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#1 2009-09-16 6:50 pm

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

So if there's no health care reform, then ...

... what happens?

There's plenty of grousing about the projected $800 billion over ten years, or whatever the figure is, that Obama's plan is projected to cost. But the cost of the status quo is going to be far higher.

The bad news is that the 10-year budget-deficit estimate for 2010–2019 has been increased to $9.05 trillion from the previous estimate of $7.1 trillion, released in May.

CBO projects that net federal spending on Medicare and Medicaid will rise from about 5 percent of U.S. GDP in fiscal year 2009 to about 10 percent in 2035. Spending on Social Security is projected to rise at a much slower pace, from almost 5 percent of U.S. GDP in 2009 to about 6 percent in later years.

Given the state of Uncle Sam's finances, how the hell is that supposed to fit in the budget? The only way it could happen is if there's spectacular economic growth. And I mean spectacular growth.

Meanwhile, across the pond in the UK, national finances are lurching back toward the nightmare of the 70s

"The Treasury is expecting to pay a lot more in debt interest, social security payments and other things it doesn't have much day-to-day control over. We are looking to have to cut public spending by 3% a year in real terms. We haven't seen anything like that since the 1970s."

That's pretty damn brutal, and it could be even worse in the US. Or maybe I should say it will be even worse, since the current debt load is totally unsustainable.

And yet this is the better choice? It's preferable over a modest, pro-corporate health care reform package?


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#2 2009-09-16 6:53 pm

Farmerkev
Official Dementor
Moderator
Registered: 2003-01-03
Posts: 19138

Re: So if there's no health care reform, then ...

From what I have seen, current proposals will do nothing to lower the increase in health care cost inflation and only serve to put the government on the hook for more expense they can't afford.


I was so depressed last night thinking about the economy, wars, jobs, my savings, Social Security, retirement funds, etc., I called the Suicide Lifeline. I got a call center in Pakistan, and when I told them I was suicidal, they got all excited, and asked if I could drive a truck.

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#3 2009-09-16 6:54 pm

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

Farmerkev wrote:

From what I have seen, current proposals will do nothing to lower the increase in health care cost inflation and only serve to put the government on the hook for more expense they can't afford.

Which the Republican Party, and the right in general, is so concerned about its alternative proposal is to do ... well, nothing.


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#4 2009-09-16 7:17 pm

mo' ron
PS3 4 EVA
From: NC, USA
Registered: 2002-10-15
Posts: 14483

Re: So if there's no health care reform, then ...

ShnickyShnack wrote:

Farmerkev wrote:

From what I have seen, current proposals will do nothing to lower the increase in health care cost inflation and only serve to put the government on the hook for more expense they can't afford.

Which the Republican Party, and the right in general, is so concerned about its alternative proposal is to do ... well, nothing.

Their plan is to move away from employer provided insurance, allow inter-state insurance purchasing, and probably remove the pre-existing condition thing.

But moving away from employer-provided insurance will never gain traction, because most people don’t want yet-another-bill to worry about, especially one as costly as health insurance.


What is the difference between Vista and OSX?
- Microsoft employees are excited about OSX.

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#5 2009-09-16 7:21 pm

robco
Curmudgeon
From: Sodom
Registered: 2004-12-04
Posts: 8319
Website

Re: So if there's no health care reform, then ...

If there is no reform, there will lots of pain the future. I could see Medicare and SS becoming means-tested and/or the eligibility age raised. More and more businesses will stop offering health coverage and more people will go bankrupt from medical bills. On other fronts, we'll have no choice but to scale back the military. Our ability to "project power" will be severely diminished. This will of course impact our foreign policy. The other lingering problem is our lack of investment in infrastructure. Water and sewer systems, electrical grids, roads, bridges, schools, etc. are crumbling from lack of maintenance and have not been upgraded in years.

Both the GOP and Dems are paralyzed. They no longer serve the people. They do what corporations want and corporations are very short-sighted. They care about short-term profits and little else. I'd like to think the situation will get so dire that change will happen or that the system will collapse, but they keep finding ways to keep it going. Our financial system is headed for ruin yet again, no lessons learned.

