Friday, February 17, 2017

"If you like..."


"But I like my health insurance company!"

"If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan."
If you click the "If you like your doctor" link, you'll see all the iterations.  It's the infamous "lie" Obama told us all to sell us Obamacare, the Big Government "takeover" of America's healthcare "system."  Of course, it was not a lie, but rather a very hopeful though politically careless thing to say.  Of course, some things were going to change, and Murphy's law has an exponential relationship with change.  And it was far from a takeover of far from a system.

All the ups and downs of Obamacare aside, here's a peek at what Paul Ryan (Rep, JackKempTopia, WI) and the GOP in the House, has in mind for us now...
Our proposal will then create a new, advanceable, refundable tax credit to assist with the purchase of health insurance on the individual insurance market. The legislation creates a new code section – 36C— to do this. The credit is:
•Universal for all citizens or qualified aliens not offered other qualifying insurance
•Age-rated
•Available for dependent children up to age 26
•Portable
•Grows Over Time

The credit is not based on income. This will help simplify the verification process and expand access for Americans who have been left behind by Obamacare. Additionally, a universal credit does not create the same labor market distortions and perverse incentives as President Obama’s law did: according to CBO, the Obamacare income-based subsidy system resulted in so many lost labor hours it would be as if 2 million full-time equivalent workers left the labor force in 2025. A universal credit fixes this unnecessary disincentive to work and makes sure our tax code is built for growth.

Older Americans will receive a higher credit amount than younger Americans, reflecting the higher cost of insurance for older Americans. Taxpayers can receive credits for their dependents – including children up to the age of 26. The credit, however, is limited only to citizens or qualified aliens. Incarcerated individuals are not eligible for the credit.
The link will bring you to their policy paper.  They want to retract Medicaid, put out "advanceable, refundable" tax credits (at one point is says "monthly"), have them flat for everyone and only progressively adjusted by age, oh and override state laws (?) to open insurance markets interstate.  That's really the crux of this.

I know I haven't been posting diligently, as I've been a little out-of-it, but I beg of someone out there to explain to me first, how this is not the federal government taking over healthcare by superseding state laws, second, how this will not lead to a few big, awful, national private insurance companies who survive the race to the benefits bottom, and third, finally, WHO THE FUCKING HELL LIKES FUCKING INSURANCE COMPANIES IN THE FIRST PLACE?  That last one, I will never understand, so you can skip that one.  The only thing I can make of it is that the American private health insurance raison d'etre is a hedge against labor inflation.  It serves no other purpose.  It has nothing to do with HEALTH.

JMJ

43 comments:

  1. I've been responsible for my own health care for over forty years now w/o any government help... explain to me why I need government help, again?

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  2. LOL! You do understand the whole point of insurance, Thersites. You put your money in a pool with a bunch of other people to use when you need it. Since most people are healthy at any given moment, in theory, you can cover everyone in the pool. It is a socialistic endeavor in and of itself. We all will probably need police or some other such service at some time, just as vital as health care, and possibly related, but we don't have private police insurance. That's because we all pool our money together to pay for the police, though at any given time, most of us don't need them. To me, as a matter of efficiency, I see private insurance as utterly superfluous. Medicare proves this. Medicare, which handles the aging and therefore most sick, has far lower overhead than ANY private insurance, and yet deals with far more sick people. It seems to me, the best, most efficient, most equitable, fairest system would be the largest pool possible - all of us. Just as at most times we are not at war (or at least it used to be that way), we still all keep a military ready. Just as at most times we are not being robbed by burglars, we still all keep a police force. Well, we will ALL need healthcare at one point or another, so we should bypass this ridiculous, pointless, superfluous private insurance of healthcare, and make it a right, and you can contract out the adjusting and such as they do in Switzerland, or have a mixed system like in England, or just one system, like in Canada, or we can just stick with what we know is working and make Medicare for all and be done with it. Just because you can do something now, Thersites, doesn't mean you can do it in the future. You do not know what the future holds. I had wonderful insurance for years, and I've had crap. I noticed a Red State/Blue State HUUUUUGE difference in that. But the point is simple - INSURANCE is for what you don't see coming. Private insurance is unnecessarily profiting from that.

    JMJ

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    1. Then pay me more instead of giving me insurance. Corporations are mini-socialisms. There wasn't any medical insurance at all until the government began limiting the amount of money corps could pay employees in WWII.

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    2. Yes, we do have a very weird "system" in the US that sorta grew out of the war. Zane covers that pretty well. I wouldn't say that corporations are mini-socialisms, though. I'm not sure what you mean by that. Cooperatives, non-profits, partnerships, and so forth can be thought of that way, but most corporations are just private service providers or product makers. Nothing inherently or necessarily socialistic about that, besides requiring an orderly society in which to operate, but that's not on them, that's on the government, on us, people!

      The only services you're really getting from private insurance is adjusting rates and investigating fraud. In some countries, this is contracted out to private companies who are incentivized by competing to see who does those things best and most efficiently.

