Healthcare Overhaul Is Quietly Underway -LAT

WASHINGTON — Emboldened by their success at the polls, the Bush administration and Republican leaders in Congress believe they have a new opportunity to move the nation away from the system of employer-provided health insurance that has covered most working Americans for the last half-century.
...
Critics say the Republican approach is really an attempt to shift the risks, massive costs and knotty problems of healthcare from employers to individuals. And they say the GOP is moving forward with far less public attention or debate than have surrounded Bush's plans to overhaul Social Security.

Indeed, Bush's health insurance agenda is far more developed than his Social Security plans and is advancing at a rapid clip through a combination of actions by government, insurers, employers and individuals.

Health savings accounts, known as HSAs, have already been approved. They were created as a little-noticed appendage to the 2003 Medicare prescription drug bill.......

http://www.latimes.com/news/nationworld/politics/la-na-health31jan31,1,7750807.story?coll=la-news-politics-national

goodbye america...

Dear Lord, maybe it's the end of the universe, but I actually agree that healthcare should be decoupled from employment.

Of course, my agreement with them stops there :)


FWIW, these health accounts sound just like flexible spending plans to me. We have them in NY. They're somewhat helpful, but nothing to write home about. They're useless for unexpected health expenses.

that health insurance should then be provided by the government, after it's decoupled from employment. But BushCo certainly doesn't think that. They want to keep it with private companies, with little or no govt oversight, and individuals get to pay for ALL of it.

Health care should have nothing to do with employment!

What we need is a national health care plan that bypasses the employer and covers the individual directly. Of course, the Repugs aren't going to offer that, but I like the idea of de-coupling health care from employment.

For the most part, we have national health care. Where we don't, the employers offer insurance as benefits. It works.

I just want to pretend I didn't read that... :scared:

it's not working for me. :-(

will receive medical care at the point of a gun maybe.

Or faith based hands on head instant get well "Heal heal heal!"

Stupid.

180

I remember seeing the preview and commenting to my friend that it was going to become a reality if things continued as they were.

Losse their health insurance under this bill? We as tax payers are their employer.

I discussed this on Light Up the Darkness a few days ago:

http://www.lightupthedarkness.org/blog/?view=plink&id=289


Evidence against Bush's health care plans
28 January 2005

The Commonwealth Fund has come out with data verifying what I've been arguing for a long time. Republicans often advocate increasing out of pocket payments for health care so that consumers would be more judicious in spending money. The problem with this is that people tend to avoid medical expenses if it comes out of their own pockets, regardless of the value of the health care. The same is likely to occur with Health Savings Accounts. This would likley lead to increased costs in the long run as preventative care and treatment of chronic diseases is ignored. It is far more cost effective to treat problems such as diabetes and hypertension early than to pay for bypass surgery, dialysis, or long-term care following a stroke.

The Commonwealth Fund compared health expenses among people in high-deductible plans as opposed to those in lower-deductible plans. Among their findings are that:

About half of insured adults with a high-deductible health plan have medical bill problems or debts, compared with less than one-third (31%) of those with lower-deductible plans, according to new research from The Commonwealth Fund. Individuals with high-deductible plans are also more likely than those with lower-deductible plans to experience access problems such as not filling a prescription, or skipping a medical test, treatment, or follow-up when needed, due to cost.

"Health savings accounts coupled with high deductible health plans have potential pitfalls, especially for families with low incomes or individuals with chronic health conditions, who are at greater risk of accruing burdensome medical debts and facing barriers to needed health care," said Commonwealth Fund President Karen Davis. "The evidence is that increased patient cost-sharing leads to underuse of appropriate care."

It would be like seniors in 1929..You would just die.

i will be VERY curious to see how centre democrats react to this.

Center Democrat = Republican Lite.

I live in a very republican area and everyone of them has great health insurance from their employers. We are self-employed and ours sucks. I do find that they overuse their benefits - running the kids to the doctor for the smallest sniffle, but it is much better then trying to decide whether your family is "sick enough" to take to the doctor.

