So let me get this straight, regarding the Senate version of health care reform

Another section of Mr. Baucus’s proposal would help pay insurance premiums, co-payments and deductibles for people with incomes less than 300 percent of the poverty level ($66,150 for a family of four). It would also provide some protection for people with incomes from 300 percent to 400 percent of the poverty level (up to $88,200 for a family of four), so they would generally not have to pay more than 13 percent of their income in premiums.

13% of your income can go toward premiums. That family of 4 at 400% FPL can pay up to $11,466 a year in premiums.

Mr. Baucus would impose limits on out-of-pocket medical costs — the co-payments, deductibles and similar charges for covered items and services. The limits would be $11,900 a year for a family and $5,950 for an individual. The comparable numbers in the House bill are $10,000 and $5,000

So that family of 4 might also be expected to pay up to $11,900 a year in out of pocket costs?

Am I reading that right?



http://www.nytimes.com/2009/09/07/health/policy/07health.html?_r=1

that's not insurance reform.

In fact, by placing these "limits" on OOP, Baucus is essentially telling private insurers they now can move your OOP out to 11466, 10K or 5K a year, even if you currently only pay say, 700 for an individual.

The insurance companies are laughing all the way to the bank. What's wrong with health care in this country is stupid politicians.

During the election season when McCain was proposing a tax credit of $10000 for families and $5000 for individuals I thought, "Great. So insurance companies will create a bunch of policies that cost roughly $5000 and $10000 and won't cover shit."

And now we have Democrats proposing this garbage. Like Jane Hamsher at Firedoglake said: "Max Baucus circulates a health care bill forcing low- to middle-income to buy "junk" insurance they can't afford to use to earn Republican support, which amounts to a giant transfer of wealth to the insurance industry."

And the nation has A Democratic President as well.

Or is it all just One Big Money Party.

And a lot of Dem politicians are in it.

Some reform that is. :(

they'd have a conniption fit before they could have their first cup of coffee.

This is just a statement of we'll stop utterly crushing some if everyone pays more for less. You don't have to risk bankruptcy just poverty.

numbers make it into the bill and the public ends up feeling like they've been duped, you can bet the media will place the blame squarely on Baucus and the Dems and there will be hell to pay at the mid-terms. Baucus is completely out of touch with the reality of how the ordinary person lives.

and stuff. I'm single, with employer provided health insurance, and have paid something like $5,800 in those items this year.

will have to pay whatever the insurance company charges. In our case my husband and were paying almost 25% of our income for my COBRA. Nothing in the bill that protects those who are a few dollars over the income level that qualifies for subsidies. They have proposed taxing the insurance company for policies that run over $13000 per year but if it's not enough to make it hurt it won't keep down the outrageous premiums.

to her back-of-the-envelope calculations, that family of 4 could pay more for health insurance than they pay for housing or Federal taxes.

and will now say about Baucus' proposal, not only is it a gift to the insurance companies, but with the large copays and deductibles permitted, it is also a gift to the credit card companies. People with chronic conditions will be faced with these copays every single year and sooner or later their credit will run out and they'll have not choice but bankruptcy.

These plans do nothing to improve access to care if you have to worry about the out of pocket expense and, in the end, will cost more as people put off necessary care until they are too sick to avoid the doctor. If we're going to control costs, we need a system where you don't have to worry about coming up with cash at point of service.

Title I, Subtitle C are for QHBPs provided by for-profit insurers. Those figures of $5K per individual and $10K for families are lower than most policies carry today.

plus the 11% of your income HR3200 allows for premium be it the public or private option. The $5K & $10K amounts are actually the most common amounts for people who have private or employer based "coverage" now. And, remember, that's only the deductibles for items actually covered, the real out of pockets may be higher.

Also, the public option in HR3200 won't take effect until 2013 and the CBO estimates that by 2019 only 10 million people will be covered by it. In the meantime, most of us will be forced to continue to contribute to the profits of the private insurers.

Forcing people to buy health insurance is not reform. We need access to health care, not forced access to an over priced insurance policies.

stated premium amounts for the public option in HR 3200.

Sec. 243 specifies the premium subsidies (starts on page 135 of the PDF). The table (below) is on page 137.




Shortly after the bill went public Steny Hoyer did an interview on NPR ("All Things Considered", I think) and Hoyer did say no one could say what the premiums would actually be per month or annually because they would be "market driven" but that they would not exceed 11% or 12% of your annual gross income and how much you paid would be based on income.

