(no subject)

[lagilman]

When is a health care bill not a health care bill?

When it provides aid and comfort to the insurance companies, not the insured.

Having gutted reform, Leiberman now supports it? Um, right.


*winds up to Hawai'i, and bitchslaps everyone in DC*

Comments

[bentleywg.livejournal.com]

I'm not surprised. This was never a health care or health reform bill, no matter what they call it. It's always been a health insurance bill.

[lagilman]

Once upon a time, it was a reform bill. So of course our Noble Democrats had to kill that, because gods forbid they actually do what they were elected (as opposed to purchased) to do.

Of course, I also blame a lot of Stupid People who were OMG skeeered of twh communist socialist liberal plan to oh noes establish a health care standard and the Silent People who were, well, silent, even though they might have supported such a plan (or benefitted from it).

Instead, once again, the Stupid have been co-opted by the Deep Wallets, and screwed the rest of us.

/bitter

[handworn.livejournal.com]

The U.S. government does not have a good track record when it comes to grand, government-paid schemes to benefit all; California's woes are rather a microcosm of that. And I don't think it was the Right that came up with the idea of forcing people to buy insurance, which is how it mainly provides "aid and comfort to insurance companies," and which I think has some Constitutional problems as well.

[lagilman]

No, it wasn't the Right -- have you somehow missed my general unhappiness with Uncle Joe, the Senator from Himself?

[jhetley.livejournal.com]

Between this and that and t'other thing, "reform" is moving into areas where I don't know if I support it or not. There's the bit about massive cuts to Medicare, for example, to make the cost projections look better.

We're edging up on Medicare, you know . . .

[lagilman]

That was always Uncle Joe's intent, methinks. Gut it until it was unsupportable, then have it killed by people who would ahve supported something useful, and once again he's played both sides.

And nobody ever seems to kick him to the curb, despite repeated calls from the populace for exactly that to happen.

There's a reason I refuse to join either party. I hate them both.

[mizkit.livejournal.com]

People were asking, when we were in America, when we were going to move back. I started saying, "As soon as they get the health care mess straightened out," to which everybody said, "Ah, never, then." Pretty much kinda looks like that, yep.

[handworn.livejournal.com]

Pretty easy for everyone else to point to government-run healthcare when they get, for one, the benefit of the development of the techniques and drugs by the for-profit U.S. system. Not saying the U.S. system is ideal, by any stretch-- it's in dire need of many reforms that could have passed already but for extremists on both sides who think their otherwise unpassable pet ideas can be made law by hitching them to what is not objectionable-- but let's not treat the situation as if it were in a vacuum, either.

The U.S. also basically subsidizes government-run health care in the rest of the world, as well, by acting as the world's policeman and sparing those countries the cost of as much military as they would need to defend themselves, alone (or even in conjunction with Europe as NATO, sans the States). It's not an accident that the U.K.'s Public Health Service and NATO came into existence at close to the same time.

[lagilman]

The U.S. also basically subsidizes government-run health care in the rest of the world, as well, by acting as the world's policeman

And yet seems incapable of taking care of its own citizens. Am I alone in seeing there's a problem there?

[hawkwing-lb.livejournal.com]

I have wandered in from the outer internets, and (begging our host's indulgence) would encourage you to check your facts.

Correlation is not causation. And quite a bit of healthcare research is done outside the States. Certainly not the vast majority, but still, not an insignificant amount. (Pharmaceutical companies can still make money by delivering better drugs in a state-subsidised healthcare setup: the government just has better leverage when it comes to negotiating the prices. Which is good for the citizen, in the end.)

Sorry, suricattus: I'd just meant to stop by to say "I like your books!"

(And I'm eagerly awaiting the paperback publication of Flesh and Fire.)

[burger-eater.livejournal.com]

Our health care "system" will improve, but not by as much as we need. Still, it'll be a start. Once a system is created, it works and people come to depend on it, it usually grows. Medicare didn't always cover preventative care, for instance.

But damn, it takes so long to get things right in this country.

[lagilman]

I'm not sure how eliminating the lifetime caps is an "improvement" to anyone save the insurance companies....

[burger-eater.livejournal.com]

The bill falls short. Yes, absolutely. Personally, I was furious at the loss of even the weakened public option and the Medicare buy-in.

