Thank you for taking the time to read the legislation and share what you found. I hope for your sake and the country’s that these planks remain in the bill through passage, and that we see that passage before the end of the summer.

Thanks Gregg. One thing I left out because it didn’t exactly fit with my narrative is the following provision in the House bill, which would set a floor of benefits for all plans (and because the House bill elsewhere favors co-pays over co-insurance, probably ban co-insurance):

(5) MINIMUM STANDARDS- Effective January 1, 2013, any benchmark benefit package (or benchmark equivalent coverage under paragraph (2)) must meet the minimum benefits and cost-sharing standards of a basic plan offered through the Health Insurance Exchange.

Hunh – on the Ed Show, Rep. Ron Kind just took the pledge, I think – or very close to it. Said he wants a public option along with other option.

Ed’s been asking them all if they’re willing to stay through the planned August recess to work on health care; Kind said yes. Came in late, so I don’t know who the other two were, but Ed quotes them as yeses on stayinng to work.

After all, they can figure this Pres. will be around this August.
I wouldn’t begrudge a week’s vacation – I think Obama’s already been on the job more consecutive days than Bush ever was.

What if anything would you add to the bill?

I am glad that you seem to like what you are hearing about this bill hopefully chronically sick people are telling all their friends and relations to support this bill.

SEC. 162. (Ending Rescission Abuse) is truly critical.
Insurance Rating (SEC. 113) seems a bit too easily manipulatable, but all in all the House bills as you describe sound like a great improvement.
Thanks for going over these important details!
I’m not sure how a public option could be considered a “sell out” or where that’s coming from. (I guess advocates of single-payer only plans)

I think Obama’s already been on the job more consecutive days than Bush ever was.

What we should have thrown a party:)

we cannot afford health care we have 700 military bases around the world to support and two wars.

which is more important these wars for profits and a mega military or the health of the american people.

I vote for wars for profits and super power status, it just feels good to live in a country with super power status. besides I love my guns and pick up truck.

signed
just you average repub
at least we have the demos on the run :-)

its fun being a repub the demos hide in fear of us
we dont need 60 votes in congress we are repubs and the demos have reid. :-)

kiss the health care reform good bye and hello vietnam again. ie afghan.

I was just thinking the other day that we have been in Korea for 59 years. Isn’t that amazing!

AND THE KILLIN’ GOEZ ON AND ON AND…

Citizen bagofhealthandpolitics and the Firepup Freedom Fighters:

McJoan over at Kos has a post up about where the healthcare bill is now and concludes that the public option is in and efforts to derail reform now are gunna focus on cost and coverage, or as I like to say:”fear and funding”. The devil will be in the details but I think we have a number of things comin tagether on this issue, most important is the education and energizing of the electorate. The degeneration of our politics into “everything is political” is gunna crash onto the heads of the corporate oligarchy and their hired stooges. If healthcare reform is stalled in this Congress it won’t come down on Obama’s head but on Blue Dogs, DINOs, “centerists” and fascist fellow travelers and 2010 will be a bloodbath for all those who sabotaged the bill this time.

Listen folks, unless the corporate bosses succeed in stealin’ all the House and Senate races and put Deibolt machines in every precinct, this issue is not gunna be Obama’s Waterloo but WILL be the corporatists’ Hiroshima.

KEEP THE FAITH AND PASS THE AMMUNITION, THE CURE FOR A SICK DEMOCRACY IS MORE DEMOCRACY!!!

Our President had a very good interview with Jim Lehrer on The Newshour…wide ranging, answered the questions..sounds confident.

He also met with Progressive bloggers today and asked that they keep pushing on health care. Think we are getting noticed. I know that John Amato was there but not sure who else.

As Howard Dean is putting it to Congress regarding the public option, you either vote with the great majority of Americans, including 50% of Republicans, or you vote with the insurance company lobbyists.

He also met with Progressive bloggers today and asked that they keep pushing on health care.

“I agree with you-now go out and make me do it.” (FDR) Seems to be the model. He just can’t come out and say it.

Public option is obviously essential for the chronically ill. But it’s also essential for others.

http://www.buzzflash.net/story.php?in=1025467.
Steve Corrick: 50 Year Olds are Unemployable Without a Public Option
icon gravatar.comblog.buzzflash.com/contributors/2026

No public option spells financial doom for those 50+ who can’t get hired because their benefits cost too much. A public option improves productivity, helps American businesses and the economy. And it’s a good thing to do as well.

