Ok, Lets Pretend the Senate Bill Becomes Law

I fully expect that there will be massive changes to the HC bill.  

The unfair to 49 states "Nebraska Compromise" is gonna split this bill wide open in the House. With Stupak and his followers refusing to back down, that alone  will create an opening for many, many others to demand changes also.

This battle is far from over.

Someone earlier today wrote a snide anti union slur comment to me and laughed at Labor hero and new AFL-CIO President Trumka and dismissed him as a fat white guy with a mustache. This both shocked and disgusted me.  What kind of "liberal" would say such a thing?

Let me tell you - unions are mad at this bill and they have a right to be,  Just for starts, how can progressives not care that much of the funding for this bill comes from a 40% special tax on good employer provided plans like those provided by organized labor.  (and few others these days) I expect the AFL to fight against this attempt to pay for this bill by hurting working families.(Where did Obamas oft repeated promise to tax the super rich to pay for all this go?) And please be sure,  there will be other changes introduced, so we dont know whats coming.

I mean the chair of the RULES committee, Congresswoman Slaughter, came out against the bill, and if you dont know how our congress works - let me tell you - thats HUGE.  Many house member will demand a public option - understand this battle is not over as yet.  So save your champagne for New Years - toasting the passage of this bill is premature.  its not passed till - its actually passed - and this hasnt happened yet, so put down your glasses...

But lets pretend this bill will become the law..

We'll still be spending twice the average of OECD countries.

Nothing will be controlling co-pays, deductibles, annual and lifetime caps.

More of us will be insured; more of us will be underinsured.

With mandates to policies that have 60% actuarial values, many of us will still be vulnerable to bankruptcies driven by medical expenses.

The biggest cause of excess expense and gaps in coverage is our crazy quilt of government programs and private for-profit insurance.

A public option to our health care system is the way to bring efficiency and rationality to our health care financing.

Instead this reform strengthens the role of for-profit insurance, which will expand their political heft.

At its core, this is not incremental change, but enshrining the basis of the status quo.

States will even be forbidden to pursue waivers to create alternative funding systems, such as single payer, till 2017.

I'd be delighted that 30 million more of our fellow citizens will have some insurance,

but this is not change I can believe in.

Tags: hcr (all tags)

Comments

35 Comments

Re: Ok, Lets Pretend the Senate Bill Becomes Law

I do not understand how people can scream bloody murder about the excise tax with one breath, and then complain that the bill doesn't do enough to control costs with the next.

I truly do not understand it.

by Steve M 2009-12-24 07:19AM | 0 recs
Re: Maybe this will help.

mytholized msm spun cw

by QTG 2009-12-24 07:22AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Because the excise tax does nothing to bring costs down, it just opens new opportunities to suck revenues into a system already based on inflating costs and eating revenue.  Only real competition will bring costs down and force systems to eliminate inefficiencies and abuses.  I'm generally pleased that this bill passed, but not because I think it does what it must, because I think it can function as a basis for emendation and reform.  Our job now is to keep the pressure on those who advocated passing and fixing to do the latter.

by Strummerson 2009-12-24 08:04AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

So when virtually every economist concludes that the excise tax is just about the most effective cost control in the bill... that counts for nothing?

by Steve M 2009-12-24 08:42AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

No.  It does count for something.  I admit I overstate the point.  My understanding of these arguments is that they have an effect on creating more healthy behavior over time and cut costs thereby.  But many health conditions are unavoidable and systems that hand the keys to those who want to maximize profits, in the absence of a competing non-profit option will always seek new revenue streams.  No?

by Strummerson 2009-12-24 09:07AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Excise tax on high-cost insurance plans. The Senate Finance Committee's bill includes an excise tax on high-cost health insurance plans. Like any tax, the excise tax will raise federal revenues, but it has additional advantages for the health care system that are essential. The excise tax will help curtail the growth of private health insurance premiums by creating incentives to limit the costs of plans to a tax-free amount. In addition, as employers and health plans redesign their benefits to reduce health care premiums, cash wages will increase. Analysis of the Senate Finance Committee's proposal suggests that the excise tax on high-cost insurance plans would increase workers' take-home pay by more than $300 billion over the next decade. This provision offers the most promising approach to reducing private-sector health care costs while also giving a much needed raise to the tens of millions of Americans who receive insurance through their employers.

link

by Steve M 2009-12-24 09:10AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Sure.  But this does not address the issue of taxing the benefits of union employees who negotiated packages in good faith with management that traded pay increase for better health plans.  That's the common critique and it seems to be a sound one.  It certainly should not be a trade-off with a non-profit plan that would reduce costs by removing institutional assistance to insurance companies' profit-driven shenanigans.  

by Strummerson 2009-12-24 09:29AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

The negotiability power of Unions is not diminished. Maybe now they can negotiate for pay increases in return for not being hit by the tax. And if I'm not wrong, most of the unions not in exempt occupations with these kinds of plans work for the government.

by vecky 2009-12-24 09:41AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

The problem is that in the US atleast their is not a whole lot of difference between non-profit and for profit insurance.

by vecky 2009-12-24 09:43AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

But the unions can renegotiate now that health-care benefits over a certain threshold no longer have a favored tax treatment that makes them more valuable than cash.  The alternative, I guess, is just letting premiums continue to spiral out of control.