Health care reform never had a chance. The left was forced to take single-payer off the table from the start. There has never been serious debate. Due to no small part of our lack of education - far too many high school "graduates" can barely read or write let alone understand fundamental mathematics or science - we can no longer have real, reasoned debate. Everything must be expressed in brief soundbites because attention spans have diminished. Any recovery will affect only a few because the good-paying jobs of the future require educated people and we have to import them from other countries. Except now people who worked here have been forced to go back to their home countries and are now starting businesses there. The US won't be able to compete. We don't have the educated workforce required. We're losing any infrastructure to support businesses. Our shortsightedness and irrational fear of government will ensure we will not be a dominant player on the world stage for much longer. We're being carried forward through pure momentum at this point.


It is an odd thing, but every one who disappears is said to be seen at San Francisco. It must be a delightful city, and possess all the attractions of the next world.
- Oscar Wilde

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#6 2009-09-16 7:31 pm

JakeTheTall
Cargo Cultist
From: In Permanent Opposition
Registered: 2003-03-13
Posts: 10133

Re: So if there's no health care reform, then ...

I think Mr robco offers a very solid assessment.  I wouldn't be quite a gloomy* about the America's overall future, but time will tell.


* And not because I'm in the robber baron group.


Jesus said to the servants, "Fill the jars with water"; so they filled them to the brim.  Then he told them, "Now draw some out and take it to the master of the banquet."  They did so, and the master of the banquet tasted the water that had been turned into wine. He did not realize where it had come from, though the servants who had drawn the water knew.

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#7 2009-09-16 7:40 pm

DevoDoc
Vardøger
From: The East Wing
Registered: 2003-05-27
Posts: 2757

Re: So if there's no health care reform, then ...

But, but, but... Ben Bernanke says the recession is over. Time to max out the credit card and buy an Escalade.


We also know how cruel the truth often is, and we wonder whether delusion is not more consoling. - Henri Poincaré
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#8 2009-09-16 9:22 pm

wellfleation
High on Life
From: Metheun, Mass.
Registered: 2001-11-13
Posts: 9040

Re: So if there's no health care reform, then ...

In purely economic terms, maybe? But he admitted that the impact will linger for much longer in terms of the unemployed. So, no, for every day people it is a long way from being "over".


FIGHThttp://img.photobucket.com/albums/v317/wellfleation/stern-h1_01.jpgPOWER

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#9 2009-09-17 12:49 am

Metacell
misanthropist
From: The space between the spaces
Registered: 2005-03-19
Posts: 5989
Website

Re: So if there's no health care reform, then ...

I hate this country.  Bin Laden was right.


Ho Eyo He Hum

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#10 2009-09-17 5:59 am

Bat
DOS über alles
Royal Wombat
From: Björk, Björk
Registered: 2001-05-14
Posts: 29797

Re: So if there's no health care reform, then ...

Bite your tongue.

Senate’s 10-year health fix would cost $856B
Bill unveiled Wednesday but hopes dim for bipartisan compromise

WASHINGTON - Sen. Max Baucus on Wednesday brought out the much-awaited Finance Committee version of an American health-system remake — a landmark $856 billion, 10-year measure that starts a rough ride through Congress without visible Republican backing.

The bill by Baucus, Democratic chairman of the Senate panel, would make major changes to the nation's $2.5 trillion health care system, including requiring most people to purchase insurance coverage or pay a fine and prohibiting insurance companies from charging more to people with more serious health problems.

"This is a unique moment in history where we can finally reach an objective so many of us have sought for so long," said Baucus, of Montana. "The Finance Committee has carefully worked through the details of health care reform to ensure this package works for patients, for health care providers and for our economy."

Consumers would be able to shop for and compare insurance plans in a new purchasing exchange. Medicaid would be expanded, and limits would be placed on patients' yearly health care costs. The plan would be paid for with $507 billion in cuts to government health programs and $349 billion in new taxes and fees, including a tax on high-end insurance plans and fees charged to insurance companies and medical device manufacturers.