As Dr Ron pointed out in his post, the negative impact of private accounts is that you tend to wait when it comes out of your own pocket.

It all sounds good in theory that people will shop around more and this is true, by the way. When my 5 year old daughter fell and broke her arm I was told by the clinic we visit that she should see an orthopeodist so I started to call around. The pediatric ortho wanted 1300 just to walk in the door. I found one on my third call who would see her for 250. She had an uncomplicated break in her upper arm. He saw her once for approx 1.5 minutes looked at one xray and said just keep it still with a sling and swath (which is what we were doing). He told us to come back for 2 revisits, we didn't and she is fine.

BUT, the flip side is I didn't see her fall and she didn't cry for more than a couple of seconds so when she said mommy my arm hurts we watched her for a day and a half before we decided to take her in, once we realized she wasn't lifting her arm more than a few inches. In little kids if you don't get a break looked at in the first couple hours it already is 'set' in its healing pattern. We got lucky because her growth plate wasn't involved, but I still felt awful. If she had had a complicated break involving the growth plate we would have had to do more orthopoedic work down the road to correct the problems created by waiting.

So far we are all healthy, knock on wood, I don't know what we would do if one of us got really sick. And I can only imagine the absolutely horrible impact of everyone living with this same sort of health "coverage" - if you can call it that. It would truly be a
"catastrophic success".

Whether it be upon my vehicles and tools or on my health. It has pretty much been proved as effective business policy to engage in "Preventive Maintenance". Why is the right wing who supposedly has a grip on financial responsibilities so against such policies. It is because the leaders make money off the broken vehicles or bodies. They are not on the businesses side in this issue or on the health of the nation's side. They are on their side and their side only. This should be a shoe in issue for the Democrats but their hands aren't all that clean either.

for. It's up to the Dems who can get the media coverage to expose the dirty behind the scenes doings of this administration.

As soon as we get sick all payments should stop and treatment should be free and payments restarted when we are well again.

And she was insured by her employer. I think she eventually got some of the money back, but that's twenty four thousand dollars, not twenty-four hundred.

Rep. Jame Moran (D-VA) has a child who survived cancer, and her treatments almost drove the family into bankruptcy, I recall. You know that congressmen have excellent health coverage.

Bush also wants to tighten up bankruptcy laws, which will result in added strain. This HSA nonsense is almost the final slap.

What other evil does he have planned? For he is truly evil.

waving over the body.

didn't you know? Aetna is the cleansing hand of GOD..


Let the Baptist, Catholic, and all other churches compete for morality. Let the profits of God's army be tax free O8)

<<Supporters of the new approach, who see it as part of Bush's "ownership society," say workers and their families would become more careful users of healthcare if they had to pay the bills.>>

:mad:

On one hand, this is a fundamental mischaracterization of human psychology. People already have a vested interest in their own health; they are not going to abuse their body simply because they know that the system will pay for the treatment of subsequent physical maladies! In fact, it is well-documented that the wealthy, who can easily afford to "pay the bills", are less likely to engage in self-destructive behavior and are more conscious of nutrition and fitness.

Furthermore, most people I know hate going to the doctor, and hate taking prescription drugs more than absolutely necessary. In fact, we often refuse medical attention for legitimate conditions, due in part to cost. I absolutely resent the implication that we need to be "more careful users of healthcare". This isn't like buying a pool table or a new car, for God's sake, where you can wait till you have more money or seek a cheaper alternative. When your life is on the line and the cost of treatment nearly devours your income, it's pretty insulting to hear morons like this tell you that you need to spend more judiciously.

<<Furthermore, most people I know hate going to the doctor, and hate taking prescription drugs more than absolutely necessary. In fact, we often refuse medical attention for legitimate conditions, due in part to cost. I absolutely resent the implication that we need to be "more careful users of healthcare". This isn't like buying a pool table or a new car, for God's sake, where you can wait till you have more money or seek a cheaper alternative. When your life is on the line and the cost of treatment nearly devours your income, it's pretty insulting to hear morons like this tell you that you need to spend more judiciously.>>

How many people ration out the meds they take to make the RX last longer to save money?
How many people put off seeing a DR... because they don't have the money for even the co pay??