The tax is imposed on insurance companies, not on union workers.  If the companies want to try and pass the tax on to employers, and the employers want to try and pass it on to workers, that's not going to happen without the exact sort of negotiation that unions were formed in order to conduct.

I have much more concern about the non-union workers who have limited bargaining power to ensure that they get something in return if their health benefits are cut.  But the market isn't a complete failure in this regard.

by Steve M 2009-12-24 09:45AM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

"Two-thirds of big companies that cut health-care benefits don't plan to restore them to pre-recession levels, they recently told consulting firm Watson Wyatt. When the firm asked companies that have trimmed retirement benefits when they expect to restore them, fewer than half said they would do so within a year, and 8% said they didn't expect to ever.

Changes like these are reshaping employment in America, injecting uncertainty and delivering the jolting news that pay can go down as well as up. The changes are eroding two pillars of the late-20th-century employment relationship: employer-subsidized retirement benefits and employer-paid health care.

Even as Congress wrestles with how to extend health insurance to more Americans, and considers putting pressure on employers to offer coverage, some companies feel they have no choice but to pull back -- dropping health plans or weighing such a move.

[snip]

The percentage of employers offering health-care benefits is 60% this year, down from 63% in 2008 and 69% in 2000, according to the Kaiser Family Foundation.

In a survey by Hewitt last winter, 19% of large employers said they planned to move away from directly sponsoring health-care benefits over the next five years.

In the meantime, workers' share of health costs is headed up. For next year, 63% of employers that offer health coverage plan to increase employees' share of the expense, according to a survey of 1,500 employers by another consulting firm, Mercer."

http://emptywheel.firedoglake.com/2009/1 2/17/the-cadillac-turned-chevy-salary-in crease-myth/

by bruh3 2009-12-27 04:04PM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Follow up

The above link discusses the impact of tax on higher end health care plans from employers.

The specific quote frames the issue for me as this, and something that is a concern: Benefits gains will be kept by the employer, while higher costs due to a lack of a) subsidies for the middle class and b) lack of cost containment in reform will result in higher costs passed on to the middle class along with continued stagnant wages.

What the tax is trying to get at, as the link suggests, is the issue of employer based health care, but it does so in a way that is flawed in that relies on employers to pass on savings and costs, when they may just pass on cost.

by bruh3 2009-12-27 04:10PM | 0 recs
Re: how come they

a) Steve is not a fan boy. He just disagrees. I think however he tends to take the party line as correct whereas I tend to question it as being propaganda or spin. For example, I mentioned my issue with the CBO. At first, I was like him. Trusting of their numbers, but when they made that statement about the MLR, that raised the red flag for me, and I did some more research to realize that they are not as good as they are hyped to be. It is good to numbers from the CBO, but we should not overestimate their value.

b) I've never heard of the website. Honestly, I am not interested in the personality battles here. I will defend myself against being attacked but you and I are not on the same page regarding why getting beyond attacks matters. It matters with regard to discussing the issues. Their goal is to distract from discussing the issues.

by bruh3 2009-12-27 05:33PM | 0 recs
Re: no, Steve is great!

I would advise that you do stop trying to argue with people who are not trying to have a debate.  When I choose to take the bait, I am normally these days trying to make a larger point. For example, when I discuss the apparent double standard that Charles has in his diary about what caused you to overreact to bad faith posters trying to attack you, the point was to illustrate how double standards in general- for parties, for people, for ideological beliefs is a bad thing rather than leave it centered on Charles decision to engage in double standards. The appropriate response if he were not trying to do so would have been to tell everyone to tone it down. However, my point is not a bout the double standard, my point is for lurkers who may read what he is saying. I make the point that this double standard analysis is exactly why we see the Democrats doing what they do. That's a far more important issue to be discussing. He is not going to respond. He rarely responds to me because I am not one of the "savvy." But it is not relevant to the my posts that he respond. I am simply getting out a counter argument. The problem with your arguments is that they tend to clutter up the place and say very little other than responding emotionally . HEre with steve calling him a fanboy just because you disagree with him- for example- is emotions.

by bruh3 2009-12-27 08:55PM | 0 recs
Re: but id never call steve a fanboy

this is just a place to blog. Don't take it anymore seriously than that. This is my one little bit ofother activism that I do considering that I don't have time to do much else due to my other aspects of my life. My advice is to do as you said you were going to do and focus on writing your diaries and constructive conversations. I apologize for mistaking you for calling steve a fan boy.

by bruh3 2009-12-27 09:35PM | 0 recs
Re: but id never call steve a fanboy

i should point out that until late summer I did more, bu tnow I am slowly getting out of politics. I am waiting to see what happens with the health care bill before making my final decision so I am nt the best reference.

by bruh3 2009-12-27 09:36PM | 0 recs
Re: no, Steve is great!

