Why, oh why, do they never listen? I've been warning the Democrats since 2005 (not that I'm anybody special) that an individual mandate without meaningful out-of-pockets limits would be a hardship for working Americans -- and that eventually Republicans would figure out how to call it a tax hike and run against it.
Now Politico writes:
... Questions about tax increases are part of an emerging Republican line of attack. Senate Republican leader Mitch McConnell on Sunday said "... We don't think it's a good idea to raise taxes on small businesses and on individuals in the heart of a recession."
Democrats: They have ears, Lord, but they hear not. It was especially disappointing to see the President defend himself from these charges by claiming they're not new taxes ...
Obama's New Taxes
... when they are. It's bad enough that the Baucus bill says "the consequence for not maintaining insurance would be an excise tax" and the House bill requires a "tax on individuals without acceptable health care coverage." I could defend these provisions if there were a strong public option and other cost containment measures. That might make this mandated insurance affordable to middle-class Americans.
But those things aren't there.
Now PresidentSenator Olympia Snowe is reiterating the position that 13% of income is an acceptable maximum out-of-pocket cost for health premiums. That is financially devastating for families at 400%-700% of the Federal Poverty Level (and many at higher levels). Since the President has ceded extraordinary power to her (as Robert Reich explains), this is likely to become law if she so chooses. It's a windfall to the insurers and a body blow to working Americans (what should they sacrifice? That savings account for their kids' college education?)
The President also spoke up in favor of the tax on "Cadillac benefits," which is becoming his other new tax. This idea might have some merit if a) it prevented insurers from passing on these new taxes to their customers and b) the tax was actually based on the benefits being offered. If most Americans pay deductibles and copays, the portion of a deluxe plan that covers 100% of these out-of-pocket costs might legitimately be considered taxable income. (Although even then union plans should be excluded, since many workers gave up wages for their benefits.)
But this new Democratic tax is based on plan cost, not benefit design. So plans with lots of older, costlier Americans will be more highly taxed than others. That means it will hurt aging workers financially while encouraging businesses to discriminate against them in hiring. It's also indexed to general inflation, which rises much more slowly than healthcare costs. That means more and more plans will be taxed every year. As the law is currently designed, those costs are likely to go straight back to the consumer.
Let's not pretend Democratic health reform doesn't include new taxes -- and mandated fee payments to highly profitable private companies. If their bill passes in this form they'll pay a heavy political price for it. And they'll deserve it.
We're Not Swiss
While we're at it, let's stop defending this proposal by using Switzerland as an example, as Paul Krugman and a number of others do. We're not Switzerland. First or all, Switzerland is a wealthier country: OECD figures show that the median household income there in 2007 was $60,288, versus $50,233 in this country. Despite their greater prosperity, roughly one-third of its citizens receive government assistance paying premiums. (Granted, they don't have an employer health insurance system and we do - but that system is eroding quickly.)
All insurance companies in Switzerland are non-profit. What's more, the Swiss system includes rigorous price controls that would never pass ideological muster in the US. And to top that off, the Swiss system includes strong managed care components that Americans would find unacceptable. The Swiss can't "choose their own doctor," to use the President's catchphrase.
Needless to say, the Swiss pay much less in healthcare costs than we do, and their costs are rising much more slowly. But our leaders don't intend to do things the Swiss way. You can't impose a Swiss-style mandate on a system that is more expensive, has less control, and is profit-based.
Next topic.
Reverse Triggers
Sen. Snowe (sorry about that "President" crack - "Czar" might be more appropriate) is bringing up triggers again, reportedly with the help of Rahm Emanuel. So, apparently to woo her, the President is opening the door to the idea that a public option would be "triggered" in states where "affordable" healthcare isn't available through the private market.
This is very bad, in two ways: First, it's a state-by-state solution, not a national one. A state-specific public option will be costlier to maintain and run. That means it will cost the rest of us more money. Secondly, what's Sen. Snowe's definition of "affordable"?
Thirteen percent of income!
They have ears, Lord, but they hear not. Fortunately for our sanity, we have the satirical (also politically incorrect and pretty foul-mouthed - but funny) blogger Bobblespeak. Bobble posted this "tweet" yesterday: "Reverse trigger: public option is created, to be taken away from the people if the insurance industry completely fix US health care by 2012."
