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Thursday, October 29, 2009

Some Questions About Pelosi Care

Politico has a good round up of the Pelosi bill. After getting the initial news, there are several vital questions to answer.

1) What about the Doctor Fix?

That's currently not in the bill. That's a fix to make sure that doctors don't get serious cuts to their Medicare services. The projections are that the fix would cost $247 billion over ten years. It's not in the bill. The bill is supposed to be just under $900 billion. With the fix that puts the bill at about $1.1 trillion. So, will it be resolved or kicked down the road? If it's kicked down the road, when will it be resolved? If it's to be resolved, will its price tag be included in the bill?

2) How much will the fine be for not having insurance?

This is vital. If the fine is too onerous, that will a major tax to young people. If it is too weak, that gives everyone the option to not get health insurance until they get sick. Either way, there is a huge problem.

3) How big a fine will there be for companies not providing health insurance to their employees?

Once again, there are problems either way. If the fine is too small, then many companies will simply pay the fine and send their employees to the government. If it's too large, that's a massive tax on small and mid size businesses.

4) What kind of a shell game are you running?

This will cost about $900 billion over ten years. That doesn't include the doctor fix. So, how much does it really cost? It's also supposed to be deficit positive over ten years but runs deficits over the last five of the ten years. Yet, it doesn't get started until 2013. The taxes are collected right away. So, we have revenues for 10 years. We have expenses for seven years. For five of those seven years, when we have both, we run deficits. So, is the Speaker really saying that this bill won't run a deficit. That's a shell game.

5) What about abortions?

Congressman Bart Stupak is very concerned about this. What language will be in there to specifically not allow federal funding for abortions?

6) What about illegal aliens?

What sort of identification will be required to get government run insurance? Will there be specific safeguards to make sure that everyone is verified to make sure they aren't an illegal alien?

7) How exactly does any of this "bend the cost curve"?

This massive nearly 2000 page bill does a lot. What in this bill will bend the cost curve?

8)How many new bureaucracies will there be?

In H.R. 3200, there were 53. How many will there be in this bill? How many new regulators and bureaucracies are people comfortable with? How much will health care change with all these new regulators and bureaucracies?

4 comments:

Anonymous said...

1) What about the Doctor Fix?

What about it? It has nothing to do with health care reform, its something that has been passed every year without vocal opposition. Its not part of the bill, because it doesn't need to be part of the bill.

2) How much will the fine be for not having insurance?

Vital yes, huge problem no. I mean, buying health insurance costs money. Should we not buy it then?

3) How big a fine will there be for companies not providing health insurance to their employees?

I don't think this is relevant. The House bill doesn't have a free rider fine like you're talking about. It requires companies to buy insurance. There are exemptions for smaller companies though so your "small business" point is moot.

4) What kind of a shell game are you running?

I'm sure it will be hard to prove that the government is spending less than the sum total of private citizens, but its not impossible.

5) What about abortions?

Bart Stupak doesn't have the votes to kill the bill over something petty like this. And he can't filibuster because the terms of amendment and debate are set by the Rules Committee, which is stacked with Pelosi appointees.

6) What about illegal aliens?

Leaving aside the fact that it doesn't make any sense to prevent undocumented immigrants from paying for their own unsubsidized health insurance, Nancy Pelosi isn't Max Baucus. The bizarre concerns of the ultra-right isn't something I imagine Pelosi concerns herself with much.

7) How exactly does any of this "bend the cost curve"?

Well that's what the Medicare+5% public option was supposed to do. Let's face it, the most effective way to keep the costs of health insurance down is to not let people make money off of it. While Pelosi managed to keep the final bill cost below $900 billion, it would have cost $85 billion LESS if they agreed to use the Medicare style pricing structure.

mike volpe said...

1)Maybe, however the votes of many Reps and Senators are relied upon to get the dr. fix to get their vote on this one. So, if that will be used to bribe, then it has to be counted into this bill.

2) You aren't getting my point. If the fine is huge, then it becomes a massive tax. If it is small, then everyone will pay the fine, wait till they get sick, and then get insurance, since there's no more denial with no pre existing conditions.

3)This is relevant as well. Really small businesses aren't counted but sales have to be $750k or more. That covers a lot of businesses. If they are forced to get insurance, that's a tax. If the fine is too small, they will all leave and have the government cover their employees.

4)So, in other words it doesn't bend the cost curve. You seem to think that having doctors work for free is feasible.

Anonymous said...

Mike, I have a question for you. I get the impression you are unhappy about the way the country is being run. At what point would you leave, if ever? I am only asking because several people I know are doing just that, and indeed I am planning to do the same. At some point it's just not worth it (probably 2011 when effective taxes for higher rate payers in NY will be 57%+).

Sorry to get off-topic but I am curious as to your response and I'm not sure there is necessarily an appropriate place to post the comment.

Thanks in advance.

Anonymous said...

Health insurance companies are aggressively raising premiums at the same time they are fighting to stop the creation of public non-profit funds that would give them serious competition.

They are padding profits before any healthcare overhaul gets passed ought to backfire. The so-called public option was already gathering support despite claims by conservatives that it would lead to a government takeover of health care.

Small businesses face an average premium increase of 15 percent for 2010, according to The New York Times. Separately, the Centers for Medicare & Medicaid Services, which run Medicare, said that premiums for Medicare Advantage plans -- those are private plans for people also enrolled in regular Medicare -- are going up 25 percent.

With costs rising like this, it is remarkable how many supporters the insurers have in Congress. Even the best of the companies are a pain to deal with.

The for-profit insurance companies are a unique feature of the U.S. health care system. No other developed country has them, and their existence is a key reason Americans spend a much higher share of their national income on health care -- while leaving many people uninsured.