But the bill fails to fulfill President Barack Obama's aim of creating a new government-run insurance plan — or option — to compete with the private market. It proposes instead a system of nonprofit member-owned cooperatives, somewhat akin to electric co-ops that exist in some areas of the country. That was one of many concessions meant to win over Republicans.

In other ways, including its overall cost and payment mechanisms, the bill tracks closely with the priorities Obama laid out in his speech to Congress last week.

The CBO is skeptical of co-ops, favorite of some hereabouts; see below.

For Dems, 60 senators is magic number
Health care proposal needs to attract at least one Republican for passage

WASHINGTON (NYT) - The unveiling of a compromise health care proposal has Senate Democrats pondering a daunting mathematical challenge: how to keep all 59 Democrats united and attract at least one Republican to pass an overhaul measure.

As many lawmakers on Wednesday got their first detailed look at a Finance Committee plan that was months in the making, senators immediately began exploring whether the plan — when combined with elements of another, more liberal one — could win enough senators to reach that magic procedural number of 60.

“We have to meld a couple of things together and see where we are,” said Senator Christopher J. Dodd, Democrat of Connecticut. “I wouldn’t say today with absolute certainty that you could get to 60, but it would be just as foolish to say you can’t get there either. This is the Senate.”

In trying to reach critical mass for legislative success, advocates of health care overhaul face an extremely delicate balancing act. With the death of Senator Edward M. Kennedy of Massachusetts, Democrats control 59 seats, meaning they need at least one Republican to join them if they are to proceed without employing a procedural shortcut that could cause havoc in the Senate.

And Senate Democrats have substantial differences of their own. More liberal members like Senator John D. Rockefeller IV of West Virginia and Senator Bernard Sanders, independent of Vermont, have been strong advocates of a public insurance option; many of the more centrist Democrats have come down just as strongly against one. Centrists are interested in holding costs down; progressives want to bring more Americans under the insurance umbrella, a push that drives costs up.

As a result, changes intended to bring the centrists and conservatives in line could drive away progressives, while any move to draw in the more liberal elements could end up alienating the centrists. There is little margin for error.

“I continue to believe that you start at the center and then move to collect additional support on both ends of the political spectrum,” said Senator Ron Wyden, an Oregon Democrat and health policy expert whose seat on the Finance Committee makes him a key player as that panel considers the new plan from Senator Max Baucus, the Montana Democrat who leads the committee.

Juggling the individual party demands can be dizzying. [..]

WASHINGTON (AP) -- The latest health overhaul plan circulating on Capitol Hill gives health insurers, drug makers and large employers reasons to heave sighs of relief, sparing them the higher costs and more burdensome rules included in other Democratic-written alternatives.

Industry players that have already struck bargains with President Barack Obama's administration and leading Democrats to help pay for revamping the health system saw most of those deals left intact - and in some cases sweetened - in the $856 billion proposal unveiled Wednesday by Sen. Max Baucus, D-Mont., the Finance Committee chairman.

You won't hear any of them cheering publicly about what they would get out of the measure, because many are still hoping for a better deal before Congress takes final action on revamping the health care system. But don't expect to hear them coming out in opposition, since they know Baucus' plan is the lesser of many evils being considered.

Take the health insurance industry.

It would score a new, taxpayer-subsidized customer base of millions who don't currently have insurance, thanks to a mandate that everyone purchase coverage - backed up by steep penalties on people who don't. And it wouldn't have to compete with the government to cover people, unlike in the four other health overhaul plans approved this year by Democratic-dominated congressional committees.

Nor would the nonprofit so-called "co-ops" designed to provide consumers with an alternative to private health insurance pose any real threat to their business, according to a nonpartisan analysis released Wednesday. The Congressional Budget Office said those plans "seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments."

Hmm. My bold. (And the industry profit margin cited elsewhere at ~3% is after, AFAIK, admin and other overhead, as well as the very high salaries of management- things we can live better without). Well, the journey of 1,000 miles, Rome wasn't built in and so on. A step at a time, but get moving.

New health proposal is industry's favorite so far


If all economists were laid end to end, they would not reach a conclusion - George Bernard Shaw

"Fire up a colortini, sit back, relax, and watch the pictures, now, as they fly through the air."

