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How much will it cost ME and what will I get?

This idea doesn’t seem to be going anywhere and I’m getting dizzy trying to decide (like my opinion matters) if I should support a “strong public plan” in the absence of real reform with a single-payer plan.  And then I realized that there are two questions that hover in the back of my mind whenever I read an update about the health reform issue – how much will it cost ME and what will I get?

And boy-oh-boy no one is letting that information leak out!

How much will it cost me?

Then (from TNR, believe it or not) comes THIS idea:

A Moneyball Approach to Health Reform

Every time we mention the impact of a health reform proposal on the federal budget with a CBO score, we should also give an estimate of how the proposal impacts a family budget. Call it the Consumer Budget Impact–the CBI. It would indicate how a family’s premiums would go up or down–and how much their exposure to significant medical debt would decline.

True, no single number can capture this. So we may need to come up with a set of numbers and perhaps compile them into an index, the way Dow Jones uses a mix of stocks to demonstrate the performance of the market as a whole. Elected officials should know if John’s family at just over the federal poverty level will be able to get coverage–and if we are expecting too much for Alice the 60-year old who is around 400 percent of the poverty level.

Remember, the subsidies in health reform don’t simply help the uninsured get coverage; they also help people who already have coverage but are struggling to pay for it. Think of the early retiree who spends over $1,000 a month, and thus over a third of his or her limited income, to keep coverage. Or the underinsured young adult who can only afford the bare-bones, high-deductible health plan. Or the workers who would lose coverage if not for the assistance and new affordable options their employer is being offered.

All of these people are insured, but in a way that is inadvisable and/or unsustainable. Depending on their income, they and millions of others will get help, so they don’t have to pay over a certain percentage of their income for premiums to get a standard package of benefits.

And while we’re at it let’s Tell Rangel to Score HR 676 so we can properly evaluate the Consumer Budget Impact of that along with all the rest.

And what will I get?

Yesterday commenter Masslib said:

I guess I’m just not interested in access. I’m interested in actual high quality health administered health care.

And THAT’s a pretty good start.


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55 Responses

  1. This entire health care “debate” is a joke. If we don’t get single payer, IMHO, the entire process will have been a waste of time. If we go forward with the insurance co’s in charge, even with a public plan, the result is likely to resemble what BW Bush did to Medicare with his giveaway to the pharmaceutical and insurance co’s in the ridiculous prescription drug program.

    • I wholeheartedly agree.

    • I’m REALLY nervous that we’ll get the Massachusetts Plan and the answer to my question will be,

      Cost?: Too much
      Get?: Crap

      I think they are very deliberately shutting out not just single payer supporters but, “Regular People”

      Look at the people on those panels and committees. They are almost all elderly white millionaire men.

      • I noticed the same thing. I was wondering where the women were…oh I could see them in the background taking notes. I watched this the other night on Cspan and was appalled. They all looked too comfortable and they spent a lot of time praising the CBO for their great work with figuring the cost!

    • Exactly. Single payer for everyone with existing insurance companies able to offer coverage not included in basic UHC. Many on Medicare have supplemental plans. It works fine. That way, at least we all receive basic care. Additionally, in order to keep down costs, no more doctor-owned diagnostic facilities. Of course doctors are going to prescribe unnecessary cat scans and MRIs if they stand to profit by them! Obama is so desperate for a political “victory” that something is going to be rushed through which will be the health care equivalent to giving money to the banks–who aren’t re-writing mortgages–instead of giving the money to consumers who could use that money to pay off or pay down mortgages.