I told my friends the only reason I get treatment for the MS is that I can be able to work. Without my Ins provided by my job, I will not be able to afford treatment on my own.

But if I were dx'd with a terminal illness, I wouldn't even bother with treatment because it would just put me in more debt.

And it's sad to say, that I'm not the only one who feels that way.

And now we have these clowns telling us that we "have to be more careful of how we spend our money on healthcare"? Compassionate Conservatives my ass.

Does anybody have all the addresses of all the members in the House and Senate. I'm going to write every single one of them.

And I'm about to write another LTE to my paper. Not that they will publish it or anything....

Just went to conference for work on this, some interesting research already conducted:

65 percent of health care costs cost are concentrated in sickest 10 percent of people. The bottom 50 percent only account for 3 percent of health care costs.

My conclusion:

Healthy people subsidize sick people in traditional insurance plans. When the healthy people leave traditional plans and create HSAs, sick people will not as they are unable to qualify for HDHP. Premiums in traditional plans will then sky rocket.

Those with HSAs will watch their money grow in a tax favored accounts, which all of us subsidize, while traditional health insurance will cease to exist. No one will pay the premiums insurance companies must charge for the plans to be profitable.

there is absolutely no one who will benefit from, this scheme.

insurance companies? no, we're all moving away from health insurance to ownership - iof they dont cover anything anyway, then they wont have customers.

doctors will be seeing less patients, as it costs much more and patients will visit less.

pharmaceutical companies will make less money, as their is no drug benefit.

patients will avoid going to the doctor, as it costs them much more.

this idea is stupid, and benefits no one.

more communicable disease.

We're a pandemic waiting to happen, b/c healthcare costs are so unreasonable. We need universal healthcare now.

No one will go to the doctor because it will be too expensive. No one will get mental health care. People will die. Why does anyone have to profit from health care? Why don't we as a nation just suck up and pay for it because it's the right thing to do, whether anyone profits or not?

This may wind up not being palatable for anyone, isn., and providers included.

why is is doing it with "less public attention"? He's ramrodding through this "rich get richer scheme" because he knows the majority of the public won't buy it!!!

:headbang:
rocknation

Privatization is such a disaster! I work with people's insurance issues in health care every day...it is heartbreaking to see the choices they have to make.

:kick:

when he was governor. He had zones for small business, and the companies competed for the small business trade.

The Jebster and his ReThugs dismantled the program first thing upon election. No break for small business.

My plan must cover my employee no matter what.

It is very expensive, and the insurance companies want me to go to individual plans per each employee.

But guess what, they get to pick and choose who they want to insure. So some of my employees and their families would not get covered. Ownership? Bah, humbug. More money, less liability for the insurance industry.

Do you want to reform health care industry? Here is my plan. CEOs that are now making millions, tens of millions a year in a publicly traded insurance company are force to adhere to a MAXIMUM wage that is a based on the average wage of the employees. That would free up tens of millions of dollars to pay shareholders and put into medical costs without raising the premiums.

Oh, and BTW, I understand that maximum wages for CEOs work well in Japan. I don't see why they wouldn't work here.

CEOs of a publicly traded corporation are not enterpendeurs. There is no reason why they get to raid a corporation.

Everyone should see this. What a load of CRAP.

of the American middle class. This admin has done nothing for the middle class..NOTHING!

Take the health insurance away from the Congress, Senate, Supreme Court, and the pResident! Make them pay for their own! Why should we pay for their health insurance while they screw us out of ours?

The many people at the office who complain about reduced benefits and higher co-pays for their insurance yet voted for * are going to have a serious wake-up call.

...with a chronic, fairly expensive but perfectly liveable condition (ulcerative colitis)?

Such a pay-your-own-way world is stupidly naive. With my current insurance, my finances barely survived the medical bills when a flare-up developed life-threatening complications and put me in the hospital for a week.