Now that makes sense! But wait ... a public option is optional by definition. If the insurance industry fixes US health care, nobody will join the public plan. That means that it will die (or "sunset," as lawmakers like to say.) That's a good enough "reverse trigger" for me.
It should be good enough for Olympia Snowe, too.
RJ Eskow blogs when he can at:
A Night Light
The Sentinel Effect: Healthcare Blog
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Dylan Loewe: Open Letter to Sen. Blanche Lincoln
During your 2010 campaign, you are going to be accused of voting for a socialist government takeover of health care, regardless of whether or not you support the public option. That frees you to vote your conscience.
Health Care Bill: Baucus Senate Legislation Finally Unveiled
Baucus Bill Sticks To Pharma Deal That Supposedly Wasn't Struck
Baucus health bill changes to address Dem concerns
Good or Bad, Baucus Bill a Start
Baucus Bill: Health Reform That Isn't
How Much the Baucus Bill Costs -- and Why the Numbers Differ
Lets take a normal family of college graduates starting out and making a decent living. This would mean both of the two parents making around 35k, a very middle of the road income for a college graduate (especially in high cost states like California or New York where much of the population now lives). 80k, of course, removes all government assistance so its straight up 13% of income.
For this family that means 9,100 in cost or around 800 dollars a month. I have no idea how that fits into any middle income budget, it sure doesn't fit into mine.
Lets look at a normal 70k family budget. You have 1,000 per month for payments/insurance on 2 mid range cars, 1,500 for rent in a modest 2 bedroom apartment (assuming very small family here) near job centers like LA, 500 for student loans for 2 graduates, 500 a month for a modest family food budget and about 20,000 in taxes and yearly fees not counting sales tax. Thats 1000+1500+500+500+1700 per month or 5200 in just basic fixed bills. Add in 800 for insurance and that puts the monthly expenditures up to 6,000 or 200 dollars MORE then monthly income, thus pushing the family into deficit territory every single month.
"The otherwise uninsured would be required to buy coverage, not because they were even tangentially engaged in the "production, distribution or consumption of commodities," but for no other reason than that people without health insurance exist. The federal government does not have the power to regulate Americans simply because they are there. Significantly, in two key cases, United States v. Lopez (1995) and United States v. Morrison (2000), the Supreme Court specifically rejected the proposition that the commerce clause allowed Congress to regulate noneconomic activities merely because, through a chain of causal effects, they might have an economic impact. "
President Obama has the House, the Senate and the White House, and he can't
get this through. He has spent most of his time on his knees to the Republicans,
who have proudly touted, they want to make this his "Waterloo."
President Obama has shown ZERO leadership on this.
He has shown ZERO fight and no passion. The media blitz also lacked
fight, passion and push. So here we are...
Is the "Decider" going to be a Republican from MAINE - MAINE?
As I have said, over and over and over, we need an FDR, an LBJ - and we
have a Dukasis (sp) sans the helmet.
Because by every measure, we are *far* from the wealthiest country in the world. Dead last in infant mortality in the 1st world. a dismal 39th in health. And we are certainly not the richest in terms of individual family annual income.
Sad, sad, sad, and politicians fiddle while we sink.
Now, seeing many of the same people who were mocking me echoing the same sentiments (if this passes I'll vote Republican/third party/won't vote), I'll resist the urge to say "I told you so" and just urge you, instead, to call your representatives and the President and express those exact same opinions to them.
If enough of us make it clear just how extremely politically expensive this Trojan horse of a "reform" bill will be for the Democratic party they just might -- MIGHT -- change course.
In the long run, I care little for the fate of the Democratic party (I'm starting to think that they're on the verge of becoming almost as irrelevant as the Republicans). What I care a great deal about, however, and am STILL willing to fight tooth and nail for, is affordable health care for all.
they get better, and this is just another example. Healthcare costs going up the way they
are, in ten years it's going to be really horrible, and a lot of damage will have been done
along the way. But that's ten years from now. Maybe five years from now, we'll still be
saying that. Are we not like frogs, put to the boil?
He has made private commitments that = giveaways to insurance cos and BigPharma (notice they aren't complaining about any of the bills.)
And he says a lot of things that sound like change, but his actions, at this point, speak volumes about what he will actually do.
Failure to reform = his failure to lead.
