THE Comprehensive HCR Kos Diary!!!! If You Read ONE THING About HCR, This Should Be It

[Beetwasher]

Kudos to Jim Bow at Kos!!

Read the whole thing, it's pretty darn comprehensive:

http://www.dailykos.com/storyonly/2009/12/29/819669/-Merging-the-House-and-Senate-HCR-Bills

[Captain Hilts]

1. But we don't spread risk and lower costs so long as insurance is tied to employment. nt

[truedelphi]

9. Ssh! Don't let that cat out of the bag.

After all, Obama explained that himself.

You see, first he said that the only real solution to the Heath Care Mes was Single Payer Univwersal HC. (Sumemr of 2004 when running for the Ill Senate.)

Then when running for office of the President, in Dec 2007, when he realized that the above slogan would get him exactly 00 cents from Big Insurer and Big Medical Interest Campaign Donors, he came up with this bit of staggering illogic: "Although Single Payer Universal HC would be the best solution, if we were starting from scratch, since we have to work within the system we already have, then we must create something uniquely American."

By uniquely American, I guess he meant our continuing to pay twice as much as the European nations do, for far less effictive care!

[grantcart]

2. Very objective look

I found this very intersting

a federal Exchange with competitive bidding (more bargaining power for the Exchange; also, see Sec. 303 of the House bill when I talk about the competitive bidding) but lacking a public option would improve the bill about 25 percent: the bargaining power of a negotiated rates public option just pales in comparison to the bargaining power and enforcement ability a federal Exchange has. And of course, the federal Exchange is a lot easier to achieve than a public option -- even one at negotiated rates -- as Sens. Lincoln, Landrieu, and Nelson have already voted for a federal sub-Exchange.


The diarist doesn't seem to be well acquainted with OPM's experience as a gatekeeper for the Federal Employee Health Benefit exchange, which is what the new exchanges are going to be modeled after, including OPM's ability to set not just coverage and premiums but also profits.

[Beetwasher]

3. Yup, The More I See Of The Exchange, The More I Like It

And think it has real potential to be effective.

[grantcart]

7. here is the funny thing

you can see how it is working NOW

http://www.opm.gov/insure/health/search/plansearch.aspx

You have heard Congressman and Senators say, for the last x years, the American people should have access to the same system that federal employees have.

The link above shows how the OPM handles the plans for federal employees, and you can go on and pretend that you are a federal employee and see how it works.

Last year private companies profit on OPM plans were about 1.7%

[Beetwasher]

8. Cool!

:thumbsup:

[TheKentuckian]

4. The exchange is a joke if it isn't national in scope and if it is a closed system

You simply cannot have for profit care, a state sanctioned monopoly, and an employer based system and end up with reform. Reform entails making some substantive and widespread changes.

[Beetwasher]

5. WTF Are You Talking About?

There will be no state based monopolies and in fact there MUST be a non-profit option in EVERY exchange.

[Lydia Leftcoast]

11. Non-profit will help only slightly

We have non-profit insurance here in Minnesota. The executives live luxuriously, the buildings are lavish, they lobby in Washington, and they advertise all over town telling us how much they "care."

They send me letters telling me that I haven't had such and such a test, which I'm supposed to have at my age.

("That's because you don't pay for it, you idiots, and I'm paying you premiums equal to the cost of the test every month.")

It's a "non-profit" insurance company that has me paying thousands of dollars a year for a five thousand dollar deductible and twenty percent copays after that.

Those bloodsuckers need to be put in choker collars and regulated like utilities. I'd be happy paying what I pay IF I COULD GET SOME ACTUAL MEDICAL CARE FOR IT.

[Beetwasher]

15. It Depends on yr definition of Slightly

people with no insurance now might beg to differ.

[Lydia Leftcoast]

18. If they did the math, people with no insurance might be better off

without it than they think they'd be.

I'm on the verge of dumping mine now.

If I had one of those policies where you have to pay $600 a month with a $10,000 deductible, I'd definitely dump it. Such a policy requires you to pay $17,200 out of pocket before you get ANY benefits.

In that case, most people would be better off gambling on not having a major illness, and if they kept their insurance, a sudden $17,200 in medical expenses would bankrupt them anyway.

[Beetwasher]

19. Sorry but that's BS

The fact is you will almost certainly have more options and someone without coverage now will get coverage that will be regulated to provide a certain level of basic coverage. They will be much better off.

[Lydia Leftcoast]

21. But there are no price controls

and the ideas of "affordable" are unrealistic. The potential loopholes (insurance companies will still be able to drop people for undefined "fraud") will be exploited. Companies will be required to spend only 80% of their take on medical care, which means that lavish salaries and perks for executives will continue. Even the subsidies are pure, unadulterated corporate welfare.

This is bigger than the bank bailout.

[Beetwasher]

23. Competition Is Price Control

Caps on increase and oversight, mnimum coverage requirements, and profit caps etc. Tell it to someone who could never afford coverage before but now will ne able too.

[TheKentuckian]

13. Any industry with an anti-trust exemption is by definition a monopoly

and Blue Cross/Blue Shield at least started as non-profits.

[Beetwasher]

14. Uh no it's not

Monopoly is defined as no competition and the xchange guarantees competition.

[TheKentuckian]

26. The ENTIRE INDUSTRY is a monopoly and they are free to fix prices

and run the game pretty much how they please.