Under a Bush plan, if I could find insurance *at all*...private insurers don't like people with preexisting conditions...I'd have been expected to shoulder a huge deductable, then make co-pays on top of that, and make up for it with savings. What savings? I've never worked a full time job with full benefits my entire career. (grad student, unemployment, temp, grad student). Where would my Medical Savings Accounts come from?

I say the whole thing is just another vehicle to give the wealthy a tax shelter, no ifs, ands, or buts, and screw the rest of us.

-- ArchTeryx

You said that you didn't work enough to accumulate any benefits so you're expendible.

I've been written off because of my medical problems (of which the UC is but one) pretty much all my life. My mother spent her life savings fighting to save me from the system, and she won, or I wouldn't be typing this. In general, people with chronic illnesses would get a death-shaft from an entirely private insurance system, or at least would have zero chance at financial viability.

At the same time, though, I'm a white male seen as a POTENTIAL high-benefit earner, because I'm in a hard-sciences PhD program. So even though I am very poor in assets and income, I'm pitched at like I have wealth, sometimes from surprising sources. Overall, though, having lived on next-to-bottom-tier income scale moost of my working life, I find white male privilege to be pretty vastly overrated. :P

-- ArchTeryx

I work in the field (health insurance) Companies are absolutely orgasmic over HSAs right now....like all Republican based proposals, however, they have the same tragic flaw....ONE SIZE DOES NoT FIT ALL!!!

If you have a high deductible plan (say $2,000) and open a HSA to pay for it....yo9ur cost of isnurance is the monthly premium PLUS $2000.00.....your cost of insurance just went up $2,000!

Another problem is Pre-existing conditions....if people are forced out of their employer-based plan and forced into individual accounts, the Insurance companies can DECLINE TO INSURE anybody they want....these people are then (usually) forced into State-Sponsored Polls which have minimal coverages and high premiums. The end result is that Private Insurance Companies will get the healthiest (lowest risk) people and government (State or Federal) will get the unhealthiest and most expensive.

The guiding principle and frame of reference for the Democrats should be The Health of you and Your Children DOES NOT depend on the size of your wallet!

If we can't kick their butts with this, why BOTHER?

snip>
WASHINGTON — Emboldened by their success at the polls, the Bush administration and Republican leaders in Congress believe they have a new opportunity to move the nation away from the system of employer-provided health insurance that has covered most working Americans for the past half-century......

http://seattletimes.nwsource.com/html/nationworld/2002166569_healthcare01.html

to mind repeatedly, recently, when I think of *, the republicans, and their policies: GHOULS!

<< Critics say the Republican approach is really an attempt to shift the risks, massive costs and knotty problems of healthcare from employers to individuals. And they say the GOP is moving forward with far less public attention or debate than have surrounded Bush's plans to overhaul Social Security.>>



As someone with a Chronic illness, I was told by three different Dr's that I can not get private insurance. At least not any plan that is worth anything. So Mr Bush ( because I refuse to call you President. A REAL President cares about the people of his country and DOES NOT VIEW them as Cattle)... What should someone like me do?

<< Supporters of the new approach, who see it as part of Bush's "ownership society," say workers and their families would become more careful users of healthcare if they had to pay the bills >>

More Careful?? More Careful? WTF is that supposed to mean?
Oh and a note to the * supporters... I do pay the bills.. it's called a copay you morons.

I really can't stand these people.

If this goes thru, I am making plans on moving out of this country.

Republicans fought it tooth and nail. Now years later they offer up the same idea secretly and pretend they came up with idea. Of course there plan has a big difference more cost to the people. If the Democrats in congress let this go through without a fight I will never believe in anything again.

:kick:

It is apparent to anyone with a single neuron in their head that this nation cannot endure under this kind of leadership.

But too many voters don't even have that single neuron, so they put the moron back in charge. A sure sign that the repug movement to destroy our educational system has worked.

The move to private SS accounts will work just fine. Until the market takes a downturn (which it must) and they become worth bupkas.

This movement to scrap the employer based health care system will have the same result: a two tier health system with the wealthy getting the care and the non-wealthy simply dieing in the streets. Perhaps govt will provide the final health care: retrieving and incinerating the bodies.