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#11 2009-09-17 7:30 am

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

That Senate bill is a piece of crap.


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#12 2009-09-17 8:05 am

daemon
blank prince HAL
From: Golden Road (Out of Perdition)
Registered: 2008-01-03
Posts: 3784
Website

Re: So if there's no health care reform, then ...

Somebody who knows Max B. and the Hard Centrists should view Moore's "SICKO!" and write the legislation.


Brigid O'Shaughnessy: I haven't lived a good life. I've been bad, worse than you could know.
Sam Spade: You know, that's good, because if you actually were as innocent as you pretend to be, we'd never get anywhere.
http://sitruc.blip.tv/file/2661495/

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#13 2009-09-17 8:07 am

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

I can't escape the feeling that this is the last chance to reform the system before events take on their own momentum.


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#14 2009-09-17 8:18 am

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

I was just reading how the whole industry is very happy about this new bill. And why shouldn't they? All it does is shovel out more money to get more people into the existing system without doing anything to reform it.


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#15 2009-09-17 8:30 am

Ribtorus
Member
Registered: 2002-07-11
Posts: 14122

Re: So if there's no health care reform, then ...

without real reform, systemic disease like type 2 diabetes, heart disease and just plain old age etc will place such a burden on insurers that the state will be forced to intervene in some relatively draconian way. Draconian in the sense that those who make their money off the top of the system will scream bloody murder but they will be so discredited that they will have lost their clout by then.


I just don't think I could see myself living in a house without mirrors.

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#16 2009-09-17 9:55 am

Tallgeese
Homo loquax nonnumquam sapiens
Registered: 2000-10-17
Posts: 34923

Re: So if there's no health care reform, then ...

daemon wrote:

Somebody who knows Max B. and the Hard Centrists should view Moore's "SICKO!" and write the legislation.

Someone who isn't bought and paid for by the health insurance industry should write the legislation. Baucus should never have been allowed near this.


I still believe in liberalism today as much as I ever did, but, oh, there was a happy time when I believed in liberals.

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#17 2009-09-17 12:14 pm

freecat
Not funny online
From: West of the East Coast
Registered: 1999-04-04
Posts: 5767
Website

Re: So if there's no health care reform, then ...

ShnickyShnack wrote:

That Senate bill is a piece of crap.

How can it offer so little and cost so much? It makes Medicare Part D look budget-friendly.

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#18 2009-09-17 1:51 pm

Tallgeese
Homo loquax nonnumquam sapiens
Registered: 2000-10-17
Posts: 34923

Re: So if there's no health care reform, then ...

freecat wrote:

ShnickyShnack wrote:

That Senate bill is a piece of crap.

How can it offer so little and cost so much? It makes Medicare Part D look budget-friendly.

Tallgeese wrote:

daemon wrote:

Somebody who knows Max B. and the Hard Centrists should view Moore's "SICKO!" and write the legislation.

Someone who isn't bought and paid for by the health insurance industry should write the legislation. Baucus should never have been allowed near this.


I still believe in liberalism today as much as I ever did, but, oh, there was a happy time when I believed in liberals.

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#19 2009-09-17 2:13 pm

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

freecat wrote:

ShnickyShnack wrote:

That Senate bill is a piece of crap.

How can it offer so little and cost so much? It makes Medicare Part D look budget-friendly.

Most of the spending goes to subsidies to allow lower-income people to buy medical insurance.


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#20 2009-09-17 2:32 pm

robco
Curmudgeon
From: Sodom
Registered: 2004-12-04
Posts: 8319
Website

Re: So if there's no health care reform, then ...

While doing little to lower the cost of that insurance.


It is an odd thing, but every one who disappears is said to be seen at San Francisco. It must be a delightful city, and possess all the attractions of the next world.
- Oscar Wilde

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#21 2009-09-17 5:36 pm

Bat
DOS über alles
Royal Wombat
From: Björk, Björk
Registered: 2001-05-14
Posts: 29797

Re: So if there's no health care reform, then ...

When the CBO opines that co-ops 'seem unlikely to establish significant market presence in much of the country' etc., that's a sign that part needs to be rethought- but there may not be time.