It’s also essential for all the folks who are now dependent on poor care via county funded health clinics and, especially those without medicaid, but them as well. They are the kinds of folks I’ve been talking with over the last two years who are suffering with a variety of chronic conditions that have produced a variety of peripheral neuropathies, like diabetes, alcoholism, spinal traumas, exposure to toxic meds (whether chemo, or other commonly prescribed medications); never mind the thousands of returning vets who have severed or damaged nerves from their wounds. The ignorance about neuropathies, which can been extremely disabling, of their medical providers astounds me, and that is true for those serving middle and upper income patients with neuropathy as well. But I can tell you that those without incomes, those non-working with low incomes and the
working poor are all receiving atrocious medical care of many conditions.

The public option really, really matters. As does the provision of more training for medical providers.

I’ve not had an opportunity to review the bills in detail to see whether some of my particular concerns are safely included, but I hope that the bills that are coming out aren’t bailouts for the insurance industry and and as gross sausage producing the same old, same old provisions.

Blessings,

My concerns about bankruptcy come from the copays which I would need to sign up for in order to be able to afford the least expensive public option and these could add up and overwhelm my ability to pay if I was sick over many years.

The overall bill draft which I read is an improvement upon what insurance now provides and I will support the drive to pass the bill. The resistance to this bill is way overblown because the bill shores up many different aspects of the existing system and makes only a few significant changes.

I like the idea that they will raise the rates paid to Medicaid providers incrementally until the rates equal those of Medicare in 2013. If they do that, the care will improve.

Unfortunately, the GOPPER lines of $hit are working.

My wife came home tonight exhausted and frustrated because a very intelligent person and well respected person, a colleague at a major university, a family friend, repeated GOPPER health care crappola today in a professional meeting and the others ate it up, hook, line and sinker. The stuff is SO wrong, such a detailed falsehood, that to unravel the lines would take more time and effort than the average bright person will listen for.

Two drinks later, she wants to just go to bed disgusted with the propaganda that may well sink any meaningful change in the US health care system.

I think we need a strong volley of truth sent out every hour of every day.

Actually, I can’t prove that. Been looking around “the google” and can’t find any figures to show consecutive days. Too lazy to gather up all the different stats and calculate.

But a posting in 2005 says he had already taken 335 days of vacation at that date, breaking Reagan’s record.

Maybe we should put together our own talking points (or perhaps someone already has and someone here has a link?) to print out and carry around for throwing at politely handiing to people like that intelligent idjit.

All with cites and footnotes, of course.
Academics should eat that up, too./s

Yes, I like your thought.

However, don’t give the academics that much credit. They ate all that $hit up today without a single fact, let alone a footnote!

This is evil stuff we are facing. I suggested my wife carry a mirror and a cross tomorrow.

My question is – what does this plan do for the chronically ill who can’t get insurance now? As far as I can tell, we’re supposed to tough it out until 2013 when the public option kicks in.

That’s kinda hard to do.

It is morally repugnant to profit off the misery or ill health of Americans. It’s criminal that medical bills to the private for-profit MEDICAL/INSURANCE INDUSTRIAL COMPLEX make up 62% of all bankruptcies filed in the U.S. each year. Americans spend 2.5 Trillion Dollars a year on Health care. The overhead at the private for-profit MEDICAL/INSURANCE INDUSTRIAL COMPLEX is upwards of 35% of the health care dollar spent each year in the U.S. That is approximately $900 Billion a year the MEDICAL/INSURANCE INDUSTRIAL COMPLEX uses for BRIBING CONGRESS and their lavish lifestyles, huge salaries plus perks and bonuses. All the while milking the hard-working men/women of this great nation of their hard earned money.
On the other hand Medicare has an overhead of 2%, Canada’s system is 1.5%, Europe’s 2.5% on average. The money that could be saved by eliminating the private for-profit MEDICAL/INSURANCE INDUSTRIAL COMPLEX is estimated at $900 Billion a year. Enough money to help pay for putting all Americans on MEDICARE/SINGLE-PAYER TYPE HEALTH CARE SYSTEM.

We have to fight back and call, write e-mails, letters-to-editors, Congress and to the White House to let them know how Americans feel about the private for-profit MEDICAL/INSURANCE INDUSTRIAL COMPLEX that currently provides the health care in this country.

Here are some Senators and blue dog(dems) who are on the wrong side of Health Care reform. Give them a call and demand,
“MEDICARE/SINGLE-PAYER TYPE HEALTH CARE FOR ALL NOW!”