Shades of Soylent Green.

And have we heard a single word of protest from the dems? I haven't. But then they ARE a part of the system.

My point is simply this: Every time in history that the wealth of a nation became so unbalanced that the poor had no input into the system, the system became unbalanced and fell. In other words, a revolution occurred.

The same will happen here. It must. Too many remember the Pre-Empire America and miss their freedoms.

Either that, or America becomes so economically poor that we are irrelevant on the world stage and are taken over by the new 'superpower'.

SCREW THE REPUBLICANS!! I HATE THEM! PEOPLE don't have money lying around to pay for doctors!!!! Assbites!

Below is a link to the Los Angeles Times..A new story to me..Bush to change corporate tax credits..Change medical insurance so that employers would only cover castrophic medical coverage..The rest of us would have to start Medical Savings accounts to put money away from that rainy day when you need an MRI or outpatient surgery..Think you have enough discretionary income to put hundreds of thousand away for that non-vital hospital stay..
We all know medical accounts are a tax dodge for the rich...Look forward to shopping around for that MRI? I called my Democratic congressman..I was the first to call to complain..We need take on this equal to his attempts at robbing Social Security..

http://www.commondreams.org/headlines05/0131-06.htm

I looked into one of these ten years ago. It sounds like a logical solution really, if you don't use alot of medical services. Put aside $100 a month or so for routine care, have a policy to cover catastrophic emergencies. Problem is, the cost of these policies is almost as much as regular insurance anyway because catastrophic illnesses are what cost so much. You have to put the money in an approved MSA to get the deduction, and you can only get them with one of these shit policies. Not to mention preventative and diagnostic tests are astronomical. My sister was just diagnosed with cancer. She had pain in her shoulder and they never even suspected a tumor. They did the MRI to see if there was a spur or something. If she'd had to take the money out of an MSA, she might not know she had cancer until it was too late. I guess we're going down Churchill's path again, "Americans will always do the right thing... after they've exhausted all the alternatives".

:wtf:

on edit:

Paid for by you and me, I wanted to add.

Don't assume he has a conscience. Corporatist @$$holes like Bush smile and pray to their gawd every night before bed and wake up to screw the working people the next day.

It had nothing to do with our catastophic insurance plan. Our MSA is a shit policy because the interest is a joke, but other than that it wasn't tied to which health insurance coverage he got. It was totally seperate. We got a tax deduction for the MSA-it comes right off the top-& he can use it for anything-dental, acupuncture, chiropratic, etc.
He's with the VA now & still has the account which he uses very rarely-mostly dental. I still have just catastrophic health insurance, but we're fortunate that we can afford MRI's etc. (not happily, but we can afford them). And certainly getting my husband hooked up with the VA has saved a lot.

That said, what have MSA's got to do with 45 millione not even having health insurance? Yeah right, put money in an MSA when you don't even have insurance. Dumbya strikes again for corporations & screw the people.

That's the biggest question I have.

They all assume we all have just gobs of extra hundreds of dollars to put into these things, when the thruth is people are getting paid so little, they have NO savings, either pay the rent OR food, and and HUGE credit card debt.

Idiots.

All of 'em.

To them, $200 K is an "average income". I'd like to be able to approach 6 figures some day before that figure is meaningless.

I was being sarcastic which sometimes doesn't play well on a board. My point was if someone doesn't have insurance how would they have money for an MSA & why would they have an MSA if they didn't have insurance? I was just being sarcastic.

are thinking tonight? BushCo promised to free them from tort tyranny, only to rob them blind with unaffordable healthcare for the masses.

Yes, I wonder what the doctors are thinking, tonight? Hope they're fat and sassy, tonight, tonight, for on the 'morrow they may yet start to starve.

This guy is so out of control! Unbelievable!!!

thats why people work which is ridiculous when America should provide that for its people!!!

Bush wants elderly and Workers to get really psst and I say go for it Buddy see what happens next!!!