      We have a few problems though...

      First, it is incredibly expensive to get a medical or such related education in America, so...

      Second, medical professionals make a lot more money than their counterparts in rest of the world, though, to be fair, they don't really see a lot of income after their education for many years.

      Third, the private insurance sector acts as a hedge against labor inflation. When you look at your company's 401K, for instance, you'll see it loaded with insurance companies. They are huge investment hubs.

      These three issues seem to be the biggest stumbling blocks keeping us from a simple Medicare-for-all system.

      JMJ

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    3. First, it is incredibly expensive to get a medical or such related education in America A result of 50 years of "easy government loan money" that keeps higher education costs increasing at rates far higher than the general inflation rate. Expect the same when government "subsidizes" health care.

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    4. That's not true of other countries with universal healthcare and far more subsidized education. The whole loan system should be thrown away.

      JMJ

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    5. You mean higher education is cheaper in the UK? Who knew?

      You mean that countries with subsidized health care systems are responsible for all the R&D that advance medical science? Who knew?

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  3. Given the choice of pay me more or provide insurance the latter always wins with aging workers who worry about healthcare. The young generally healthy 20 and 30 something prefer the pay me more Which is wholly understandable. Until they have children.

    Jersey make good points. Frankly it boils down to priorities. Medicare is efficient and cost effective. Increase the pool as well as increasing monthly "premiums" 10 or 15 present from what they are now and viola, a happy healthy society.

    Agenda driven politics and profit driven agendas (in the case of big pharma obscence profit) are what stands in the way of the obvious.

    Great post Jersey.

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    1. Moral hazard, thy name is RN. When you have a program that experiences $70 billion a year in waste fraud and abuse, why would anyone in their right mind want to "expand" it?

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    2. Les, thank you, that's right! I forgot about Big Pharma! That's another stumbling block.

      FJ, 70 bil is nothing compared to the profits of Insurance and Pharma, and Lord only knows how much of that is lost to "waste, fraud, and abuse" (an old conservative catch-all that when closely observed almost always turns out to be a snipe hunt).

      Here's what it comes down to - health insurance, by it's very nature, as understood by every civilized country on the planet except ours, is simply a way to pay for something that we will all need at some point but have no idea what it will be or how much it will cost. It demands a socialistic system to work. Private insurance is nothing BUT waste, fraud, and abuse! That's all it is! Moral hazard? I showed you above how some countries deal with that. That's what police and prisons and courts are for. Want less abuse, concentrate more on investigating fraud. It seems to me a disjointed private/public system does nothing to help with that!

      It's good to have you, and Les of course, visiting, by that way! You always make for lively debate!

      JMJ

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    3. A "private system" establishes the cost. Government grants of "patents" and "medical licenses" keep outside competition down and allow Pharma and medical providers to overcharge. If I need surgery, why can't I go to the best "barber" in town?

      Privatize the whole mess. Stop granting patents and licenses. Low cost medical care is now readily available. All by simply removing government from the middle.

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    4. Patents are merely devices that allow individuals to draw "rents" from a "knowledge based" economy. W/O the government's enforcement, these "rents" could not be collected.

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  4. Okay FJ, why do you suppose no other civilized country does that? What do you think they do not understand? No patents? No licenses? No insurance(?)? I can't even begin to imagine the consequences of what you're describing. I'd like to see some patent reform, especially for important lifesaving breakthroughs. You can always reward companies handsomely if we have to do that. But no patents? No licenses? You are going back to the days before science!

    JMJ

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    1. What do you mean "no civilized country does it?" Ever been to Taiwan? In the 70's, when I was there, they had no "bilateral" patent agreement with the US. You could buy anything you wanted, music, books, etc. at the bare "production" cost. The same was true of China until very recently. Not everybody is a member of the PCT. Heck, international cooperation and recognition of patents didn't even start until the 1890s It's just a legal "tool" that enables global capitalism to function smoothly.

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    2. Well, by "no civilized country," I meant an all private system. When it comes to patents and all sorts of other rules and laws and such, countries around the world vary widely. I assume people still go to the Caribbean for "Doctorates," or go to Mexico, as someone I knew did, for risky experimental treatments, or buy some of their drugs from Canada, as I do. I am not a fan of international patent laws, and am familiar with issue from my days in international trade in my dealings with Customs. But I wouldn't throw out the baby with the bathwater. The concept is sound. Application - and flexibility and human welfare, etc - is another matter.

      Good point!

      JMJ

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    3. What's "sound" about the concept? Product life cycles have gotten shorter and shorter whilst patent coverage periods, longer and longer?

      Year filed Maximum term of validity Established by
      -1789 - -
      1790–1835 14 years from issuance Patent Act of 1790
      1836–1860 21 years from issuance Patent Act of 1836
      1861–1994 17 years from issuance -
      1995- 20 years from filing Uruguay Round Agreements Act

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    4. Pharmaceuticals cost $5 billion per drug to develop. At 20 years patent life, we're paying a hell of a "premium" ($250m/yr) to allow the developers to recover their non-recurring costs

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    5. FJ, you don't think there should be patents at all? I mean, I agree with you, the patent system now is really awful, but what would you do? I say, make it reasonable, reform it, but I'm not sure what you're driving at. I am more than open to ideas. Heck, you are one of the very few people out there who even talk about this, and it's a very serious issue!