      • In Ontario, “basic care” includes any necessary health services for both acute and chronic care. For instance, 2 babies were born to families on my street in May. (Both families are experiencing layoffs due to the collapse of the automotive industry.) One baby was born in our local primary care hospital. She took a wrong turn on the way down the birth canal necessitating an emergency C-section. The full surgical and pediatric complement took 15 minutes to assemble at 6a.m. on a Sunday morning.
        The other baby was a 30-week premie, less than 2 pounds, born in a tertiary care medical center where she staid until she was out of ICU and an incubator. She is now in a secondary care level medical center closer to home, and her mother goes in to nurse her 4 times a day. At 3lbs.14oz. she has a way to go before she can move in with her parents.
        My point is, every resource is brought to bear to look after these babies and their parents. No matter how extreme the requirement, it all comes under the heading “basic care” if it improves the medical outcome.
        At no point was there any concern or consideration of cost of service in making decisions about what was medically necessary; not by the health facilities… not by the families. Neither family will ever receive a bill for services from doctors or hospitals. The stress of their situations will not be exacerbated by facing crippling expense.
        Whether a medical crisis involves birth, trauma or death… whether the condition is urgent or chronic… no civilized society punishes people for their ill-fortune.

  2. Thanks for another enlightening health care post, KB!

  3. The author also said something else I liked:

    My first reaction was to react as Jerry Seinfeld would: The cost estimate is not $1.5 trillion…not that there’s anything wrong with that! After all, the House proposal looks to be the one that would extend better help to more people while providing a lot more value to health care consumers. If doing health care right costs $1.5 trillion, then that’s money worth spending. As Paul Krugman indicated, it’s still less than the Bush tax cuts-which were $1.8 trillion, without any of the same health and economic benefit.

    He’s wrong that any of the plans are “doing health care right”

    But he’s right that

    ” If doing health care right costs $1.5 trillion, then that’s money worth spending.”

    I totally believe that!

    • Why is the cost basis for health care always seen in terms of a 10 year cost. Does the Defense Budget show its outrageous cost by the 10 year period? If that were the case, Defense would cost 9 trillion or so. Why do I never hear that figure?

      • Because if they talked about annual dollars, it would sound like peanuts compared to the money they’re giving away to the bankers every year.

        It really frustrates me that even the progressive Congressmen they interview on TV don’t boil it down to annual dollars.

        And that they don’t do that Cost to Consumer comparison. We’re being bled dry NOW by Insurance Companies and getting less for it every year

        My premium went up $100/mo and can now only go to hospitals in my city. Terrific. There isn’t a Cancer Center in my entire state – much less this city!

  4. It seems that some in Congress are pushing to get abortion services excluded from coverage on any public plan. I suggest this counter:

    Send it back saying that if abortion services are not covered, then included will be also mandatory state-funded paternity testing on any man a woman names as father – refusal or avoidance to be answered with an arrest warrant and jail time/fines.

    Then, IMMEDIATE garnishment of the man’s wages for support for that unborn child, to begin the moment it comes back a match – no lengthy process, no filing, or family court proceedings or arguing by the woman, just automatic govt enforced GENEROUS child support, including the pregnancy/birth expenses, in every single case of a paternity match. No arguing, nothing the woman has to do, wages are garnished automatically, and immediately.

    Let’s see how fast they’d back off. They’d shit themselves backpedaling.

  5. I suggest going even further. Since the government would prohibit funding abortions, then the government is responsible, along with the proven father to provide support. Including housing allowance, health care, babysitting, education assistance, total dental care, college scholarships to any school, tutoring allowance, music and sports mentoring. Yea, that should change the landscape of that argument!

    • Don’t forget generous and fully paid maternity leave for the mother, as well as the hospital expenses. And hit up the father for that, not the govt. Men won’t care as much if they don’t feel it’s personal. Oh, and the father is required to take time off from work to care for a sick child/baby half the time, or he can pay for the mom’s lost work time for his “half” of the illness incidents.

      Again, make laws to enforce this automatically – no lawyers and court cases and fighting for the mom.

      Until every man in EVERY CASE feel the immense burden of FULLY supporting a new life, at least economically and socially if not physically, then they can STFU about whether a women’s reasons for choosing not to have that child are “valid enough”.

      • Oh, and when men scream and balk and say this is too huge a burden and unfair, just shrug and tell them, “Don’t want those kind of consequences? Use birth control or keep your zipper shut, if you don’t want to be “punished” with a baby.”

        • (((((Clapping wildly)))))

          The stakes in procreation aren’t anywhere near equal. Let me know when the first man dies in childbirth, then they can talk to me about compelling people to risk their lives involuntarily.

