Cover Everyone
It’s all over the news but, it’s been there before. Will the Democrats finally get this right? I hope so — because if they fail, the Republicans have some truly awful ideas. House Republicans are working on this depressing plan:
House takes up a plan tied to health care overhaul
In the House, Republicans unveiled a budget plan that would gradually eliminate the traditional fee-for-service Medicare program, offering a stark — and politically problematic — alternative to blueprints from Obama and his Democratic allies.
The plan would have future Medicare beneficiaries — people 54 and younger — enroll in private health insurance plans and receive a subsidy on their premiums. Benefits would not be changed for people in the program or those 55 or older.
“If we don’t reform our entitlement programs, they go bankrupt and people’s benefits get cut automatically,” said Rep. Paul Ryan of Wisconsin, the top Republican on the House Budget Committee and author of the plan.
Democrats warned that the GOP proposal would result in sharply higher costs for the elderly as the value of the subsidy fails to keep up with health care inflation.
Health Care for Everyone
But the Democrats seem prepared to deal with this issue for real this time (giggle – no, it’s NOT HR 676):
Much of the debate centered on who should bear the blame for mammoth deficits and what should be done about them. However, the most contentious question may be whether to use the measures as a precursor to advancing health care legislation under fast-track rules that would allow it to pass through the Senate by a simple majority after just a 20-hour debate.
We mentioned last week that the insurance companies are getting desperate. They’d even cover me — if Congress would just pass a law forcing me to buy insurance! Jay Rockefeller thinks there is too much “happy talk” but, I say there’s not enough. One wrong word could make this could all fall apart but, I’m ready for a little hope. The New York Times expands with more details on the plan:
Democrats Agree on a Health Plan; Now Comes the Hard Part
Efforts to overhaul the health care system have moved ahead rapidly, with the insurance industry making several major concessions and the chairmen of five Congressional committees reaching a consensus on the main ingredients of legislation.
The chairmen, all Democrats, agree that everyone must carry insurance and that employers should be required to help pay for it. They also agree that the government should offer a public health insurance plan as an alternative to private insurance.
. . . .
Congressional leaders have set an ambitious timetable, under which the House and the Senate would vote on separate bills by the end of July. Senator Edward M. Kennedy, Democrat of Massachusetts, has kept the heat on negotiators.
President Obama’s pick for secretary of health and human services, Gov. Kathleen Sebelius of Kansas, told senators at a hearing on Tuesday that “health reform would be my mission” if the Senate confirmed her nomination. Ms. Sebelius backed Mr. Obama’s call for giving Americans the option of a government health plan as an alternative to private coverage — “a public option, side by side with private insurers,” she said.
It’s been hard to know what they mean by a “public option.” But, with the confirmation hearings for Kathleen Sebelius details of the various proposals are starting to leak:
Democrats seek compromise on health care plan
At issue is whether middle-class workers and families should have the option of a government-sponsored plan that would compete with private insurers. Obama and other Democrats support the idea, which Republicans adamantly oppose.Sen. Charles Schumer, who is working on the issue for the Senate Finance Committee, said Thursday one potential compromise is based on insurance plans that most states already offer their employees. Obama’s health secretary nominee, Kansas Gov. Kathleen Sebelius, likes the idea.
. . .
The state employee plans are similar to how big companies insurer their workers. Companies budget each year for health expenses, then hire an insurer to process claims, negotiate rates with doctors and hospitals and cajole employees to follow healthier lifestyles.
In California, the state sponsors three medical network plans for employees and retirees. These plans are offered alongside traditional insurance plans. The state-sponsored plans, administered by Anthem Blue Cross, account for about one-fourth of the 1.3 million people in the state employee health program, said Karen Perkins, a spokeswoman for the California Public Employees Retirement System, known as CalPERS.
The idea of using the state employee plans as a model came last month from two policy experts, Len Nichols and John Bertko.
. . .
In an interview, Schumer said he is looking at Nichols’ idea as a possible compromise and is beginning to sound out other Democrats. He said he has some room to maneuver because Obama and many Democrats did not spell out what they mean by a “public” insurance option.
But Schumer said other Democrats insist that option should look like Medicare, in which the government directly sets benefits and payment rates.