Hoyer's comments about the premiums being "market driven" jives with a summaries of the bill says that the public option will "operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self-sustaining – financed only by its premiums." (I'm sorry, I have this document saved, but I didn't save the link.)

until Title II, Subtitle B:

TITLE II—HEALTH INSURANCE EXCHANGE AND RELATED
PROVISIONS
Subtitle A—Health Insurance Exchange
Subtitle B—Public Health Insurance Option - Begins on page 116
Subtitle C—Individual Affordability Credits

The Public Option is only referred to and talked about in Title II, Subtitle B, Sections 221-226.
Subtitle B—Public Health Insurance Option
Sec. 221. Establishment and administration of a public health insurance option
as an Exchange-qualified health benefits plan.
Sec. 222. Premiums and financing.
Sec. 223. Payment rates for items and services.
Sec. 224. Modernized payment initiatives and delivery system reform.
Sec. 225. Provider participation.
Sec. 226. Application of fraud and abuse provisions.

There is no 'Senate Bill', not least because Baucus' bill isn't even a bill yet -- it's a draft, as yet unmarked up by his own committee, never mind voted out to the Senate floor.

Why the fuck is this POS being proposed under any circumstances, and by a so-called Democrat no less?

...and whatever goes to conference out of the Senate will look almost entirely like the Kennedy HELP draft?

Baucus handed something in because he said he would. It's a non-starter, even with the other Democrats on the committee.

The action's in the House.

Baucus handed that in because it will make the "compromise" that will come out in the final bill look good by comparison. Only it won't look good to the majority of middle class Americans who will still be looking at big premiums and out of pocket costs.

Republican of Maine."

That is the single most ludicrous sentence I have read in all the oceans and oceans of discussion about insurance reform.


In keeping with our Schooldays Theme today:

Metaphysical exercise -

If all the Democratic trees fall down in a forest and leave a single Republican tree standing, is the forest Democratic, Republican or Bi-Partisan? Explain your answer.

Bonus points for pointing out Maine on the US Americans map.

Additional bonus points.Think up names that would have gone better with Snowe than Olympia.(example - Frostee)
Write Senator Snowe a letter explaining why you think your name is a more better choice for her.

We have government mandated private insurance in MA.

Low income people actual receive less affordable care then our former free care system, and middle to upper middle income people are faced with unaffordable monthyly payments for full coverage family plans.

My sister and her husband lost their coverag about two months ago. (They have one child).

The cost for the 'affordable group pool'...1,400 dollars a month for a young healthy family.

It is highway robbery.

And, the system is collapsing btw. The costs are so high that the system in MA will be financially insolvent in less then two years.

The devil is in the details.

We NEED single payer NOW.

This is actual Romney care which is what they are trying to push on the rest of us. The figures you use are outrageous!

Too many DUers are still buying the bullhockey peddled during the primaries that mandates will magically make insurance cheap for everyone.

if you have the time

Surely, the goals could not have been a plan to reduce cost and increase access. This plan sucks ass Max!

"Hmmmm. . ." The dapper little Belgian stroked his mustache thoughfully and turned away from the window. "You are right,mon ami, something does not make sense."

federal workers exempted (for now), in the history of this country.

One person with no dependents can be out of pocket nearly 6 grand. At least the family gets a bulk "discount". The reason I bring that up is that singles and young people vote overwhelmingly Democratic. And we're basically telling them to hand over a shitload of money to insurance companies and go fuck themselves. Great.

if a single person is making $43,000/year their premium at the 11% maximum comes to $4,370 a year + plus $5,000 for copays and deductibles. Assuming their employer is not paying for any part of the premium that could leave them with nearly $9,400 out of pocket plus any "incidentals" (i.e. dental & vision expenses that are only covered for people under 18).

We are screwed.

Once you add in the premiums it's much more.

That averages out to about $19,300 per average 2.6 person household.

It may be preferable to shift some of that cost onto taxpayers, but without major transformative reform, the costs can't just go away.

The bigger problem is bankruptcy caused by illness. This reform will end that problem. I could figure out a way to deal with a $6000 medical bill and keep the house. I couldn't deal with the cost of a $50,000 heart attack.

Using emotional extortion to get us to go along with this putrid, corporate welfare horseshit.

The bigger problem is bankruptcy caused by illness. This reform will end that problem. I could figure out a way to deal with a $6000 medical bill and keep the house. I couldn't deal with the cost of a $50,000 heart attack.

Think the bankruptcies will go away? Think again. Most people can't put a $50K heart attack bill on their credit card, so when they do go bankrupt as a result of it judges still have some latitude to write down those debts. But you know how a lot people are going to pay that $6k out of pocket that this glorious "reform" is sticking them with? That's right, they're going to put in on Visa. Then when they take a pay cut or lose their job or run up some other debts and have to go bankrupt, they are fucked. This isn't just a giveaway to insurance companies, it's a boon to the CC industry too!

