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Paul Abrams

Paul Abrams

Posted: September 21, 2010 12:54 AM

On September 23, 2010, key provisions of the Affordable Healthcare Act (aka, Health Care Reform, or "HCR") become active.

As of that date, it shall be illegal for insurance companies to drop your coverage when you become ill. It shall also be illegal for insurance companies not to insure your children due to pre-existing illnesses. And, parents will have the right to insure their children up to age 26 under their policies.

The day should not be allowed to pass, however, without calling the Republicans to task. With votes.

I propose "Sense of the Senate (and House)" Resolutions that read as follows:

"The Senate (House) joins the American people in celebrating September 23, 2010, as the day when insurance companies will no longer be allowed to drop peoples' coverage when they become ill, or to refuse to insure children due to pre-existing illnesses, and when parents will have the absolute right to insure their children up to age 26 under their policies. This is a day, long overdue in America, that the people shall have a new birth of freedom against the dictatorial powers of health insurance companies".

Bring this to the floor of each chamber for a vote. Yes or No. Up or Down. The American people or the insurance companies.

Let us see what the Republicans do. If they vote in favor of this resolution, they will have associated themselves with President Obama's health care reform, and alienate their base. If they vote against it, they will have voted for the insurance companies and against the American people.

We know where Rush, Beck, Palin stand. I suspect we also know where Senator Jim DeMented (R-SC) stands. On the House side, we can probably predict where the "Tea Party " caucus will wind up. Would it not be great for Taryl Clarke (Bachmann's bright, reasonable and wonderful opponent) to have this albatross to hang around Bachmann's neck?

There is one additional benefit. It would convey to the people of this country that Democrats are indeed proud of what they have achieved. Not perfect, but a giant first step. Something that can be built upon in the future. Until now, Democrats have conveyed the message, "we didn't really mean it". This would provide them the opportunity of reversing that perception.

Of course, Ms. Bachmann et al. will refer to something in the Constitution -- which they probably have not read, and certainly do not understand -- and rail against the federal government.

But, using federal power to free people from the dictatorship of the insurance companies? Providing health care security, guaranteeing children's coverage, enabling 26-year-olds to be covered under their parents' plans.... versus some abstract and totally false reading of the Constitution?

That's an argument we can win -- big time.


 
 
 
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03:06 PM on 09/22/2010
Health care explained simply. The basics. All you need to know. If that is true why did it take 2000 pages to make the bill. When the bill was signed nobody had really read all of it. Now we are suppose to believe that it is all very simple, and that these people have read every bit of the law and have analyzed every situation.

Health care needed reform but not like this. This is bill is going to create problems for many years to come.
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RyanC1384
12:31 PM on 09/22/2010
If you are still confused about what this bill is all about check this out:

The non-partisan, non-profit research organization the Kaiser Family Foundation, produced a helpful 9-minute cartoon video explaining the basics of the law.

http://www.doubledutchpolitics.com/
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Lee Johnston
Just my opinion I could be wrong
12:24 PM on 09/22/2010
I have read several articles about all these new regulations that will come into effect soon. My first thoughts are that all these sound reasonable. My concern is that were all these policies really needed. I don't know about other states but in mine, Insurance Companies cannot drop your insurance if you get sick. Actually I never heard of this happening. There are limits to what they will pay and what procedures are covered but I've never known anyone dropped by their insurance for getting sick. Also how can your children have pre existing conditions if you insure them when they are born? Maybe you mean if you change insurance companies pre existing conditions cannot be denied. If you wait till your sick to get insurance that seems unreasonable to expect a company to insure you after the fact. My insurance covered my children for as long as they were in college till the age 24. If you are still supporting your 26 year old children you have more troubles than just insurance.
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aceempress
12:10 AM on 09/26/2010
Actually, I personally know people who have been dropped from their insurance because they reached the "cap" due to cancer. My own daughter was denied insurance from Blue Cross after she graduated from college due to a pre-existing condition. I cut my finger this year and had to have stitches and nerve repair. This was the first claim I've had since I gave birth 22 years ago. My insurance companies called me numerous times to try to find a way to blame it on my employer, or anyone else so they could deny payments. Just because you personally don't know anyone affected by our draconian health insurance policies doesn't mean they don't exist. Now, I'm thankful I can cover my daughter while she finished law school. Thank you, Obama.
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R Car
09:23 AM on 09/22/2010
Finally the myths about healthcare reform should go away thanks to Consumer Reports. Get expert, unbiased, and fact-based information on healthcare reform on what the GOP and Tea Parties refer to as "Obamacare":