For once the Democrats appear to be ready for a battle. Getting this debate on a “fast track” (July!!!) and making it possible for Health Care for Everyone to pass by a simple majority are HUGE steps. And while I’m ALL for H.R. 676, I’m desperate enough (I mean, even the Walgreen plan is looking good) that opening up something that resembles the state plans could be OK.
. . . . .
It all comes down to just how affordable “affordable” is.
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Filed under: healthcare Tagged: | Charles Schumer, Health Care for Everyone, HR 676
PSA of the Day: Single payer advocate and activist Dr. Jess Fiedorowicz of the Physicians for a National Health Program on Thursday, April 2, 8-10 p.m. CT (9-11 ET/6-8 PT)will be on CorrenteWire.com for Q&A.
There’s a post stickied at the top where you can begin posting questions. Dr. Feidorowicz took some questions this morining and has dropped in off and on since then.
Cool! Thanks for the notice.
LINK for posting questions for Dr. F. Again, 9-11 PM, EDT.
KatieBIrd, I highlighted some of Schumer’s comments during the Dr. F Q&A, and got a response from him which made sense.
(Will blockquote work? Oh, dear–where’s preview when I need it?)
Sorry, but the direct comment links don’t seem to be working….
Wow. UHC would begin to restore my faith in the Democratic Party.
(nodding) Me too.
Now, my assumption is that neither party cares about the people, they care only about winning. If the Dems get the US national health care, I will no longer say that. (I will still hate Obama, but I will have to admit there is a difference between the parties).
UHC is issue # 1 for me. My life, as well as the lives of countless others in this country, could depend on it. Please Dems, don’t let us down again.
Wow, me too.
Keeping my fingers crossed.
I wonder how similar the proposed compromise is to Hillary’s proposal in 1993? I think that her proposal then included having state or region -based public plans compete with the private insurers. I also wonder whether opponents of the plan will use Obama’s Harry-and-Louise style ads against this plan? I don’t know how easy it will be for Obama to advocate for this plan given his clear opposition to insurance mandates on adults during the primary. At least Democrats won’t face the same opposition from certain private insurers that they did last time, so who knows?
Like you, I’ll keep my fingers crossed and take what we can get.
They’re already running ads against health care here in Nevada.
You’re kidding! What do they say?
Here’s the ad and the background:
http://trailblazersblog.dallasnews.com/archives/2009/04/new-harry-and-louise-health-re.html
They were talking about it off and on all day on CNN.
And WHO is running the ads?
Dunno, they just pop up from time to time. But, I did hear on CNN that the guy is willing to spend up to 5 mil of his own money.
DO NOT GET TOO EXCITED. The people of Tennessee will tell you that you cannot necessarily trust a politician just because there is a (D) after his/her name. They had an ambitious insurance plan. Tennessee eliminated medicaid for the poor. Created Tenncare, all citizens could buy into it. The drug costs alone were unsustainable for the poor state’s budget so the democratic governor, Phil Bredesen, decided that the sickest people were really a drag on the plan and decided to eliminate coverage for those people. With 3 weeks notice, coverage for treatment and drugs were eliminated for the sickest people in Tennessee. You could still see a doctor and get a diagnosis, but you could not get treatment or medicine. Then that was also eliminated and he decided that only children and families with underage children would be covered. If you were poor and elderly or had AIDS or a chronic disease, you had to move out of state or start making those “final arrangements”. BTW, Gov. Bredesen was at one time the CEO of Tenant Healthcare. So don’t get too comfortable. The rug can get pulled out from under you at any time. See Families USA for more information. They’ve studied this for a long time.
I followed those horrible stories. And I know this might not end well. But, I’m a dreamer and I HAVE to latch onto good news when it’s there. And this is the best news we’ve had for quite a while.
Before you guys get to excited, have you ever reviewed the plans that some states offer their employees? Most are self insured with limitations on many services and they discourage participation in HMO or POS by contributing less to them. Please go back and read a copy of Hillary’s 2008 proposal. That’s a plan that would work.
Yes, this does look like the 1993 plan that failed not because of lobbiest, but because it takes freedom of choice. I have been in managed health care for 25 years and this is not health care for everyone, this is socialized medical care.
Yes, I was a state employee and then a county employee for 30 years.
At one time, I had her plan just about memorized…. But, she’s not leading this fight and HER plan isn’t on the table.