Thanks to Dateline_Molly for this Link . Now, when I call each member I can quote to them how much money they were PAID/BRIBED by the MEDICAL/INSURANCE INDUSTRIAL COMPLEX to throw their constituents under the bus and deny them SINGLE-PAYER HEALTH CARE.

(blue dogs)
Ross D-AR, Boucher D-VA, Kind D-WI, Pomeroy D-ND, Tanner D-TN
Polis (CO), Titus (NV) and Altmire (PA)

These are the problem Democrats on the Energy and Commerce Committee: John Barrow (GA-12), Bruce Braley (IA-01), Bart Gordon (TN-04), Baron Hill (IN-09), Jay Inslee (WA-01), Jim Matheson (UT-02), Charlie Melancon LA-03, Zack Space (OH-18) and Bart Stupak (MI-01).

Joe Lieberman I-CT, Chuck Grassley R-IA, Lindsey Graham R-SC,
Susan Collins R-ME, Olympia Snowe R-ME, David Vitter R-LA,
Saxby Chambliss R-GA, Tom Coburn R-OK, Jon Kyl R-AZ,
John Thune R-SD, Richard Lugar R-IN, Jim DeMint R-SC
Jeff Sessions R-AL, Richard Shelby R-AL, Mel Martinez R-FL,
John McCain R-AZ, Mitch McConnell R-KY, Jim Inhofe R-OK,
Lamar Alexander R-TN, Dick Burr R-NC, John Cornyn R-TX

Mark Pryor D-AR, Thomas Carper D-DE, Mary Landrieu D-LA,
Max Baucus D-MT, Kent Conrad D-ND, Ben Nelson D-NE,
Maria Cantwell D-WA, Kay Hagan D-NC, Blanche Lincoln D-AR,
Ron Wyden D-OR, Evan Bayh D-IN, Diane Feinstein D-CA,
Arlen Specter D-PA

Here are the toll-free numbers for the Capitol Hill Switchboard:
(House and Senate)
1-800-828-0498
1-866-338-1015
1-866-220-0044.

Also give the President a call or write an e-mail:

White House Comments Line:

1-202-456-1111 M-F 9:00-5:00 est. (NOT A TOLL-FREE #)

President Obama’s e-mail: http://www.whitehouse.gov/contact/

Nothing rattles the Congress and White House more than informed CITIZEN/VOTERS ringing the phones off the hook for real health care reform. Call the House, Senate and the White House and demand,
“MEDICARE/SINGLE-PAYER TYPE HEALTH CARE FOR ALL NOW!”
SEMPER FI!

Mr. Bag:

We went round and round the other night on dkos. I hadn’t seen this. It clarifies. Three quick comments:

1. This post is mistitled. It should be called “What the House bill means to chronically ill Americans,” or “What aggressive insurance regulation means to chronically ill Americans.” These provisions in the House bill, assuming that the feds can effectively enforce them, would obviously be incredibly beneficial in a system that maintains private insurance coverage. Fantastic victories. But they have nothing really to do, one way or the other, with the “public option” — except, of course, that they would also apply to the public option, the public insurance alternative to private coverage.

2. The problems with the public option as written in the House bill remain when it comes to the economic claims that proponents have made for cost control. It will be too small unless we open it to everyone.

3. Whatever the outcome of the current process, my hope is that Americans with chronic illnesses, including several in my own family, will no longer have to suffer for lack of insurance, or even for fear of losing insurance. Best of luck to you.

I don’t think copays will go up under this reform. If anything they should go down. All Kaiser plans (my husband’s health insurer) have maximum out-of-pocket costs that are less than visiting the Emergency Room for a broken ankle, from what I understand. For the public option to compete, it would have to offer similar maximums. I don’t you have to worry that a public option would make you broke.

That’s a very fair criticism of the title. (I stink at writing titles).

I would argue that if the House bill or the Senate HELP bill doesn’t pass that a public option that it is probably pretty unlikely that these good reforms are enacted in a meaningful way. The public option removes a lot of incentives insurers have to discriminate against patients by establishing a system which puts customers, and not Wall St. investors, first.

Thanks for the well wishes.

And thanks to everyone for their comments and for taking the time to read this!

maybe you can wait till 2013…

I would add a prohibit actuaries, and other professionals who have the power to deny coverage or claims, from owning stock in insurance companies. In my judgment a lot of the problem is that increases in stock value that come with medical loss ratio manipulation act as de facto bonuses for insurance employees.