But subsidies are going to help a lot of people be covered that weren't covered before, and the insurance they get will be better, too. The exchanges will help a lot of people (they're designed to help freelancers like you, in fact). The excise tax, along with a number of other small provisions, should bring down spending.

What's more, if some version of reform passes now, it's much easier to amend and increase it. All our major social programs excluded people and had terrible compromises, but they got better.

America loses over 20,000 people a year due to lack of coverage. This reform package, as watered-down as it is, will save lives.

I still wish I could sign up for the strong public option, though.

[lagilman]

(they're designed to help freelancers like you, in fact)

I've yet to see anything that helps freelancers, honestly, and heard a lot of hurt. Can you give specifics?

[burger-eater.livejournal.com]

The health exchanges are designed to bring all the people who can't get or can't afford insurance because they are self-employed or work for a company that doesn't offer it. Currently, the individual market is a DMZ, but the exchanges (depending on their final form) will allow individual patients to pool risk.

Also, it will be a regulated market, allowing patients to compare and contrast policies, rather than take who ever will accept them.

Again, depending on how they're set up in the final law, within a few years small businesses will be able to join the exchanges, too, bringing down everyone's costs with more risk pooling. (Currently, patients who get insurance through their employer won't be eligible) If it's popular and it works, larger businesses would be able to purchase insurance there. Another option would allow employers to give patients vouchers so they can choose their own plans.

A lot depends on how the exchanges are set up: the larger they are, the more pooling and the more affordable they become. The larger they are, the better the rates they can negotiate with doctors and hospitals, making them even more affordable.

It's the exchanges where the real reform will happen. The public option was a darling of the left because we want single-payer. Medicare Part E (for "Everyone") if you will. But the creation of the exchanges puts on a path to recreating the German private insurer system, which is one of the best in the world. We'd still have a long way to go, but it's a start. And while everyone was fighting over the "government health care", this solid reform was passing unnoticed.

I agree that the ban on lifetime caps should have kept, and a strong public option (which would have been available only to people in the exchanges anyway) would have save billions of dollars. But this is what we can get and it will help people. It might even help me put my day job behind me.

[lagilman]

The health exchanges are designed to bring all the people who can't get or can't afford insurance because they are self-employed or work for a company that doesn't offer it. Currently, the individual market is a DMZ, but the exchanges (depending on their final form) will allow individual patients to pool risk.

We already have the ability, at least on a state-by-state basis, to do this -- that's how I'm part of a freelancer's group policy. However, that group is threatened by the current plan... so how is this an improvement, that I might not be able to keep my plan?


Also, it will be a regulated market, allowing patients to compare and contrast policies, rather than take who ever will accept them.

Regulated with no lifetime cap, and a requirement that even if you can't find one that you can afford, you have to get insurance or be fined. How is this the affordable health care that we need? Where is the assurance that costs will go down, rather than up, now that insurance companies have no competition save themselves (and we've seen how well that works up to now...)?


Again, depending on how they're set up in the final law and right there you have a problem, assuming that "they'll take care of it later" considering what a hash has been made of a very basic "give people afforadble options" start. "Pay you now, pay me someday maybe" isn't a plan I'm fond of, in any instance.

We've given up a lot, and so far I havn't seen anything that we've actually gained. And I am saying that, mind you, as a someone who is NOT a Progressive. I'm just really tired of people who were more than happy to take their social security and Medicare checks (either now or eventually) screaming about Oh Noes Teh Soshalisim!" with regard to a public option. WTF people, are you REALLY that ignorant?

[burger-eater.livejournal.com]

Actually, a system very similar to what they're creating on a Federal level is working pretty well in Massachussettes (that's spelled incorrectly, but I'm supposed to be day jobbing and I have to be quick). Everyone is required to have insurance. There are subsidies for people who can't afford it ($100 Billion in the federal plan) and fines for people who refuse.

MA is keeping costs at a reasonable level and the plan is doing well, even thought it only covers one state and, by conventional wisdom, that shouldn't be enough people to make it work. A national plan should do better.

The fight for reform isn't over yet, even though the Senate has a bill. There's still reconcilliation with the house, and both legislatures still need approve a combined version. Maybe they'll be able to put a ban on lifetime caps back in. Maybe they'll be able to strip out the odious Stupak amendment. None of this is fully settled yet.