This game is being played exactly as he wanted it to be played. Public Option will now be swept off the table also, as it is the only threat left to insurance mandates, and it is a weak solution AT BEST to the overall problem we face as a nation.
We have mandated insurance and fines if you don't pay.
The plans are concocted by the insurance companies and approved by the state. Catastrophic
is not considered adequate, and so you are fined if you buy one of these.
More importantly, the plans are sliced,diced, tiered and steered so the poor get little choice of doctor or hospital. Mass General and the other prestigious hospitals are for the rich.
Second, if you make one penny over 52K for a family of 4, you get no help from the state.
Third, the plans discriminate on the basis of locale, and age. The Baucus plan says insurance companies can charge up to 5X more for older Americans than they do for younger ones.
Fourth, the newly mandated have inundated the not for profit hospitals. The state has cut Medicaid and Medicare reimbursements to precisely the same population that have been ordered to get insurance and whom the taxpayers of MA are supporting. Boston City is suing the state.
Several thousand MA residents are still without coverage because they can't afford any of the plans. The cheapest for two costs $775 per month.
We are stuck with a tab that = more than 20% of our income.
Meanwhile, insurance cos and their executives continue to make obscene profits and salaries.
I don't know why the media doesn't tell it lie it is.
A small but important correction. The 'fine' is that you lose
the personal deduction on your state income tax, which will
cost you around $500 per year. Health insurance premiums
can cost you at least that much per MONTH. So, in effect, the
MA deal is you face a modest tax increase if you DON'T get
the insurance. And a lot aren't, which provides a modest tax
revenue increase for the state.
It looks like the Congress has found this mistake and decided
to fix it by coming up with a much larger penalty, which MA has
considered but does not have the will or means to implement.
Nobody cares if USA is "37th in Health Care". Nobody cares where the trigger point is. Everyone understands that the way to stall Senatorial Stupidity is to shout opposition to percieved "Tax Hikes!". At that point all the beauraucratic geeks get caught up in endless arguements over "Is Not - Is Too!" and America lives to see another day!
I'm trying to figure out what your argument is based upon... actually I'm trying to figure out what your argument IS? What's your solution? What should we shout that will not end up in "endless arguements over "Is Not - Is Too!" " ? I think the purpose for revealing the truth is alert voters about who is selling them out and how. One must reveal the deception practiced by our elected officials.
"percieved" tax hikes ??? Unfortunately the perception is based on rather sordid reality. Not only the Obamucus plan imposes new taxes, it imposes them for the benefit of private entities. These entities are not elected, they don't vote before increasing taxes, they simply... do it. It's taxation without representation and you are invited to study what that is.
I wonder if anyone has done any breakdowns on income, weight, political orientation, and state--what I'm getting at is that it seems to me that a lot of less-educated people with lower incomes may lack insurance and also have disproportionally high degree of medical issues due to obesity, smoking, etc, bad health practices associated with low education and income levels etc. So if the section of the society with bad health habits is also the underinsured section, then extending subsidized insurance to this group could actually be more expensive than expected. Ironically, I suspect there are a good number of rednecks pissed off at "liberal elites" who are themselves well-insured and are trying to extend health insurance to said rednecks. I also think its relevant to look at welfare and think of the tragedy of the commons--will offering too much health care to those who are not really used to taking care of themselves well lead to overuse of the system or dependency on its ability to "repair" health problems. If someone else is paying to fix my car, why shouldn't I just skip oil changes--after all, I can get a new engine free! It's analogous to moral hazard in some way that eludes me at this hour of the night.
Again, this is true under any health insurance system, However, as long as you maintain it your automobile can sit in a garage for years and still be ready to roll. But the human body sometimes breaks down accidently, and sometimes because of traits inherited from parent or grandparents. You can avoid smoking and all other external potential causes for cancer, and still wake up one morning with leukemia - a cancer with a high degree of genetic involvement.
Does a civilized society have a responsibility to collectively assist in the alleviation of the suffering of individuals, especially when there is a high risk that such suffering is caused incidentally or accidentally where the individual's responsibility is not at issue? I believe it does.
The best alternative? A Republican filibuster, cots in the Senate chambers, new elections to follow up on replacing nonperforming bought-and-paid-for Senators of the present lackluster lot. And of course, daily news casts of the Republican health care filibuster. The Rethugs know that the angry vote. The Democrats should learn the same politics.