In a perfect world, I’d cap insurance profits, but that isn’t realistic.

Bag’s essay is misleading in two respects.

First, as has already been pointed out, there is no connection between the virtually worthless “public option” provisions in the Democrats’ bills and the antti-cherry-picking provisions in those bills Bag celebrates — provisions requiring guaranteed issue and community rating and prohibiting rescissions of coverage just when you need it. These provisions, if they become law, will either be enforced by appropirate authorities or they won’t be enforced. Enforcement will not be enhanced by the existence of a “public option” (even a big one, as opposed to the tiny little creatures proposed in the Senate HELP and the House bills).

“Competition” between insurance companies, or between insurance companies and the tiny “public option,” should it survive, will have no influence on whether these anti-cherry-picking provisions are enforced. If “competition” had any influence on cherry-picking, that inluence would have been apparent decades ago.

Second, Bag overlooks the distinction between “cherry-picking” and “lemon dropping.” It is one thing to lower premiums for chronically ill people (in exchange, of course, for raising premiums for the healthy) and to force the insurance industry to accept applications from chronically ill people. It is entirely another to make the insurance industry provide health care to sick people when they need it rather than deny them services and so frustrate them they disenroll and go somewhere else. Forcing the insurance industry to accept sick people is a little bit like forcing the wolf to let the chicken into his lair. You really want to think twice about celebrating such a “victory.”

If there is one thing that is now well established about American health insurance companies, it is that they are incredibly clever at finding ways to screw patients, especially their sickest and most vulnerable enrollees. These methods are myriad, difficult to detect, and very very expensive to detect and prosecute. To detect patient abuse by insurance companies, we will need hundreds of thousands of police officers with MD or RN degrees roaming the halls of our hospitals and hanging out in examining rooms and listening in on converations between doctors and insurance-company “utilization review” bureaucrats. We will need another army of human beings to prosecute the abuses that are detected. There are no provisions in the Democrats’ bills to finance these armies.

The routine screwing of patients — especially vulnerable and chronically ill patients — by insurance companies is not a new problem. It has been going on now for at least a quarter century. It is the natural outgrowth of America’s doomed experiment with HMOs and the tools HMOs pioneered to cut costs — tools which collectively came to be called “managed care” by about 1985. By the late 1980s virtually all US health insurance companies were using some form of managed care to deny necessary services to patients. This problem has been endlessly documented (cf. Mark Green’s report on New York insurance companies, former MN Attorney General Mike Hatch’s investigation of the abuse of mental health patients by Blue Cross Blue Shield, or “Sicko,” to take just three of innumerable examples).

Sending a trillion dollars over a decade to the US health insurance industry — which is what the Senate HELP committee bill and the House tri-committee bill will do — may accurately be called “an insurance industry bailout.” The presence of anti-cherry-picking provisions in these bills doesn’t change that fact. Nor should they reassure the chronically ill.

Kip Sullivan

You are right. I apologize for worrying out loud. Now, back to the fight!

Kip beat me to it, and with much more meat on the bone. Undoubtedly, the House bill contains crucial and long-overdue provisions, if enforceable and enforced. But these don’t address the gross inadequacies of the public option.

The insurance sector has long known that the days of policy denial for preexisting conditions are numbered and is totally cool with that, so long as “guaranteed issue” is coupled with mandated insurance purchase. For a good discussion of this see the article on health care reform from last February’s Harper’s (sub required for on-line access), or just Google on Ignani, AHIP, mandate, and “guaranteed issue.”

As for recissions, I hope and expect that the bill’s provisions will drastically reduce them, although again, that depends on how “fraud” gets defined and how violations are detected and addressed.

But none of the major critiques of the public option per se (see, eg, this, or this, or this) have anything to do with preexisting conditions or recissions. Rather they address 1) the vast diseconomies of not only sustaining but expanding (via the “exchange”) wasteful multipayer bureaucracies and 2) private-insurers’ continued incentive (indeed fiduciary responsibility) to fight claims and minimize payouts to holders of even ostensibly “high-quality” policies.

Kip:

The insurance company CEOs are “health criminals” who should be in the Hague, or at least vilified for killing people like the tobacco CEOs.

Got a link on this?

Sending a trillion dollars over a decade to the US health insurance industry — which is what the Senate HELP committee bill and the House tri-committee bill will do — may accurately be called “an insurance industry bailout.”

Bailouts aren’t too popular right now, since everybody seem to be getting them except those who actually need them…

Lambert,

The trillion-dollar figure is based on three rough calculations.