The competion is FAKE, its an inside game. They work out how things will play out cooperatively and then pretend to compete.

Its a fucking sham and the same exact sham they've been running for years. This bill demands that arrangement continue, otherwise why was it such a critical mission for industry toadie and former fox watching the henhouse Nelson to maintain the anti-trust? So they would continue to really hold the cards.

[Lydia Leftcoast]

28. And for a further reality check, read the online comments to Bob Herbert's latest column:

Put them in order of recommendations, and you'll get a pretty accurate view of readers' opinions. Remember: these are people who by and large voted for Obama.

http://community.nytimes.com/comments/www.nytimes.com/2009/12/29/opinion/29herbert.html?sort=recommended

[Beetwasher]

29. You Don't Know What A Monopoly Is

Look up the definition. You're looking very stupid.

[sendero]

33. They will be in competition ....

... just like the airlines. Ever watch how they do business? One raises fares, the others follow suit within HOURS.

There is very very little competition in big business in this country any more, it is all smoke and mirrors, a "free market" myth.

[Beetwasher]

35. The Airlines Are Not Administered By The OPM

Big difference.

[sendero]

36. Oh, our great bureaucrats..

.. that are supposed to ensure that there are no anti-trust violation in big business?

You crack me up.

[Beetwasher]

37. FEMA Was A Terrific Program Under Clinton

Bush, not so much.

These things work if adminstered properly.

Just because there's the possibility some numbskull Republican is going to misuse an agency, doesn't mean we shouldn't pursue development and progress.

[grantcart]

6. your facts are in serious error

the exchange will have multi state plans, must have non profits and the plans, including the profits of the plans will be controlled by OPM

It appears that you have not actually read the managers ammendment on the Senate bill

[truedelphi]

10. Good thinking. However, the Administration

Currently in power is not fond of logic.

Main Statement starting in Dec 2007 - "Although Single Payer Universal Health Care is the best and most logical solution to the health care reform debate, if we were starting from scratch, since we have to work with the system in place, we will have to come up with something uniquely American." So it is broken, and we have to fix it, but we cannot move away from it, but stay inside it, even though we all agree it doesn't work. (Some logic there, Barack.)

And by that, he meant to keep letting the Insurers and other Big Medical Interests gauge us for everything they can, while mandating we buy from said insurers, et cetera.

[Lydia Leftcoast]

12. Someone is thinking inside the box

Why does health care have to be deficit neutral and war and occupation and prisons never do? (What a country, eh?)

Why have deductibles? Other civilized countries don't. Deductibles KILL.

Why finance the proposal by cannibalizing the existing system? Yeah, yeah, the Republicanites will squeal about taxes. Let 'em. They aren't going to vote for reform anyway.

What value do insurance companies add to the health care picture?

[Beetwasher]

16. The Line For yr Revolutionary Upheaval in a single stroke

starts over there in la la land, right next to fantasy island.

[Lydia Leftcoast]

17. Hmph, they didn't even TRY

I know what trying looks like.

They didn't do it.

[Beetwasher]

20. Maybe I Should Try farting myself to the moon

I mean why not?

[Lydia Leftcoast]

22. OK, irrelevant argument like those posed by right-wingers

I'm done.

You enjoy YOUR fantasy land where this bill makes everything sweetness and light for America and will make Americans love the Dems forever and will be the starting point for single payer some time in 2050.

[Beetwasher]

24. No Its Not Irrelevant

You are lving on another planet where people could shit ice cream if they only tried.

[Lydia Leftcoast]

25. The majority of First World people on this planet have what I'm asking for and more

as do many of the second-tier countries.

[Beetwasher]

27. So?

So that means u can get it done here? Right now!?

La La land.

[Lydia Leftcoast]

30. Yeah, because I wouldn't CAVE every time someone threatened to filibuster

and I wouldn't START with closed door sessions with the insurance companies and Big Pharma (I bet you didn't like it when Cheney met behind closed doors with the energy companies) and I wouldn't declare ahead of time that single payer was "off the table" and I wouldn't keep trying to woo Congresscritters who would never vote for the bill anyway.

I would have started with a PR appearance at one of those free health care tent events and declared that the fastest, most efficient way to treat the most people for the least amount of money was single payer. Then I would have gone around telling people that I would NOT sign a bill that didn't have single payer. I would place Americans who had lived overseas and had good experiences with foreign health care on all the news programs. Every naysayer would have been met with a yea-sayer. At every appearance, I would tell the public to pester their Congresscritters "because you have to talk louder than the millions in bribes, oops, I mean, campaign contributions that Representatives and Senators are getting from the insurance lobby."

After a few months of Republicans screaming like idiots, I would have checked the national mood, and if it was favorable, I would have passed the bill without them.

I totally do not get the fear of filibusters. Let the idiots look like idiots, have the Dems walk out, and let the idiots blather at one another for a few days. They'll wear out eventually.

[Beetwasher]

31. LOL!

Oh yeah! You are all that!

Gosh! Just try harder! Maybe praying would help too! Must be nice to live in yr little fantasy world where if only everyone followed yr expert opinion things would be immediately perfect! For you!

[Lydia Leftcoast]

32. See, you can't even admit that Obama could have done a better sales job

All you have is ridicule.

It's dinner time. I'm out of here.

[Beetwasher]

34. You Have No Idea That Things Would Have Been Any Different If only he followed yr advice

Why should I admit something is true that no one can possibly know?