60-39. This appears to be a good sign. They may not be able to pass anything.
The problems with this bill are legion. Let’s cover a few:
1) This will explode the deficit by trillions of dollars. The Medicare cuts are a three-card monte political ploy; they will never be upheld by future Congresses. The true cost of the bill is being dishonestly hidden by starting costs several years into the plan. The actual cost to the deficit may be as high as $5T over ten years.
2) This will be a devastating blow to civil rights in America. The government will not only demand you buy insurance, they will force you to cover abortion and lots of other things you may or may not want to insure against.
3) This will stifle R&D. The more of America that works under gov’t-”negotiated” price controls, the smaller the last big free market for new drugs and treatments gets.
4) This will further cripple a weak economy. The bill requires massive tax hikes in addition to massive deficit spending.
5) This will drive premiums sky-high. There will be less incentive to buy insurance before you need it, and more incentive to consume unnecessary medical services when you have insurance. This will result in insurance increasingly only being carried by people with high medical bills, meaning premiums will need to be extremely high and insurers will start going out of business as their volume of insured falls.
Here are a few commonsense solutions that don’t involve ruinous debt, oppressive government intrusion in everyone’s lives, a collapse in medical advancement, or a massive tax hike in a bad recession.
1) Expand Medicaid. 50 million of the 62 million people who can’t afford insurance are already on it. We can cover the rest without reshaping the entire system.
2) Allow interstate competition between insurers. Why is it we can buy auto insurance from anywhere, but have pitifully few options for health insurance? Unleash the free market.
3) Give individuals the employer health insurance tax credit. Right now it’s hard for insurers to compete for your business, because you don’t have a lot of control over who your insurer is. If you weren’t paying an extra 20-40% more than you would through your employer, it would make a lot more sense to buy your own, and employers would start offering you a choice of health plan or cash equivalent.
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Your numbers on Medicaid don’t sound right at all. And I’d have to ask: wouldn’t that just make Medicaid the dread “public option” that will supposedly destroy the insurance industry?
I won’t argue with the rest as I lack the energy, but I’m pleased that now, by defeating the filibuster, we are now talking about HOW we will reform our badly broken, desperately-in-need-of-reform system, rather than whether it’ll be reformed.
Your numbers on Medicaid don’t sound right at all.
They’re actually pretty conservative.
http://www.cms.hhs.gov/ActuarialStudies/downloads/MedicaidReport2008.pdf
Estimated average Medicaid enrollment was 49.1 million people in 2007. At some point during the year, 61.9 million people, or about one of every five persons in the U.S., were enrolled in Medicaid.
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The number of people who can’t afford insurance and aren’t eligible for Medicaid is about 12M, as covered in a previous post.
And I’d have to ask: wouldn’t that just make Medicaid the dread “public option” that will supposedly destroy the insurance industry?
No, because everyone understands and accepts that Medicaid is inferior to most private insurance, and its only available to the poor. The public option is supposed to be as good as anything else and available to everyone.
badly broken, desperately-in-need-of-reform system
It’s the best health care system in the world. People are complaining it doesn’t meet some impossible Platonic ideal.
If the best in the world is me not being able to go see a doctor without paying 100 dollars per visit on a sliding scale, then I’d hate to see worse.
Indeed, “the best in the world” is a very subjective judgment. Certainly if you have excellent insurance, you have access to excellent health care. But that doesn’t make it “the best” by all measures, nor frankly does it make it the worst. But we’re driving people to bankruptcy left and right just because they lose their jobs and they or a family member get sick–which also has a very negative impact on the health market and everybody’s insurance by the way, one of the many hidden costs of our current system (in effect, a hidden, invisible tax I might add).
I recently had to have a hospital stay, unexpected. The bill ran into tens of thousands. When — not if, when — I declare bankruptcy, all of you insured people will be paying that bill for me. I’m hardly alone. Or even if I don’t bankrupt, it doesn’t matter: at my current means, it’d take many years to pay. All for a two day stay.
This stuff matters, it’s real. Everybody pays hidden taxes under the current system, if they have insurance and often even if they don’t.
And, why is it that I suspect the “public option” will be inferior in many ways to private insurance? What, private insurers can’t innovate, can’t offer more coverage for more money, etc.? I’ve heard nothing suggesting that.
The things we need to do:
1. De-Link health coverage from employment
2. Medical malpractice reform — shut down the ambulance chasers and the over-testing and defensive medicine it engenders.
3. Open up competition by allowing health insurers to cross state lines.
4. Have people take responsibility for their own health. The 3 biggest killers are heart disease, cancer and stroke. Major components of all 3 are lifestyle.
A buncha other stuff, too, but no need for multi-trillion dollar, big-gov’t reform.
-HB
Indeed, “the best in the world” is a very subjective judgment.
No, really, it is objectively better.
I recently had to have a hospital stay, unexpected. The bill ran into tens of thousands.
That’s tragic but the reality is you did get the best care in the world .
You can probably negotiate them down to a much smaller sum, then work out a payment plan that isn’t too painful. Depending on your state, you may be able to get an interest-free plan, which can make long-term payments very small.
And realize you won’t be any better off under this bill. Yes, you’ll have insurance, but it won’t be free. You’ll end up paying more in the long run, one way or another. There is no free lunch. You may end paying with your life when rationing kicks in.
What, private insurers can’t innovate, can’t offer more coverage for more money, etc.?
Private insurers can’t operate at a loss. Gov’t can.
If the best in the world is me not being able to go see a doctor without paying 100 dollars per visit on a sliding scale, then I’d hate to see worse.
Worse would be a two-year wait for a free doctor who doesn’t have an access to an MRI.
Dean, the solution to that problem is simple – sever the tie between your employer and your health insurance and nobody has to go without health care because they lose their job. Well at least in as much as it helps reduce costs of both health care and insurance because no job usually means no to a lot of things, not just health care. Bankruptcy = I got no money. Usually you get that money from a job, where you would normally get insurance too.
And I have to agree with Dave here. I don’t see how you expect your situation would be significantly different under Obamacare. The fact of the matter is health care IS expensive what with drugs, MRIs, ultrasound machines, automated vitals monitoring, etc. AND health insurance to guard against significant outlays due to hospitals stays are ALSO expensive. Please don’t fool yourself into thinking that these costs are going down by any significant amount, they aren’t.
I have a great job and I have “great” insurance. Its still a bitch sometimes, we still pay co-pays for everything, preventative care is inexplicably not covered in many cases, and yet between myself and my employer, the plan costs over $20K per year. Right now you are not paying that. Instead you pay about the same amount to a hospital. I pay by month, you pay in one lump sum. That money still comes from somewhere, and it isn’t a magic fairy.
Frankly I don’t see why you think someone else should be paying or subsidizing your health care. Nobody is subsidizing mine.
BTW, they did not defeat the fillibuster. The “fillibuster” ends when they have 60 votes to send the bill to the floor for a vote. That DID NOT happen. All they did was get 60 votes to open debate. When the debate is over and the Democrats still want to put this monstrosity to the floor for a vote, THAT is when they have to get 60 votes, including those of Ben Nelson, Mary Landrieu, and Joe Lieberman and those votes will not be there so long as a public option health insurance plan is still included.
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