The bill funnels dollars to the insurance industry three ways: (1) by expanding Medicaid/SCHIP, which have been turned over to the insurance industry in most states; (2) by creating subsidies for people who qualify to buy insurance from insurance companies participating in the exchange (or exchangeS if states decide to create their own exchanges); and (3) by penalizing employers who don’t offer “acceptable” coverage to their employees(this requirement is often called an “employer mandate.” I believe the sum total of these provisions is roughly a trillion dollars per decade.

I base this estimate on CBO’s analysis of spending under the House tri-committee bill available at http://www.cbo.gov/ftpdocs/104…..r3200.pdf.

CBO estimates the portions of the tri-committee bill dealing with expanded insurance coverage will funnel about $1.2 trillion over the decade 2010-2019 to the insurance industry plus the tiny PO(see the “enclosures” that accompany CBO’s letter). Of that, $440 billion is to expand Medicaid/SCHIP, and $770 is for subsidies for people who qualify to buy health insurance through the exchange (or possible exchangeS if some states decide to create their own exchanges).

Calculation 1: About 60% of the states have turned their Medicaid/SCHIP programs over to the insurance industry (that is, they have privatized what used to be old-fashioned single-payer programs for the poor). So 60% of the MA/SCHIP funds, or about $250 billion, will go to the insurance industry.

Calculaion 2: I believe all of the $770 billion in subsidies for exchange participants will go to the insurance industry. If I’m right about that, the total of the subsidies plus the portion of the MA/SCHIP funds going to insurance companies is a little more than $1 trillion.

CBO disagrees, however. CBO predicts that the little PO will enroll one-third of the 30 million people who will be eligible for subsidies (and to shop within the exchange). CBO estimates the tri-committee’s PO will insure 9-10 million of the 30 million people who will be eligible to shop in the exchanges and get subsidies. If the CBO is correct, then the little PO will get about one-third of the subsidies and the insurance industry the other two-thirds, or “only” $500 billion. In that event, using just these two calculations, we’d have to say only $750 billion will go to the insurance industry in the decade analyzed by CBO — $250 billion of MA/SCHIP funds and $500 billion subsidy money.

But CBO admitted it was making a wild guess as to whether anyone would enroll in the PO. CBO discussed only one of numerous factors relevant to the PO’s survival, and its comment about that one factor — whether providers will participate in the PO when the tri-comm bill says explicitly that providers are not required to participate AND they will be paid less in many states than they’re paid by local insurers — was pure speculation (CBO guessed some docs would participate). So I think we should assume the PO won’t survive and all of the $770 billion in subsidies will wind up in industry coffers, along with the $250 in MA/SCHIP money, for a total just over $1 trillion.

Calculation 3: The CBO’s estimate covered several years in which the tri-comm bill is irrelevant because it has not taken effect. CBO’s estimate is for 2010-19, but the expansions in coverage don’t begin to take place till 2013 (the fourth year of the decade under analysis). So, if we’re talking about dollars per decade when the bill is in effect, we have to up the numbers I discussed above by about 30%.

So either way, whether the PO survives or doesn’t, it is reasonable to assume the tri-comn bill will funnel at least $1 trillion to the underprivileged insurance companies. There are some good provisions in the tri-comm bill, such as a provision that eliminates the huge overpayments Congress has forced Medicare to make to the insurance companies that participate in Medicare. But you could insert another 3,000 pages of good provisions in this 1,000-page bill and it still wouldn’t change the fact the tri-comm bill is an insurance industry bailout.

Kip

Let’s deal with the poster’s lead:

There has been a lot of misinformation about how the public option is “really a sell out to insurance companies” posted on various websites.

Of course, it’s impossible to know what the “misinformation” might be, working from something as vague as “various websites.”

Anyhow, here are the essential numbers on public option that never get mentioned:

130 million — Number of enrollees in “public option” as “progressives” sold it to the public, based on work by Jacob Hacker.

9 million — Number of enrollees in “public option” in legislation as crafted, based on CBO scoring.

I don’t know what bigger indicator you need of a “sellout” to the insurance companies than reducing 130 million to 9.

Now, I certainly hope that all the good things that thebagofhealthandpolitics writes about really to come true, and the thebagofhealthandpolitics is, in fact, in the 9 million.

But that still leaves, oh, 121 million up the creek, right? And if somebody can explain to me how a so-called “public option” (or “plan”) with only 9 million enrollees in it can “keep the insurance companies honest,” I’d be very glad to hear it.