      JMJ

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    6. Shorten patent life to something reasonable, like the life of an I-phone ~3 years. Corporations benefits from today's patents, not "people". Why protect "their" rights?

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    7. I think it depends too on what you're patenting. With medicine, it can be a real nightmare. With some new widget, it may not matter, but for liability and a few other matters. I don't see this as a very easy subject.

      JMJ

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    8. Why does it cost $5 billion to bring a drug to market? Because it can...

      ps - also get rid of the 'liability' protections government grant "corporations". :)

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  5. Just found you, now I must lose you!

    Burr Bye!

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    1. Well, guess that's one less bordello for me...

      JMJ

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  6. Malia Obama, one of ex-president Barack Obama’s daughters, has recently shared devastating news with her parents. Malia, an ardent pothead, is pregnant, and the public is not sure who’s the daddy. It may be Soulja Boy, Shifty D, or a guy named Dennis from the West Wing. Of course, there’s been no talk of marriage.

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  7. ... "second, how this will not lead to a few big, awful, national private insurance companies who survive the race to the benefits bottom"
    ----------
    We already have that situation.

    I notice that Jodi Ernst and Marsha Blackburn, two hardcore cons, were both booed at local town hall events when they tried to answer questions about the future of the ACA.

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    1. Yeah, I know what you mean. And I just loathe and detest these rightwing pundits who suddenly discovered that we have states with one or two insurance companies controlling most all the market and then blame it on Obamacare! The depths of the flagrant deceit just know no bounds.

      JMJ

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    2. Then why "stupidly" impose "state" limitations on selling health care insurance policies? This is government trying to protect local markets, but at the same time granting "national" corporations a "cost advantage" in serving those local markets. Want to help the small companies? LIMIT the capitalization of big ones.

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    3. Another view, Farmer, is that by allowing states to set regulations insurance companies can't sell across state lines while only following the regulations of the lowest enforcement state.

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    4. So allowing California to set its own emissions standards is also a mistake???

      Bigger more efficient corporations are good for health insurance, but not retail stores? Make up your mind, Teddy Roosevelt... good trusts or bad trusts?

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  8. Back in 2010, I attended a townhall meeting that Congressman Ed Royce's staff organized. At the meeting, someone asked what happened when 0bamacare got voted in, under the protests of the GOP. Ed Royce brought out the fact that Congressman Dana Rohrabacher had written a simpler substitute bill that Nancy Pelosi poopooed and played partisan politics with. Pelosi shot the 47 page bill down because it was written by GOP Congressman Rohrabacher, was easy for the public to understand, and wasn't a monstrocity. Pelosi played with power along with Harry Reid to discredit the GOP by playing dirty, sticking ALL OF US with a rotten goose egg of a law.

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  9. The only thing wrong with the ACA is it isn't affordable. Unless you're part f the working poor, indigent, or very wealthy. In which case you don't need the ACA anyway.

    Medicare restructured and made universal would work by far better than the ACA or the system prior to the ACA.

    Folks stopped talking a long time ago. And, we note that the Heritage Foundation supported a similar concept until it became Obama's hallmark legislation.

    https://www.forbes.com/sites/theapothecary/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate/#5fb2e4096187

    http://americablog.com/2013/10/original-1989-document-heritage-foundation-created-obamacares-individual-mandate.html

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    1. Single payer Medicare wouldn't invest a dime into medical R&D. Like the Venezuelan oil fields, the "production" would "decline" the minute the policy was instituted. You NEED rich people willing to spend $billions for R&D. Single payer systems are parasitic.

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  12. Rich people, I think you're talking about corporations, spend billions to make more billions. Period.

    So, I'm guessing by your statement Canada with its single payer system invests nothing, takes advantage of US R&D, keeps healthcare and drugs reasonably priced and it's citizens happy. At our expense?

    If I lived on the US Canadian border I'd buy medications in Canada.

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    1. Sure, Lily will give you a real good patent use "discount" there.

      Turns out that while research and development costs are quite expensive, manufacturing costs aren't as high. Thus drug companies can recoup their R&D costs in the U.S., with high drug prices, but can still make a profit in Canada and Europe just by covering the costs of making the pill.

      Source: Why Drugs Are Cheaper In Canada Than In The US - Drugsdb.com http://www.drugsdb.com/blog/why-drugs-are-cheaper-in-canada-than-in-the-us.html#ixzz4ZdeaGB1h

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    2. Of course, w/o Governments enforcing patent rights, there would be no "billions to recover" in higher prices to Americans ONLY.

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  13. Jusdt sayin' 'ello Jersey, didn't know you had a blog even! Will visit my crankiness upon you sometimes!

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