BTW, why are you using GDP figures when we are talking about the cost of premiums and out-of-pockets borne by individuals and families? How much does that average 2.6 person household who makes, say, $50k annually pay in premiums and out-of-pockets now? It ain't $19,300, that's for damn sure or else we'd be seeing a helluva lot more bankruptcies. Are you seriously arguing that you want people to be paying more than they're already paying for their insurance?

GDP includes the value of everything we make or do. The cumulative pay for all of us collectively is some number less than the GDP.

THUS, if everyone were to share proportionally the cost of healthcare, it would be some number greater than 17% of our income.

If you have a magic wand to make healthcare cheaper, then by all means wave it to your little heart's content. Absent that, healthcare costs what it costs, and the debate is all about how to spread that cost fairly and sustainably.

The poor have to be taken care of by the middle and upper classes. Under this reform, if a person who gets sick takes a pay cut or loses their job, they become poor and others will cover their medical costs.

My OP is linking to a NYT article about Max Baucus' plan and the...pay attention now...premiums and out of pocket costs paid by people under the Baucus plan.

GDP includes the value of everything we make or do. The cumulative pay for all of us collectively is some number less than the GDP.

THUS, if everyone were to share proportionally the cost of healthcare, it would be some number greater than 17% of our income.

So I guess you are arguing that people should be paying even more than they are now for insurance. That's the only reason I can fathom for why you are trotting out GDP numbers in what appears to be a defense of the premiums and out of pockets in Baucus' plan.

If you have a magic wand to make healthcare cheaper, then by all means wave it to your little heart's content. Absent that, healthcare costs what it costs, and the debate is all about how to spread that cost fairly and sustainably.

I do. It's called "ban profits by health insurance companies". There's a reason that America spends substantially more per capita than any other developed nation. It's because of the massively fucked-up bloodsucking private insurance industry that you are shilling for on this thread. Notice I didn't even say "single payer".

The poor have to be taken care of by the middle and upper classes. Under this reform, if a person who gets sick takes a pay cut or loses their job, they become poor and others will cover their medical costs.

Fucking slackers! Seriously though, the important thing is that insurance company profits will be protected because taxpayers will pick up the tab to subsidize their private health insurance. Oh, and the credit card companies will still be able rake them over the coals to pay back all those out of pocket costs they charged while they still could "afford" the mandatory MaxCare premiums. Plus interest.

You have ten roommates. Collectively, you make $1000 weekly. Pizza costs $200. You've all agreed to feed your two unemployed roommates. You think that the pizza-industrial-complex is taking advantage of your need for sustenance by charging you and your 8 employed peers $25 each.

You and your roommates can tweak the formula if you think that's unfair, but the overall bill is still $200.

You're right about my motivations. I'm really a pizza delivery guy hoping to take advantage of you with fancy math tricks.

I am not shilling for private insurance. I'd like to spread magic pixie dust and turn this country into one in which we could implement single payer. Failing that, there's no reasonable way to reduce costs now. As a compromise, a robust public option is the only good way to control cost inflation to keep costs from reaching the 20% that it is projected to reach in the next seven years.

That still leaves us with the dilemma of how to share that 17%, which requires people to understand math on some rudimentary level.

This lesson is lost on those who were too young to remember 1994, but If we fail this time 'round - there will be no reform within the next 20 years.

And no, for the 360,000 people who will die in the next two decades for lack of insurance, nothing is not better.

I'm not even going to address it. Talk about strawmen. Jesus. :eyes:

Let's look at a scenario that is in the realm of reality. Here's Marcy Wheeler of FireDogLake's breakdown of how Max Baucus' plan (which has no public option, BTW, and is the subject of my OP) will affect a family of 4 making $67,000 a year:

Federal Taxes (estimate from this page): $8,710 (13% of income)

State Taxes (using MI rates on $30,000 of income): $1,305 (2% of income)

Food (using "low-cost USDA plan" for family of four): $9,060 (13.5% of income)

Home (assume a straight 30% of income): $20,100 (30% of income)

Bad Max Tax (Baucus' plan): $20,610 (31% of income)

Total: $59,785 (89% of income)