          • Yep. How about a legally binding contract that states that if at any point in life that child needs a kidney, a liver, a heart, a lung – dad has to give up his. If he dies as a result, too bad. Should’ve kept his zipper closed.

          • The first man to ever try childbirth will probably die in childbirth!

          • Ralph B

            I suspect that a few of them would muddle through the process. I always find it amusing that men are considered to be the stronger of the sexes. I don’t think when people make those kind of statements they are taking into effect how much “strength” it takes to go through hours and hours of labor. I had one guy tell me I couldn’t possibly have had real migraines because otherwise I would have sought medical treatment and pain meds(Hello? Not if my family didn ‘t have the funds I wouldn’t have.) I informed him I had two completely natural childbirths so if he could please not bother to tell me what kind of pain I could or could not tolerate without the benefit of medication. It shut him up pretty quick.

          • Men are the stronger of the sexes. That’s one of the biggest jokes I’ve ever heard. I know perfectly well from watching my wife give birth that I would not have made it through. I don’t think most men would make it through either.

            When it comes to real strength, women have it all over us.

    • This could get fun. I have 4 kids, so know a lot about the expenses and sacrifices involved. Let’s see……

      If kiddo’s grades drop below a set level, then the father has to kick in for private tutoring. If that doesn’t do the trick, then he kicks in for half the cost of private school. Oh, and he can pay his portion of mom’s lost work time for soccer games, teacher conferences, etc as well as sick days. Plus a stipend for any proven lack of workplace promotion for mom, as a result of all those days off.

      Now we’ll go into the health side-effects. Dad will remain equally financially on the hook for any health problems resulting from that pregnancy. If mom ends up with bladder problems and needs a bladder tack, he pays half. Ditto for any low back or disc problems caused or aggravated by the pregnancy – he pays for half the treatment, and half for any lost work time as a result of it. Painful varicose veins from the pregnancy? He pays half. Ditto for pregnancy-caused hemmorhoids, dental work due to loss of teeth calcium…the list goes on.

      I like this idea. Let’s put men equally on the hook, as much as possible, for all the burdens of child-bearing.

  6. Why is it assumed that all insurance needs to be for-wall-street-profit? Why not have insurance run as not for profit companies? There would still be competition, structures already in place, would still employ and pay employees.

  7. I watched this program on PBS that really helped me to understand the issues involved in the health care debate. Called, “Sick Around the World,” the program examines the health care systems in 5 (five) democracies: Switzerland, Great Britain, Taiwan, German, and Japan.
    SICK AROUND THE WORLD

    • FRONTLINE | Sick Around the World | Preview Germany | PBS

      • FRONTLINE | “Sick Around the World” Coming April 15 | PBS “The US rates 37th in the world”

        • Thank you for posting these dramatic clips from the program on health care. I hope this gets everyone to watch. (I just came from the bookstore with a bag full of books on economics.)

  8. Exactly. This is why I don’t see the political legs of the so-called public option. Because at the end of the day, as voters, we are going to and should ask, “What’s in it for me?” And, from my reading of the proposals so far, the answer is nothing.

  9. HR676 – The Single Payer Solution, Part 1 of 4

    • HR676 – The Single Payer Solution, Part 2 of 4

    • This morning Dennis got quite sarcastic about how much people “love” their health insurance. You know the same people that have been declaring bankruptcy because their illness wasn’t covered by their plans! We keep hearing these Repubs telling us how much people love their health insurance companies. I just think Dennis was pretty accurate in his statement, sarcasm and all.

      • Yup, Dennis is getting it done, and won’t let them shut him up, SPEAKING TRUTH TO POWER! Anyone seen Michael Moore? Should we list him as missing, now that the fight is on?!?

  10. What Is Single-Payer National Health Insurance?

    To begin with, it is NOT “Socialized Medicine”, far from it in fact. Also, it does not mean that our medical system will be taken over by the government and run like the post office as many of our opposition friends would mistakenly have you believe.