It's an uncertain time. I don't know the specifics of your freelancer plan (and I wouldn't expect you to explain it over the internet) but the exchanges are designed to offer comprehensive care at a decent price.

Will you have to lose your current plan? That's the problem all health care reform has faced. That's the meme that defeated ClintonCare: people know the system is a mess but they're afraid to lose what they have. They'd rather hold on to a flawed system than trust legislaters to create a new one.

Maybe that's justified. Maybe we should be middle of the road conservatives--not the paranoid goofballs who hold of pictures of Obama with a Hitler 'stache or signs about "lyin' Africans." The regular, boring old conservatives who want to keep what they have, no matter what, because a new system might be even worse than the one that's bankrupting us and killing tens of thousands of Americans a year.

Personally, I think it will be better. Not great, by any means. This country is stingy, and progressive legislation is often awful in its original form. I don't know if you saw this editorial from whenever ago (http://www.washingtonpost.com/wp-dyn/content/article/2009/08/12/AR2009081202575.html), but progressives would have wanted to kill Social Security in its original form, too, for all the exclusions and exceptions in it (especially the ones that were designed to exclude non-whites). Over the years, though, it's expanded and improved. (It's still too stingy, though.)

It's similar to Obama's stimulus package from earlier this year. It was heavily beaten up and watered-down. It was weakened terribly, but when it passed, it helped people. Now we're looking at a second one (highway repairs and "cash for caulkers"), and there's talk of a third. If that initial stimulus had been killed because it was too weak to do everything we needed, we would be in much worse shape than we are now, and we certainly wouldn't be looking at additional stimulus.

I expect HCR to be better than what we have but not anywhere near sufficient, and I expect it to improve over time.

Getting back to work now. I hope I haven't blathered too long and didn't write something rude. I didn't intend to, but sometimes when I'm typing quickly I misjudge my tone.

[lagilman]

What I'm getting from your comments is a lot of "maybe it will be better" and "things have been worse." And a sort of cranky tone about "boring middle of the road" etc that is coming across as insulting to many of us who consider ourselves rather middle of the road, on both the conservative and liberal side (I'm not sure where you think you've plugged my politics, but you'd probably be quite surprised).

And I'm still not convinced, considering all the changes so have have involved telling the insurance companies "do what you want, no competition," how this is going to be "better" that what we already had. Specifics, please, not "well, maybe they will..."

Anyone from MA want to weigh on on that plan? I haven't been following it, being sort of preoccupied with the CT and NY ones.


And yes, btw -- am history major once-upon-time, with a focus in the 1920/30's Americana, so know about the financial scenarios of the time, Social Security, etc.

[burger-eater.livejournal.com]

Sorry. I'll bow out of the discussion.

[lagilman]

*sigh* I'm not asking/telling you to bow out, just that I'd like something specific you can point to, rather than "maybe it will." You say you think this is an acceptable plan...and I'm asking why?

Otherwise we're all just turning around in circles.

[burger-eater.livejournal.com]

I'm bowing out for my own comfort level. I have no problem at all insulting someone who deserves it (including in health care discussions (http://whatever.scalzi.com/2009/08/31/okay-then-health-care/#comment-162000)) and I'm proud of that fact that Certain People can't stand me. But when I insult someone accidentally, it makes me very uncomfortable.

Plus, my life lately = stressful.

This post (http://motherjones.com/kevin-drum/2009/12/starting-over) has a list of improvements the current health care reform bill will make. I don't think it's sufficient, but I believe it will make things better.

[lagilman]

fair enough. *hands over the plate of virtual gingerbread*

[burger-eater.livejournal.com]

::Accepts gratefully::

[smoemeth.livejournal.com]

Last night the WTNH political reporter absolutely pwned Sen. Jackass on live television. Direct quote: "Senator, you know where I am right now, I'm in Hartford. I can see the corporate headquarters of Aetna and Cigna right out my window. Can you honestly tell me that those companies have had nothing whatsoever to do with your position?"

There followed a full five seconds of absolute silence before Joe started sputtering "well, well ..." and then ended up not answering the question at all.

Pwned, I tell you. I was a beautiful thing.

[lagilman]

Can we send that reporter a holiday/thank you card? Chocolates? The undying, if unhealthy gratitude of the citizens of this nation?

[smoemeth.livejournal.com]

It was Mark Davis, in WTNH's Hartford bureau. I'm sure the address would be easy enough to find. :)