Remainder for all other expenses (including education, clothing, existing debt, transportation, etc.): $7,215 (or 11% of income)

http://emptywheel.firedoglake.com/2009/09/08/the-bad-max-tax/

Do you think $20,610 a year is an acceptable amount for a family of four making $67,000 to be required to contribute to their "share" of the health care costs that you seem to believe are immutable? That's 31% of their income. Is that OK with you? Just answer the question. No going off on tangents about pizzas or the House plan or guilt trips about how "people will die if we don't do something!" no matter what the something is. Are the costs to a family of four making $67,000 a year under the Baucus plan acceptable to you?

b) It doesn't matter what I think is an acceptable amount. The poor can't pay for their care, so the bill must be paid by someone else.
c) No one with an income of $67k who pays $20k in mortgage interest and $21k in medical expenses will pay $10k in federal tax. Medical expenses and mortgage interest are both deductible. In fact, when I plug the numbers you've provided into a tax calculator, I get a $350 credit. That's "get money back".
d) given the choice between expensive reform and people dying, I choose the former. You choose the latter. Fair enough. Sorry to lay that whole "your so cheap that you'd rather kill people" guilt trip on you.
e) I'm not going to legitimize your false assertion with an answer. Your premise is a lie. It is just as illegitimate as demanding my approval of "Obama's death panels".
f) I'm much more concerned about the effect of reform on those in the lower half of incomes. For them, it's all good. For those in the upper end, they have the security of knowing that their insurance will be there when they need it and that they know that unlike today, the worst possible case scenario is a number which will not bankrupt them. Knowing that my my worst case scenario has a cap is an improvement.

And I know you don't want to soil your beautiful, pious mind with icky politics but if the Democrats pass a bill that looks anything like Baucus' we can kiss the next several elections goodbye. What do you suppose the Republicans will do to those subsidies? Hmm?

I'm reminded of the debate over globalization. Liberals like Paul Krugman who supported "free trade" guilt tripped us about how those poor people in the third world are suffering and need us to invest in their economies. Of course, Krugman also stressed that there should be strong regulations, environmental safeguards, worker protections, and a solid safety net here. What he missed is that those things should have been put in place BEFORE we started shipping thousands of manufacturing jobs overseas. And now Dr. Krugman (who was a very big proponent of the individual mandate during the primaries) is expressing concerns about a bill coming out that has a mandate and no public option:

What worries me is not so much that the backlash would stop reform from passing, as that it would store up trouble for the not-too-distant future. Imagine that reform passes, but that premiums shoot up (or even keep rising at the rates of the past decade.) Then you could all too easily have many people blaming Obama et al for forcing them into this increasingly unaffordable system. A trigger might fix this — but the funny thing about such triggers is that they almost never get pulled.

That's one major problem, but it seems to me there's another more immediate one: the sense of fundamental fairness. Because an individual mandate without a public option makes this bill pretty much what the Rabid Right opposition says it is: government intrusion.

Already the cost of an individual mandate has hit the wires. I don't know if this AP story will hold up, but supposedly the Baucus plan calls for fines up to $3800.

It looks to me that without the public option this is the first time the federal government would force citizens to pay out money to a profit-making private enterprise, or even the supposed nonprofits like Blue Cross that spend millions on lobbying and executive bonuses.

The Nobel Prize winning economist is a day late and a dollar short on this, as he was on free trade, but it's nice to see he finally gets it. You should heed his words, too. The profit motive and waste of private insurance companies need to be gutted and there need to be strong regulations in place BEFORE we force people to buy insurance.

if this is what gets passed as "reform" the champagne corks will be popping in the Citibank corporate offices as well as at United Health Group.

I thought about what you posted and that hit me. You're acting as though lack of insurance is what's causing the bankruptcies so we'll support mandating the shit coverage that is already causing most of the bankruptcies! Slick.

Do you work for an insurance company?

You do know that;

Insurance companies will no longer be able to engage in discriminatory practices that enable them to refuse to sell or renew policies today due to an individual’s health status. In addition, they can no longer exclude coverage of treatments for pre‐existing health conditions. The bill also protects consumers by prohibiting lifetime and annual limits on benefits. It also limits the ability of insurance companies to charge higher rates due to health status, gender, or other factors. Under the proposal, premiums can vary based only on age (no more than 2:1), geography and family size.

... right?

Does dreaming up disinfo ever get tiresome?

http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf

Do you ever tire of red herrings?

:crickets:

It's pointless to argue the merits of a rumor.

The NYT article is pretty detailed as to the existence of a proposal and that it was circulated. Here is the framework that WaPo posted online: http://voices.washingtonpost.com/ezra-klein/BaucusFramework.pdf You can click on properties and see that it was written by Liz Fowler, Sen. Baucus' Senior Counsel and former WellPoint lobbyist.

are filed by people who had insurance.