You joined on December 5th. How is it that you can reference events here when you weren't a member?

by Charles Lemos 2009-12-27 11:04PM | 0 recs
Re: how come they

a) Steve is as solid as they come. His opinions are always well formed and well presented...and he has always kept a level-head and civil tongue (I've never seen him lose his cool). If he chooses to engage in a subject you can bet he will be well versed in it. He is well respected both here and on other blogs.

b) Motley Moose is another progressive blog. It is just one of the many blogs that has branched from MyDD....Dkos is the most recognized of them. There are many who are active on both MyDD and Motley Moose. The opinions of these members are their own and they are varied...they do not represent either MyDD or Motley Moose as a whole anymore than someone who posts both on MyDD and Dkos represents Dkos as a whole. FWIW, Steve M himself is actually one of the original members of Motley Moose.

And, no, bruh, you are not anywhere near the same page as ludwigvan...not even the same chapter or book.

by Kysen 2009-12-27 11:05PM | 0 recs
Re: because we dont want

I am not a big fan of the excise tax as a means of raising revenue.  But I am a big fan of it as a means of controlling costs!  In fact, the more you look at it, the more it seems to be just absurdly good policy.

by Steve M 2009-12-24 08:43AM | 0 recs
Re: because we dont want

The avg family plan costs 13K. The excise tax hits plans over 23k. What the hell kind of benefits are you getting for an extra 10K a year? With total out-of-pocket risk for middle-income families capped at 6-8k your way better off with the new plans in the senate and house bills.

by vecky 2009-12-24 09:37AM | 0 recs
They call them Cadillac Plans

And for good reason!

by NoFortunateSon 2009-12-24 12:31PM | 0 recs
Re: because we dont want

Stop insulting people.

by Charles Lemos 2009-12-27 11:01PM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Another area I can agree with you... Richard Trumka is one of the greatest leaders in the labor movement.  I love that he got the AFL-CIO job.

In conference they need to move towards the house financing.

by labor nrrd 2009-12-24 08:33AM | 0 recs
Re: heroic bad ass

what we need is EFCA with card check

by labor nrrd 2009-12-24 10:09AM | 0 recs
lol

by JJE 2009-12-26 06:09PM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

If you remembered correctly that it was NFS, why did you then purposely accuse me of it and use this as the basis of an accusation of racism?

by Strummerson 2009-12-27 06:26PM | 0 recs
Re: my last comment b4 i go to xmas cheer

For the record, this is bullshit and I have never rated a single comment by ludwigvan in any fashion.  Another in a series of lies.

by Strummerson 2009-12-24 09:09AM | 0 recs
Re: my last comment b4 i go to xmas cheer
I rated it appropriately I think. There's something sketchy going on with that guy.
Be careful.
by QTG 2009-12-24 09:14AM | 0 recs
Stru, I agree with QTG, there's something

not right. Avoid him.

by louisprandtl 2009-12-24 03:02PM | 0 recs
The Internets don't work that way, bud

You don't want people responding to your diaries? Then don't post them.

by NoFortunateSon 2009-12-24 12:33PM | 0 recs
NFS, please see above comment. Avoid

this fellow as something does not seem right.

by louisprandtl 2009-12-24 03:03PM | 0 recs
Re: NFS, please see above comment. Avoid

Agreed, although this is the only way I can respond to you. Trolling and mental illness share a border. He has already demonstrated the ability to go into peoples' diaries and extract personal information to use against them. My advice, and to the advice of others, is to pay attention to the normal diaries, respond to them, and recommend them, and let these efforts die off the list.

by NoFortunateSon 2009-12-25 03:53PM | 0 recs
waah waah...

by louisprandtl 2009-12-27 02:33PM | 0 recs
Re: Ok, Lets Pretend the Senate Bill Becomes Law

Ludwig wrote a diary without cartoons?

by mikeinsf 2009-12-24 01:30PM | 0 recs
cool story bro

but livejournal is probably a better forum for your e-drama.

by JJE 2009-12-26 06:09PM | 0 recs

Diaries

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