http://www.consumerreports.org/health/insurance/health-insurance.htm
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jcaunter
Profile: schizoid, INTJ, IQ145
09:11 AM on 09/22/2010
Give me a strong public option and I will find a reason to vote for your Democrats again.

"If we allow the perfect to be the enemy of the good, we'll never get anywhere..."

-Paul Abrams

"Ultimately there is no dividing line between Wall Street and main street."

-Barack Obama

Seems to me that with the "enemy of the good" excuse you Democrats have figured out (you think) the perfect way to shovel even more money at your corporate buds without (you think) totally alienating your base. Well, you're calculations were wrong; the base isn't as dumb as you had hoped it was. You have alienated your base and you all are about to be toasted in November. No amount of elaborate sophistry is going to change that fact.
11:57 PM on 09/21/2010
I'm pretty sure they've already chosen.
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Michael Ives
09:10 PM on 09/21/2010
But, using federal power to free people from the dictatorship of the insurance companies?
^Or having insurance companies write the legislation and feign mild agitation at the unfairness of the bill. How about we quit listening to the squawking of both parties and understand bowing before the top-hat wearing cigar wielding robber barons who WRITE such legislation is intolerable; furthermore, representatives who allow such naked fascism and yellow-journalists who endorse blatant lies for the sake of political allegiance should have their deception held to flame.
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Paul Abrams
08:16 AM on 09/22/2010
You're right, the bill was flawed. But, it is much better than what we've had. The tectonic tensions created by the bill will compel future changes--but only if we stick with it, and kick the can down the field. If we allow the perfect to be the enemy of the good, we'll never get anywhere--as we had not for the last 100 years!
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LesleyAnne
05:48 PM on 09/21/2010
Today two large insurance companies announced that they are dropping children-only coverage in several states. They will continue to find ways to wiggle out of losing their large profits and game the system as each portion of the new health care law takes effect in the coming years. Too much was compromised in this law when it was being passed.
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R Car
09:22 AM on 09/22/2010
Why are health insurance companies needed anyway? They are paper pushers, they are not providing a tangible service, they are just like financial institutions who provided students loans, they are middlemen. Why can't an agency of the federal government provide this service? It would be cheaper because we the people, as share holders of the federal government are not looking for hugh profits for providing healthcare insurance.

Finally the myths about healthcare reform should go away thanks to Consumer Reports. Get expert, unbiased, and fact-based information on healthcare reform on what the GOP and Tea Parties refer to as "Obamacare":

http://www.consumerreports.org/health/insurance/health-insurance.htm
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parlimentMike
Don't settle for less evil, demand good
01:20 PM on 09/21/2010
Er, the Democrats cemented Insurance's interference in health care. We're further from reform than before we voted for Change. I don't buy my car from my grocery store, how is it the Dems think I should be buying my health care from a financial institution?
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Cleverboots
12:00 PM on 09/21/2010
Here's to Health insurance reform, the appointment of Elizabeth Warren and the first of many such forward steps to help the American consumer!
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FoonTheElder
Always choosing between the lesser of two evils
11:28 AM on 09/21/2010
First of all, a single payer health care system would get rid of the insurance mess and could save $1 trillion per year ($3200 per person x 310 m) by aligning U.S. costs with the rest of the developed world.