If all economists were laid end to end, they would not reach a conclusion - George Bernard Shaw

"Fire up a colortini, sit back, relax, and watch the pictures, now, as they fly through the air."

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#22 2009-09-17 5:55 pm

ShnickyShnack
::: title edited due to Satanic influences :::
From: Rockin' out
Registered: 2001-05-25
Posts: 22237

Re: So if there's no health care reform, then ...

robco wrote:

While doing little to lower the cost of that insurance.

That's right.

In other words it proposes to use nonexistent tax dollars to fund a health care system that's already sending the country toward bankruptcy.


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#23 2009-09-17 5:55 pm

robco
Curmudgeon
From: Sodom
Registered: 2004-12-04
Posts: 8319
Website

Re: So if there's no health care reform, then ...

I was a member of one of the co-ops mentioned. It's true that theoretically members run the show, but in reality, the member board makes few decisions. They do hire the execs, but they run the day-to-day business. Since they do compete in the marketplace for staff, supplies, etc, they wind up paying market rates. While they have low administrative overhead, the cost of providing care is pretty much the same. They did lower costs in ways people didn't like. Seeing an actual physician for more than a few minutes was rare. Basically you had a single physician (FP or internist) working with a staff of about 4-5 PAs and RNPs. Most everything was handled by the PA or RNP who would call in the doctor if something seemed wrong. It basically turned into Kaiser. You can't go out of network and specialty care is hit-or-miss. The physicians are salaried however (some prefer that over FFS reimbursement) and the co-op takes care of their malpractice insurance. On the plus side, they're huge and pharmacy costs were low. But getting a referral to a specialist was sometimes a pain. My mom hurt her back and they kept giving her stronger and stronger pain meds for almost a year before they finally sent her to an orthopedist. The co-op sounds nice, but in practice, it's basically Kaiser Permanente. The upside is that they do have a vested interest in prevention and wellness and have some of the best programs around. For example, they offer classes for folks with diabetes to manage their condition to prevent complications and pay for all testing supplies and insulin. They also cover smoking cessation and offer classes in healthy eating, etc. So basically it's good preventive care, OK routine care - but if something goes really wrong with you, it's a hassle getting to see good specialists.

GHC and Kaiser came about under unusual circumstances. Replicating their success would be challenging to say the least. Most people don't like the idea of managed care.


It is an odd thing, but every one who disappears is said to be seen at San Francisco. It must be a delightful city, and possess all the attractions of the next world.
- Oscar Wilde

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#24 2009-09-17 6:20 pm

daemon
blank prince HAL
From: Golden Road (Out of Perdition)
Registered: 2008-01-03
Posts: 3784
Website

Re: So if there's no health care reform, then ...

Bat wrote:

When the CBO opines that co-ops 'seem unlikely to establish significant market presence in much of the country' etc., that's a sign that part needs to be rethought- but there may not be time.

REthought?! Baucus' delay wasn't enough time to think things through? That gang of sux gave us the summer of hate.

Four committees have passed four bills already. ALL have a public option version, to my knowledge.


Brigid O'Shaughnessy: I haven't lived a good life. I've been bad, worse than you could know.
Sam Spade: You know, that's good, because if you actually were as innocent as you pretend to be, we'd never get anywhere.
http://sitruc.blip.tv/file/2661495/

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#25 2009-09-17 6:29 pm

Bat
DOS über alles
Royal Wombat
From: Björk, Björk
Registered: 2001-05-14
Posts: 29797

Re: So if there's no health care reform, then ...

daemon wrote:

Bat wrote:

When the CBO opines that co-ops 'seem unlikely to establish significant market presence in much of the country' etc., that's a sign that part needs to be rethought- but there may not be time.

REthought?! Baucus' delay wasn't enough time to think things through? That gang of sux gave us the summer of hate.

Four committees have passed four bills already. ALL have a public option version, to my knowledge.

Passing Committee's just the first hurdle, but I hope some get further. What's the breakdown, House/Senate?


If all economists were laid end to end, they would not reach a conclusion - George Bernard Shaw

"Fire up a colortini, sit back, relax, and watch the pictures, now, as they fly through the air."

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