anybody to keep banging that drum that only scares people into opposing everything associated with you.

[Jakes Progress]

31. Let go? Hell it's been ripped from me by the people I voted for.

And you are very naive to think that people aren't going to die at exactly the same rate and under exactly the same conditions as before we gave tax money to the insurance ghouls.

[dflprincess]

11. Call me silly, Jake Progress,

but do you suppose a single payer system - perhaps something like <ummm> Medicare could eliminate those costs you speak of? Is such a thing even possible or am I (and perhaps you) totally out of touch with reality?

[sandnsea]

13. Would it reduce premiums by 90%?

Do you think hospitals could function adequately on Medicare reimbursement rates alone?

[Jakes Progress]

16. Is America in a space/logic warp?

How can it work in Canada and not here? How can it work absolutely everywhere else for all income levels and not here?

Big old elephant in the room.

[dflprincess]

18. When everyone is in the same pool, the premium cost

(paid through a tax) would drop dramatically. Canadian DUers have posted that they pay about $200/month for their health care. A post here last night quoted an article that in the Netherlands it costs about $140(usd) every month.

Once the middle man was removed, the premium costs would drop, reimbursements could go up and we'd still all save money.

[sandnsea]

20. Those are both too high, way too high

I couldn't afford either one and I've got no kids.

[dflprincess]

22. Hopefully, you would qualify for a subsidy

though, as I said, I think the income caps are way too low for subsidies and need to be raised to something more realistic.

The thing is, the amounts listed above, are way lower than what my premium is now (which is employer based so I don't pay most of it) and that's for single coverage.

[sandnsea]

23. That's my point. We've got to talk about the subsidies

and what a reasonable premium is for working people. If we don't get that right, it'll be just like the long term care revolt back in the 80s.

I pay $56 a month for hubby and self right now. It's gone up to $120 some years. That's on a $1100 a month pre-existing condition state insurance pool policy. We've got a $500 deductible and the out of pocket is minimal so far. But I can get to the doctor. So I will fight to reduce those $1100 premiums the taxpayers have to pay, it matters to me. But my first priority is getting everybody to the doctor, anyway we can. Including excellent subsidies to insurance companies if that's the only thing this stupid-ass country will pass.

Believe me, I would LOVE for this country to turn into France tomorrow. I Would Love It. Not going to happen.

[Oregone]

28. Its *already* subsidized in that country mentioned

Although some provinces expect you to pay a small premium (and some don't), 90%+ of the funding is from taxes monies and not premiums. If you cannot even make the premium, thats covered too.

Single-payer nations can shift the funding from premium based (regressive, flat model) to tax funded (clearly progressive). Some try and create balances and seek out affordable amounts for premiums (though they don't force the poor to pay them). But anytime these symbolic premiums only cover a bit of the actual costs, you can most assuredly consider the program "subsidized" (and in Canada, the Federal government is cutting the unique provincial programs that subsidy check).

[Jakes Progress]

32. So what the real measure of good health care

should be is what would be good for you.

Get ready for hoops and circles. You will need to spend several hours a week doing forms to qualify for any subsidies. In France, you taxes cover your health care. They could do the same here.

[sandnsea]

36. Jesus Christ. I Have Subsidies

I spend an hour a YEAR filling out my form. Much less time than I do filling out my taxes.

People are spouting off about shit they know NOTHING about.

Learn something.

And there will be subsidies whether you fill out a tax form to get them or some other form, or whether it's a public or private plan. People will have to qualify for a sliding scale monthly amount.

What is that amount going to be? Do you have any clue at all???? Or have you just yelled "single payer" so much that you've got no other thought in your head?

[Jakes Progress]

42. Yes they do spout off.

Have you ever filled out SCHIP forms? I guess not since they are done several times a year.

I'm not the one who doesn't know what they are talking about. I'm glad you are literate. That means you won't be one of the hundreds of people who come to the center where I volunteer by helping them work with dozens of prying and invasive forms for a variety of government and insurance and legal and medical reasons. I know the forms. I know that they will be used to deny help. But then, what's that to you if you get yours.

And the answer is that the "subsidies" that will come from other's tax money to help pay for your insurance will not be enough. First there is the cost of the service. Then there is the cost of the pharmaceuticals (which have already been promised that they can keep their 2,000% margin of profit) then there is the profit for the insurance companies which covers the advertising, bribery (I mean lobbying), salaries, and bonuses for the very rich.

As for not having a clue. The clue is found somewhere further out than the six inches in front of the face of those who are solely concerned about their own benefit and who lack the ability to see that this whole thing is a stalling tactic by those who will use you and your money. A strong public option would be good for many. But most will continue to live in fear of each cough and every slip. The whole thing is a scam without the single payer method that you think is so impossible. So if it is impossible, buy a ticket to France. Even with public option, your life won't get any better and your chances of escaping the burden of debt that illness can bring will not improve. So don't yell single payer. Don't whisper it. Don't even think about it. Without it, people with the situation you describe are screwed. But don't roil the waters. Don't upset those in power.

I know that the administration and the party sold us out on single payer. My comments were about what should be. I already know what will be. Au Revoir.

[Oregone]

25. "Canadian DUers have posted that they pay about $200/month for their health care"

Try $106 for a family in BC. Free elsewhere.

If you can't afford that, its subsidized.