The games that insurance companies play when forced to take pre-existing conditions, is to jack the rates up even more than they already have, to pay for it.

Why is the system an expensive mess?

"Breaking Down “Additional” Spending in the U.S.
When McKinsey’s researchers analyzed health care spending in different countries they adjusted for the fact that more prosperous countries will invariably spend more on medical care. But even after taking higher per-capita income in the U.S. into account, they found “additional” (or excess) spending in the U.S. concentrated in five areas: hospital inpatient care; outpatient care, drugs, administration, and insurance(in that order), with inpatient care and outpatient care accounting for 80 percent of additional spending. (Pricey drugs and devices administered in a hospital or outpatient setting, show up on hospital bills).

Looking at the major components of our health care system, MGI analysts found the main sources of higher spending: “Input costs—including doctors’ and nurses’ salaries, drugs, devices, and other supplies, the profits of participants in the system--explain the highest proportion of additional spending –or $281 billion.” (Note, these are 2005 numbers.) “Inefficiencies and complexities in the system’s operational processes” add another $147 billion. Finally, administration, regulation and intermediation cost another $98 billion of excess spending.” 

The report goes on to note that our fee-for-service payments to physicians encourage them to do more and see more patients. U.S. doctors see, on average, 1.6 times more patients than physicians in other countries. They also are paid more: in other developed countries specialists earn an average of 4 times GDP per capita, while generalists earn 3.2 times GDP; in the U.S. these numbers rise to 6.6 and 4.2 respectively.

McKinsey observes, in our for-profit system, “physicians frequently co-own facilities, such as ambulatory surgical centers, diagnostic imaging centers and diagnostic testing and procedure laboratories, and receive a share of their profits. The profit sharing counts for another . . .  $8 billion of higher spending.”

In hospitals, the cost per day is 2.6 times higher than the OECD average, largely because we emphasize “acute care,” and “complex surgeries.” Many U.S. patients receive far more aggressive, intensive care than their counterparts abroad: One in five is likely to die in an intensive care unit (even though 90 percent would prefer to die at home.)  Yet, McKinsey confirms on average, the quality of care is no better, and we don’t live as long as the citizens of many other nations."

http://www.healthbeatblog.com/2010/09/no-obesity-is-not-driving-health-care-inflation-part-1.html
12:42 PM on 09/21/2010
So the solution is to turn the whole thing over to the Government that is now wasting $500,000,000,000 in medicare?
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CTDFalconer
Think twice, post once.
01:15 PM on 09/21/2010
You seriously call Medicare a waste? That definitely puts you on the fringe.
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FoonTheElder
Always choosing between the lesser of two evils
02:10 PM on 09/21/2010
Medicare takes care of the most expensive health group, the elderly, at a price that an insurance company wouldn't touch.

Insurance companies would charge $20,000+ a year if they had to cover the elderly, which is exactly what the Republican budget proposal wants to do when they propose to eliminate Medicare.

“"The Roadmap for America’s Future, which Rep. Paul Ryan (R-WI) calls for radical policy changes that would result in a massive transfer from the broad majority of Americans to the nation’s wealthiest individuals.

The Roadmap would give the most affluent households a new round of very large, costly tax cuts by reducing income tax rates on high-income households; eliminating income taxes on capital gains, dividends,interest; and abolishing the corporate income tax, the estate tax, and the alternative minimum tax. At the same time, the Ryan plan would raise taxes for most middle-income families, privatize a substantial portion of Social Security, eliminate the tax exclusion for employer-sponsored health insurance, end traditional Medicare and most of Medicaid, and terminate Children’s Health Insurance Program.

The plan would replace these health programs with a system of vouchers whose value would erode over time.

Analysis by the Urban Institute-Brookings:

The Ryan plan would cut in half the taxes of the richest 1% of Americans The higher one goes up the income scale, the more massive the tax cuts would be.