***
I’m NOT saying this is the best of all possible plans. But, it MIGHT be something (remember, I said that even the Walgreen Plan was looking good to me at this point)
Too many people don’t have ANY health care plan available to them. We’ve GOT to get them something.
This would be OK for people that don’t have coverage, but why change the coverage people are happy with. I was laid off a couple of years ago and could not afford Cobra, so I know how people feel. I had to buy my own “hospital only” plan to afford care. If employers/employees are happy with their plans, they should be left along. Their can be competition among the carriers to offer afforable care. The reimbursement from Medicade in some cases does not cover the provider cost and I would be afraid that we would become like parts of the rest of the world, the one’ that can pay cash get the better treatment.
LA is cutting our contribution drastically this year. Everything is going up but my salary.
“Socialized medical care” by definition is when the medical care is provided by government employees.
On the other hand, if the physicians, nurses, techs are not gov employees, it’s not socialized.
Coverage specifics are a different matter than who the health-care providers work for.
There were deaths and suicides. My sis there works for a Hospital where she does outcome management. She felt helpless and horrified and couldn’t believe this was happening. Many people not affected were in denial about what was happening until it was too late. They couldn’t believe that it could happen. Over at Firedoglake, there is a notice of a Frontline special coming on detailing what the insurance companies have been up to for years. Many dems are in their pocket. I always believed that was the reason for the pushback to Hillary’s work to get everybodu UNIVERSAL healthcare. She certainly took fire from all directions back then. She might as well have been in Bosnia. Here’s a link to the Frontline story.
http://oxdown.firedoglake.com/diary/4539
A friend of mine watching something on The Health Care Industry watched something on Frontline last night — she was pretty shocked and she thought she’d seen the worst — first hand.
I’m not optimistic about the Dems who are have been and still are holding hands with the major inusrance companies.
We who are already retired and have insurance from former employers will likely see our coverage dropped so that we are forced into buying new, probably less desireable, coverage.
Don’t expect the corrupt to suddenly become saints.
I don’t expect sainthood — just a tiny bit of compassion.
by no means am I cheerleader for the insurance industry, but people should realize that before the 1995, health care insurance was a loss leader. Companies made their money on life, diability etc. But, companies could not compete with the likes of BC/BS who has a not-for-profit status (blue law) which started offering other products. Also, we have to look at advances in medicine. People are being cured/treated for illnesses where death was certain. 20-years ago I could write a case where there were HIV/Aids (large groups) because this was considered a short term illness now people are living with HIV for years with the cost of medicine cost 10′s of thousands of dollars a year.
Ojalá!
i am woefully ignorant on this subject.
katiebird, do you know if employers would be allowed to use the state plan, i.e. offer it as one of the choices to their employees?
Murphy that was something Sebilious was hoping to do in Kansas – Make the State Plan available to everyone…. But the Republicans pissed all over that idea. I don’t think they even went with the scaled-back plans to cover the kids.
I know this is all still way too vague. Especially the cost…. We’re paying almost $800/mo for just my husband and me. I’d like to think “affordable” would be much less per month.
the state plan in Mass has had mixed results. It HAS reduced the number of uninsured, dramatically, but it is REALLY draining on the state budget, and the revenues/cost savings Deval Patrick promised have failed to materialize . . .
Oh my…the MA plan is awful. It has not done anything to control costs, and the only people able to opt-in to the public insurance plan, which is quite good, are low income. The plan is unsustainable.
That’s why we have to have a Federal Plan and Federal Options — it’s too big a problem for individual states.
KB, I feel for you and and am in the same boat. The Walgreen’s plan would at least provide a discount for some of your medicines and some drug companies will really help you if you ask. They really will. But how would you like to be told that you can’t get the medicine at all. Many plans disqualify you if you go outside the network or receive any type of discount from another entity. They look for any loophole to get out of paying. My point is that I will not trust the politicians. I want any plan studied in detail by advocates for the people. I want everything out in the open and available to the masses long before there are votes and especially before any amendments are snuck in during the middle of the night.
Glen, I happen to have Health Insurance (that is barely affordable and most would NOT be able to afford it) But, I’m surrounded by people in my family who do not have insurance and because of the obscure way Insurance works, I can’t just add them to my policy (with an appropriate adjustment in the payment) — I want them covered someway/somehow/somewhere
And I understand what you’re saying…..