[Oregone]

27. Yes, it has been demostrated to do so

I just learned my BC premiums ($108 a month for my family, $54 single, $96 couple) cover only 10% of the overall budget, and if you cannot afford that, its further subsidized (free in other provinces). That means 90% of the medical budget in BC is publicly subsidized and funded via tax monies for all people. Soooo...yeah, they got it right up North. With single-payer, you have the ultimate control over how progressively you wish to fund the health care.

Hospitals exist here BTW. You don't need to go to the witchdoctor to get patched up.

[dflprincess]

43. $108 a month?? Yowsa!!!

pity I don't qualify to emigrate. I couldn't find a post where someone quoted the $200 figure, but I used it a couple days ago in another thread and was told I was nuts (by a supporter of the sell out bills currently being pushed) and that Canadians pay way more than that. I wish I'd had the amounts you just posted then!

[Jakes Progress]

15. By George, I think she's got it.

[Oregone]

24. Yes, the tax-payers need to cover the expensive compensation and shareholder dividends

You want sliding scale? Its called a tax system. Its easy to apply with real Medicare for All.

[zeos3]

30. I disagree

That's like saying:

The house or office space I rent has a leaking roof, the doors and windows are about to fall off and there's no insulation and there's asbestos all over the place. The most important thing is a subsidy to pay the landlord! Not fixing the roof or any of the other problems, paying the rent is the most important thing!

Or:

The chicken I buy is tainted with salmonella. The meat I buy has e coli. The medication I'm taking causes heart attacks. I need a subsidy to pay the grocer and pharmacy! The FDA is not important, I need the money to be able to afford this stuff at Walmart!

Or:

I just bought a car and the transmission is shot. The brakes don't work and there are all sorts of electrical problems. I need a subsidy to help make the car payment! Lemon laws are not important, I need help paying the the loan to the bank or manufacturer!


Let me be clear. I am NOT implying that you want a handout from the government for everything. I am NOT saying that you are wrong about premiums being way too high and that people could use help paying them. What I AM saying is that I disagree with you point that subsidies are THE most important thing.

First, let me say that I hate the idea of public money going to those who broke the system in the first place. Having said that, the subsidies will do nothing to curtail the rate increases the insurance companies love so much. They don't care where the money comes from as long as it ends up in their pockets. The subsidies will come from our pockets anyway but you don't feel it as bluntly because we will be giving it to the insurance companies indirectly.

Lastly, when you say "If the subsidies become too expensive, they will implement all the other cost containment because people will want to keep their health care." Don't you think this is a perfect argument for the right wing? If only the subsidies become too expensive, the right will pounce on this fact to say that a government program or any other "interference" in the private sector will break the bank. Say goodbye to a public option or a single payer system after that. All we'll here is that the free market will solve all our ills and the rest of that BS.

[sandnsea]

34. lol. So rent a mansion to a homeless person

The amount of the monthly payment isn't going to run that person out of there faster than a leaky roof or absent door, right?

The problem is too many people with no experience with the problem are spouting off on the solution.

[zeos3]

41. It's not about renting mansions

If you rent a dilapidated home for a homeless person, are you really doing them a favor? The criminally negligent landlord gets rewarded and I'm not sure if the homeless person is much safer or better off living in a slum.

I'm not here to pick a fight with you. I just read your other replies and understand your perspective a little better but I'm telling you the subsidies are not the most important thing, they are temporary relief to a bad situation. This quick fix will hurt you in the long run.

There is no reason to believe the out-of-pocket costs won't keep increasing and, for that matter, the premiums as well. If anything, I believe it might make people more complacent because the insurers can get their increased monthly premiums without directly alerting the consumer because the government is paying for it. The government us, you and me. We are still paying for this broken system with our tax dollars. I'd rather have our money go to a system that eliminates the for profit health industry.

BTW, I have 10 years of experience with this problem plus 47 more years of experience in the family.

[IndianaGreen]

33. Why are you carrying water for the health industry?

I'm reminded of the scene from Michael Moore's film SiCKO, where he sat down with a small group of Americans living in France. One of them, an African American woman, commented that in America people are afraid of the government, and that in France, the government is afraid of the people.

Could there be a connection between free health care, free college education and the higher level of protests, strikes and demonstrations in France?

http://socialistworker.org/2009/09/03/market-cant-cure-health-care

[sandnsea]

35. lol, why don't you read what I write

instead of replaying your socialist cuckoo tapes in your head.

I wrote up above that I would LOVE to wake up tomorrow and have this country turn into France.

You're the one who is carrying the water that is killing people because you keep throwing out the baby with the bathwater.

Why can't you accept reality??

[Cleita]

38. We do and that's why we question your words.

You also have a very trollish way of insulting and hurling ugly accusations to people who don't agree with you and question your motives.

[Cleita]

37. Not with my tax money. I don't approve of any taxpayer's money

going to the insurance companies. I want my taxes going directly to the providers of health care like Medicare does. Parasite middlemen, whose CEOs make $100,000 an hour shouldn't be getting welfare from our government.

[zeos3]

39. Agreed

This was the point I was trying to make in my reply #30.

[Sebastian Doyle]

40. This thread was brought to you by.....

...The Kaiser Permanente Corporation. Profiting from sickness since 1971 (Thanks Dick Nixon!)