    Basically, House Resolution (H.R.) 676, the “New Expanded Medicare” bill now in the House of Representatives simply creates a new and far more functional “single payer” method of collecting and distributing payments for medical services while leaving the medical system itself completely alone and intact. This will eliminate the hundreds of complicated and redundant payment plans currently imposed on the system by private “for profit” health insurance companies and save literally BILLIONS of dollars every year by eliminating such wasteful duplication. This will allow your doctors offices and hospitals to function much more efficiently and serve your needs much more effectively as well. Just imagine what a huge benefit this will be!

    Taxes: We all know that nothing of any real value is ever free, but if you think of the taxes that will be required to support national health insurance as simply a lower cost alternative to the staggering private health insurance premiums that most of us already have to pay but which will be totally eliminated under the new system, then it becomes immediately clear that this could be a really good deal after all!

    “Health care is a defining right in a democratic society.”

    The advocates of HR 676 rely on donations, the insurance industry doesn’t need to raise funds, they have plenty of money from the profits they are making. Find out how much your representative is getting from those that want to keep Single Payer off of the table of discussions on Health Care Reform.

    Enough talk already… together let’s just get it done!
    http://www.hr676.org/
    The Citizens Alliance for National Health Insurance
    The primary purpose of HR676.org, Inc. is to raise funds for a national and ongoing multi-media advertising campaign to support the passage of …

    House Resolution (H.R.) 676
    The United States National Health Insurance Act
    (“Expanded & Improved Medicare for ALL”)

    Sponsored by Rep. John Conyers (D-MI) and Rep. Dennis Kucinich (D-OH)

  11. The most salient feature of single payer healthcare (Medicare) is that 95 cents of every dollar goes to patient care, Private insurance is more like 60-65 cents with the rest going to administrative costs. The insurance industry and their congressional minions stand to lose a fortune if this is enacted.

  12. Single Payer Day of Action – Colorado State Senator Morgan Carroll delivers a passionate case for a single payer system in Colorado and the US during the National Single Payer Day of Action (May 30, 2009)

  13. The most salient feature of single payer medicare is that 95 cents out of every dollar goes to patient care. No insurance company even tries to match that.

  14. Americans with pre-existing conditions can’t get coverage…meet one of them. Support HR 676.org

  15. OT-I just watched a news service on the Obamas at the G8, and their visit to the Pope.

    I couldn’t believe what journalists were spouting.

    About Michelle- She seems like a simple mom and American tourist in Rome, but under the surface beats a lawyers heart-a lawyer who never gives up her fight for the weak and the poverty stricken of the world. An exceptional woman chosen by an exceptional man.

    About her husband- For Obama the next step on his journey will be the most heartfelt and soul searching. He will be visiting Africa, the place his father left behind 50 years ago, and now his son will return as President of the USA.

    • The same lawyer who worked to divert the weak and poverty stricken from her employer’s emergency room? Suddenly, she’s Mother Teresa because she became First Lady? Ridiculous.

    • this is not the obamas i know.this is fiction.

  16. Currently, on c-span, some Repubs(Brown-GA and Poe-TN) are bloviating on the House floor about the horrors of having a government bureaucrat between you and your doctor. The room is almost empty and these two are apparently going to talk for several hours. There is no one there to point out that there is currently an insurance company desk jockey between you and your doctor. When will a Dem just say, out loud, what we all know to be true?
    And that is just one of the dishonest memes they are repeating over and over. I just want to scream!

    • Having DONE medical billing and pre-certifications etc, I wholly agree. It makes me CRAZY that none of these Dems have the balls to point out the massive bureaucracy standing between you and your doctor NOW.

      • Exactly. Why is it better to have private insurers between you and your doctor? I read people saying do we want the insurers to still be able to deny coverage to people who are sick? But it actually starts before that. Your doctor orders a CAT scat, but the insurers decide it isn’t necessary, etc., so you don’t even know your sick!

    • I saw an add on TV last night by “Conservatives against a government run health plan” that was laughable (if it wasn’t so dangerous)

      It ended with a guy labeled Government Bureaucrat standing by a woman’s hospital bed shaking his finger and head, “no” — she wasn’t going to get her health care!!

      I’ve tried to find it on YouTube but couldn’t — I’ll keep looking. I was SHOCKED!

      • I mean how many of the people they’re trying going to scare are seniors who’ve been perfectly happy with their Medicare for years?

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