I’m just saying that this week the news is pretty good. And I’m in the mood to dream that something good might come of it.
(Do I wish that it was much better news? YES)
State insurance? We’ll see. That isn’t anything like a federal public insurance option, ie Medicare. Wait and see how they decide who can opt in and who can’t. This is a mess. Sadly, there is one reason and one reason only why they don’t just open up Medicare, the private insurance lobby.
Jane, that is what terrifies me. I’ve lost coverage that was supposed to be guaranteed more the remainder of my life through my employer of 30 years. It was the first thing cut when they got into financial trouble. I will never take anything for granted and will no longer trust anyone. I could have been living a comfortable life as I saved and did what I was told to do to acheive that. One major illness wiped it all away. I’ve had to take any job I could get and still live in poverty. I could never buy a home or have a new car ever again. I thought I was going to be able to buy insurance for a measly $800 month. But apparently, a drug prescribed to me years ago disqualified me for the plan. They won’t even tell me what it was and I’m curious, since it was many, many years ago, how they knew I had taken it. Sorry to be interjecting into this so much, but it has become my passion. So many people are suffering.
Glenn, I think you should get a lawyer to insist on telling you what disqualifies you for insurance — that’s outrageous!
Did they eliminate your coverage? Insurance companies do not allow massive plan changes. And, they new company looks at the previous coverage. Is your plan an ERISA plan? If so the Dept of Labor is the agency they has oversight and if a major change was made the DOL would get involved.
I am not too familiar with the US health care system, but the bottom-line is that health care will always create a deficit and somebody will have to pay for it – likely via tax or increased govt debt.
The quality of health care provided varies in Europe but is for most nations a big headache, especially given the aging population. V likely is that benefits will be cut as the system is not sustainable.
We don’t have a health care “system”
We have a health care clusterf**K
KB, I get it and its almost a guilty feeling when you have some coverage yet a family member has to go to an emergency room for a cold or flu just to get an antibiotic. I’d like to see Medicare for all. I realy believe that Medicare’s problems stem from fraud because of lax oversight of providers. Do you know , in Florida, I could become a Medicare provider for medical equipment quite easily, bill for services never performed and get paid faster than the reimbursement rate for doctors. By the time they caught me, if ever, I could have closed up shop, moved to a new location with a different name and start all over. Its happening here in epidemic proportions. Don’t even get me started on the people I know that have a Hoverround (motorized scooter), some folks have 2 or 3 and they definitely don’t need them. But Hoverround pays a recipient to refer people to them since Medicare will pay for it – no questions asked. It may not be that particular company, but its one of them at least. I must add that many people do definitely benefit from them also.
My dad was telling me about that hoverround scam. He’s 87 and get solicited almost every day for that stuff.
He told me that when my mom was discharged from the hospital they gave her a machine that she was supposed to use everyday. And that Medicare would pay for it. Dad called the company to find out how much it was costing (even though Medicare was going to cover it) — $75/month. Dad went to a medical supply shop & bought it for $65 ($10 less than 1 month rental) Then went straight back to the rental company. Demanded a receipt. He still gets copies of bills that they send to Medicare for the Machine. Every month he sends them on saying that THEY do NOT have the machine…. This has been going on 3 years.
Fraud is rampant.
I should tell my mom to get a Hoverround through Medicare so I can use it. They look like fun.
One of my biggest fears overall, is that I will end up needing one of them, not because I’ll be disabled… but because I am so lazy and getting lazier by the year.
I doubt this sort of thing is going on much now — for my patients the average time to get a wheelchair (manual or power) is at least 6 months. (I have a lot of patients with mobility impairments.) If one of my patients needs a motorized wheelchair/scooter, they must first be seen & examined by me, referred to physical/occ therapy, then get thoroughly evaluated by a physical or occupational therapist to see if they need equipment and what exact type of equipment, then have a detailed letter of medical necessity written. And often another face-to-face exam by me within 90 days of my prescription for the exact model of equipment. Then the equipment company sends me paperwork which asks for details on all of the above, which I have to complete, and send them copies of chart notes. Then the patient waits at least 6 months before actually getting the equipment.
