:shrug:
By Don McCanne, MD
http://www.pnhp.org/news/2009/july/paygo_that_builds_r.php"As expected, Congress ran into problems when they tried to figure out how to pay for health care reform. They stubbornly adhered to the principle that reform must be built on our dysfunctional system of profitable private plans for the healthy and taxpayer-financed public programs for the sick, even though numerous studies have shown that this is the most expensive model of reform.
Before the process began it was already understood that health care has now become so expensive that a health plan with adequate benefits would require massive public subsidies to make it affordable for average-income individuals and families. It is the size of the subsidies that would be required for them to work that would be the budget busters. Now that they are at the point that decisions must be made, they are relying on a process analogous to innovation in the marketplace, shunning their obligation to be responsible public stewards.
For the average American, they are establishing a standard of a bottom-tier package of benefits (a bizarre concept that requires greater out-of-pocket spending for those needing health care than that required of the wealthy with their higher-tiered plans). They are paring back the income eligibility levels such that there would be no subsidy above 300 percent of the poverty level ($32,500 for an individual or $66,000 for a family of four). These numbers simply do not make health care affordable for middle-income Americans when you consider that the Milliman Medical Index is now $16,771 (the average cost of family health care for the healthier sector covered by employer-sponsore plans). That doesn’t even count the taxes that middle-income Americans pay to support the massive government spending on health care programs.
Congress’s “market innovation” for pay-go is to fully fund the waste built into the private insurance model of health care financing, and pay for it out of the pockets of middle Americans who happen to need health care - defeating the very purpose of health care reform..."