To offset some of the cost of these massive tax cuts, the Ryan plan would place a new consumption tax on most goods and services, a measure that would increase taxes on most low- and middle-income families. About three-quarters of Americans would face tax increases.

The federal debt would soar to about 175 percent of GDP by 2050."

http://www.cbpp.org/cms/index.cfm?fa=view&id=3114
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Paul Abrams
01:19 PM on 09/21/2010
To boil down what you write to a simple concept, there are two major drivers of overspending (for the same outcome) in our healthcare system: i) the intensity of care (that is responsible for about 50% of the overspending); and ii) the structure of the system. There are other "cuts" at the same analysis: we spend 80+% of the total amount of money for an individual's healthcare in the last year of their lives, so a more realistic perspective would save money and not change outcomes--a very similar analysis to the "intensity of care" comment above. And, 2/3ds of medicare payments are spent on 10% of the medicare population--much of this is due to (ii), the structure of the system.
The Affordable Healthcare Act is far, far from perfect. But, it is a necessary first step.
Moreover, it includes in it an experimental program called "Independence at Home" that changes the structure of the system for elderly patients who will be seen preventatively at home by nurse practitioners and physicians assistants, who can electronically transmit information to physicians and care for the patient in their homes. By reducing visits to emergency rooms and reducing hospital admissions, Medicare should save about $150B over a 10 year period, and the individuals will get better care and have better outcomes.
10:24 AM on 09/21/2010
It will be interesting, as the writer indicates, to see what the Republicans do. Unfortunately, for Democrats like me, we already know what the Obama Administration has chosen, and they have done the bidding of the health care industry. After abandoning universal health care and jettisoning the public option without a backward glance, the President and the Congress then handed control of the new health care program completely over to the health care industry. Once again, it is difficult to see much of a difference between the parties on this issue, and it is difficult to get excited about an issue your own party mishandled.
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Paul Abrams
01:26 PM on 09/21/2010
I am as disappointed as you are that healthcare reform did not go further. But, after trying for 100 years to do the obvious, it was clear that the entrenched interests were and remain very very powerful. Let us not let the perfect be the enemy of the good. There is a lot, a lot, in this bill that is very good, including covering 33 million more people who will no longer be jacking up your premiums and mine because they get too sick before they are treated. The bill pilots a program called "Independence at Home" that will revolutionize care for the elderly--in their own homes, at much less cost, and with improved outcomes. It is a giant leap forward, but not the endgame.
Anyone who studies this knows that in several years the pressures left in the system will require relief--in the form of some public option. Indeed, a state has the right to devise their own public option and put it into effect in 2014, which is not so far away. It will take them a year or two to devise it and get to ready to go anyhow. Although you might argue that they could have done that anyhow, they really could not, because the were no subsidies for the less well-off and no universality. Now a state can use the benefits under this act and develop their own public option.
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R Car
09:26 AM on 09/22/2010
Kenhamlett, if the votes are not there, they are not there. Unlike the GOP, dems don't march in lockstep.
08:48 AM on 09/21/2010
Great idea! One that a political party with backbone and cojones would run with. What a shame that doesn't describe today's Dems.
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ESerafina42
Abandoned by wolves, raised by Republicans.
10:40 AM on 09/21/2010
Amen - one reason I refuse to join the Democratic party, though I would choose them if someone forced me at gunpoint to pick one.
11:01 AM on 09/21/2010
I am a Democrat and proud of it (most of the time). But the failure of party leaders to advance our narrative rather than reinforce the other side's, to consistently and proudly fight for our values, and to take and stay on the offensive against the Republicans as we approach the election is maddening.
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LesleyAnne
06:01 PM on 09/21/2010
So you would rather vote rRepublican and tea party? Let me know how Rep. Paul Ryan's (a Republican) tax bill suits you in the next few years if they get back into power. Unless you are a very rich person, you will be hurting.