I have no problem turning down patients who don’t need motorized equipment. Or who ask for a handicapped parking permit when they really need the exercise of walking a bit farther.
Well, my blood pressure is probably up again. Thanks KB (for the post, not the blood pressure problem -that happens all the time since last May I believe), I’m gonna put on my happy face and hope for the best too. But you can bet I’ll be paying close attention as we all should. Too bad Obama’s army couldn’t be putting their energy into this with us – maybe they will but I never have liked his answers to the debate. It seems he’s on the Insurance Company’s hotline. Dinner and wine will take care of my health tonight. Tommorrow is another day although I’m sure I’ll check-in before bed. Thank god for this site. TC is my go-to first thing in the morning and last at night. If it weren’t for all the wonderful and informed people here, I don’t know what I’d do.
I have a rare type of brain tumor that is pressing on my brainstem. I have Medicaid but no doctors in my state can treat my condition. And the place I need to go ( Johns Hopkins ) will not accept my out-of-state Medicaid. I am losing my vision and having small strokes and can get no treatment. Our health care system is a total mess.
That is heart-breaking. I live right near Hopkins, and am consistently seeing stories about how the wonderful doctors are saving children and sick people from around the world. Figures that they do not treat Americans. I hope this does not sound flip, but can you move to Baltimore just long enough to get the treatment?
I have considered that but it is just not feasible, financially or otherwise, at this time.
Are there any other places you can go for treatment, that might take your insurance?
I have tried Mayo and several other places. They won’t accept out-of-state Medicaid. They say their “hands are tied”. Geez, the last thing you want is a neurosurgeon who’s hands are tied!
Just wondering. Do you also have Medicare? That is not state-specific.
I am not old enough to qualify for Medicare.
Have you applied for SS disability? If you did and were eligible, you would be eligible for Medicare which as you are well aware is a federal program. If you have not, go to the Social Services Department of your hospital and apply. You may be able to get emergency approaval based on your current health.
Unless a person is age 65, one must be entitled to social security disability to get Medicare before age 65 or have chronic renal disease. I don’t think Social Services can help. But if a person has worked in 20 out of the last forty quarters before onset of disability, (if under age 31, fewer quarters are required), in a job covered by social security, then the possibility of being qualified for SSA disability exists.
This is tragic. My heart goes out to you Beata.
MYIQ, there is a group of women here that do soemthing akin to sychronized swimming with their chairs. They are good too. Lots of practice, but most importantly, they are having a blast. I expect to see them in the Senior Olympics one day. I have a video, I’ll try to find it. How as your birthday?
It sucked – I’m about 30 years in either direction away from when birthdays are a big deal.
Marginally on topic:
April 02, 2009 05:59 PM ET |
By Dan Gilgoff, God & Country
I’ve learned that the White House will kick off its much-discussed plan to reduce abortions tomorrow morning with a conference call to religious leaders and abortion-rights advocates that will feature key White House aides. The call reflects the White House plan to bring faith-based groups, including conservative ones, together with pro-abortion rights organizations to reduce demand for abortion. Until now, those two camps have frequently been at loggerheads.
(snip)
I guess that Obama’s anti-choice religious advisors do have his “ear”.
Why do I get a sick feeling when I read this sh*t.
It is nothing less than expected from them… they need to pull in support from the religious right to make up for the people on the left and the middle turning against them… talk about single issue voters, those people gave the jig up when they went after Michael Steele in their own party for daring to have his own opinion on the subject… Those ultra-religious ultra-right are quite easy to win over if you give them a little of what they want… I am all for breaking up that coalition so we can bring the moderates into a new coalition for the purpose trust-busting/anti-corruption movement on politicians and corporations, particularly the bankster-financiers.
Its late and I am dreaming…
This is tragic. My heart goes out to you Beata.
P.S. – Sorry, forgot to tell you great post!
I’ll just put my .02 in, as a nurse of 30 years, who has been following this issue for almost as long…
The movement away from “fee for service” has been the push of many healthcare advocates for years. It is the whole thrust behind HMOs. There is nothing wrong with paying to keep people well, as opposed to paying only when they get sick (as is the fee for service model.)
If the Dems are fighting to maintain a “fee for service” model… we need to ask whose pockets they are protecting with that model. Hint: it ain’t ours!