I'd say the next time His Lordship goes for a colonoscopy at the finest facility available, they should insert his entire health care plan. Then we'll see how much he thrives....

First, Bush nearly eliminates all taxes earned on passive income, Dividends, capital gains, and the estate tax, yet keeps taxes high on labor.

Next, he allows outsourcing and globalization to send all jobs in the private sector overseas.

Next, he moves to eliminate money spent on education.

Now, he wants to take away employer paid healthcare.

What he, and the Republicans, really want to do is to create a world where the only options that most people will have will be join the military or work in a low-paying, no benefits, go nowhere, dead-end job. Only the people born into wealth will have any opportunities in their world.

But, Gays won't be allowed to marry and that's what really important to the American people.

We will be two classes of people, investors and those who serve them. The investors are the only ones who are going to own anything too.

Anybody who underestimates the worker is the same person who was guilotined or Communinism which was destroyed.

Actually I'm enjoying the Compassionate Republican coming out and showing his real colors...

I don't know who he thinks he is but in the scheme of things he is a fly on a pile!!!

buzzing away stinking and a nuisance and ready to be swatted!!!

I read this article last evening on Yahoo and became so damn pissed at the thought of such a despicable act possibly being shoved down ALL American throats. There are plenty of Repub working class families in the area in which I live and they could not believe me when I informed them of what their hero had in mind. I just had to be wrong or read some cray liberal crap.

So, I come home this evening and turn on the evening news to see how the * pundits would spin this shameful pandering, but alas there is NOTHING BEING SAID OF THIS!

It's time to scream loud, hard, long and forceful to both the media and our own US Reps and Senators that we demand this issue become widely known and that it is struck down before it ever has a chance to take place.

If the powers that be wish to steal our health care right from under us, I demand National Health Care in it's place. And nothing short of that will ever satisfy me.

I pay premiums in addition to having a high deductible. Since I am a healthy person, I do not even use 2000 of health care per year but I am still paying the premiums. Do I have to have a HSA? Could I just let it ride..since I don't use that much health care, the tax savings to me would be negligible. We have something similar at work. In addition to the traditional HMO we have something called TExFlex. You can have money deducted from your paycheck (before taxes) and put into an account from which you can reimburse yourself for things the HMO plan does not cover (braces, for example, copayments, deductibles). It makes sense for people who have a lot of expenses (kid's braces for example or expensive drugs) but it is not instead of traditional health care but in addition to it.

do really we need more government control, the department of healthcare delivery? keep Bush out of our medical cabinets, stop the corporate takeover of healthcare..Doctor's offices and mandatory souse accounts!

The Bush plan is nothing more than another government takeover of our bank accounts! Bush's government run plan shall result in the micromanagement of healthcare delivery from some egocentric Washington bureaucrat, denials of care in the emergency room, and the approval or denial of Medicare coverage based on pre-existing conditions. In the words of Bob Dole.."More cost, less choice, more taxes, less quality, more government control, and less control for you and your family, that's what the President's government-run plan is likely to give you.":spank:

What an effective ad that would be! Use the conservative's own characters against them!

http://extfile.bah.com/livelink/livelink/78186/?func=doc.Fetch&nodeid=78186

This is from the Booz, Allen, Hamilton consulting firm.

>>
Beyond revolutionizing healthcare benefits,
defined-contribution plans will create 50
to 100 million new individual investment
accounts. The $1 trillion annual money flow
will trigger a convergence of healthcare
benefits and traditional financial services.
>>

It is true that the general public, while fuming over a $25 copay for their statin drug, doesn't generally realize that their insurance company just paid $150 to the drug company for the drug. However, the idea that the small amount of cost savings incurred by the individual taking "ownership" and paying for it themselves will somehow offset a shift in premiums from the employer to the employee is ludicrous.

Overall, this is simply cost-shifting. Most people working for large corporations don't realize the huge amount of money the employer is already paying as part of their healthcare insurance. It will only work if the employers increase wages to the workers to pay for the premiums, which won't happen at the same rate that your paying higher insurance premiums.

Economics is much simpler than they want us to believe. If they keep us confused, they win.