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TOPIC: *HEALTHCARE*: "America’s Affordable Health Choices Act of 2009" *RESEARCH INFO.*


Platinum

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RE: ***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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jdona, violet socks has two excellent articles on this matter!! Obama's plan is NOT universal health care and that is my problem with it. I wanted HR676 which would be health care for all but, privately run and cheaper AND cover everyone.

There is SO MUCH confusion on this bill. Some think it's universal national health care and it isn't. Some think *obama people* that it is universal health care and they are for it!

It's not. It is my friends a mish mash. If you like HMO"s and you like how it is now on steriods you will be happy with this bill!! This bill gives the insurance companies GREATER say in who qualifies and who doesn't all in the name of "reform" You will not qualify on a lot of things you are qualifying on now and you will be cut off sooner. The elderly get the real shyt end of the stick in this bill. Also, it will RUIN any chance of real health care reform that works in the future because people think it's "universal health care* as a buzz word and if anyone ever tries again to reform health care some will point to this MESS and say "See! they sky fell and it doesn't work!"

If for no other reason this has to be stopped because not even Obama understands this bill, no one does. AND he is cutting medicare and medicaid to help pay for it. That to me is just heartless, cruel and hateful!! How could he?? Do you all now that only the really poor, dying and elderly use the majority of those services?

I think this is the most evil human I have ever seen in government.

I WANT HR676 someday or Hillary's plan which would have worked equally well..but NOT THIS!!

So whether or not you oppose this because you think universal health care is from the devil or whether you oppose it because he is going back on being for single payer it has to be stopped!

This is a cut throat horrible bill and typically like Obama he gets praise for doing evil.

Call every person you can and get them to write letters and call and get this mess off the table before it's too late for us. I can't believe the harm this bill will do to the elderly and really sick like cancer patients. If you've ever needed hospice get ready for it to disappear!!

God I hate this man and his disgusting inept ways. Why on earth would anyone think this mish mash mess is a good idea? Pelosi, Obama and that whole lot have lost their minds.

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Diamond

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Obama IN HIS OWN WORDS saying His Health Care Plan will ELIMINATE private insurance (YouTube) - by JustTheFacts wrote:

[]


Please visit the link at the top to see the discussion regarding this.

-- Edited by Sanders on Monday 3rd of August 2009 08:51:48 PM

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Diamond

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The summary document is very well put together and was helpful. It is missing some key elements but information from other sources in the posts above have helped with this summary feedback.

The proposal is closer to Hillary Clinton's 1993 approach.  There is a government-run "new" plan in the offing here - one distinct from Medicare. Hillary Clinton's proposal in 2008 was to focus on those without insurance. Hillary Clinton's 2008 proposed approach was to open the plan available to the Congress (the one with  a smorgasbord of options at varied costs) and subsidize for those unable to afford basic level of coverage. This would have been minimal government intrusion into the marketplace and would have still kept the industry entirely in the private sector.

The proposed Act AHCAA changes the game significantly by what I feel is a government-run "insurance" plan and operational oversight wing, one distinct from current Medicare. It also creates an "independent" operation (somewhat like the Federal Reserve - that is a parallel that i draw) to oversee implementation and be the arbiter of benefits.

Health care Insurance vendor perspective
  • I picked this group first because they will be the most affected by this plan in the immediate future and they have the most to loose; so they will be vocal.
  • In the proposed model, however you clothe it, the government is  "entering" the health care insurance sector as a vendor, with an income stream that comes via the IRS, enabling it to essentially fund the cost of entry.
  • Whether or not intended, a drastic overhaul of the medical insurance sector business models would likely result from having government "enter" the industry as a lower-cost player.  The insurance industry will be forced to take out costs and offer lower cost options to stay viable vs the Federal plan.  I hope this results in the Federal Plan getting a stiff competition very early on in the process.. and I hope the private industry strives and survives the test of times.. But I am not hopeful of this given the numbers I saw on costs and the subsidies available from the government for small businesses. The deck is certainly stacked against the insurance companies, especially small insurance companies that may be presently offering self-insurance programs.
  • Is our health care insurance industry ready for it? Is it sound enough to withstand a "low-cost" player entering that market? I hope so. If it is, it can be a very good thing for the consumers.  If not, it will level create a massive shakedown in the insurance industry, as well as the finance industry as the two are presently intertwined.
Consumer perspective:.....

.....Cost
  • ++ I expect that the costs of care at the Point of Service/Rx Product will go down.
  • --- I expect that the cost to the taxpayers will go up significantly.
.....Choice
  • ++ It is clear that if we have coverage, it can continue.
  • ++ It is clear that the Act will result in a safety net should one loose existing coverage for any reason.
  • --- It is unclear how one comes out of a low-cost government-coverage plan.
  • --- It is unclear whether the plan really allows existing insurance companies to issue new policies. I would expect that in the free market it is possible.. and I would expect that it will sooner or later happen. i.e., will there be new choices available in the market for the consumer.
.....Coverage
  • -- It is not UNIVERSAL HEALTH CARE. After all the talk, it still leave people not covered by any umberlla.. the very issue it is supposed to remove. So, the worry is not entirely gone.
  • ++ Worry-free assurance of a certain minimal level of coverage is a great thing. It is a safety net that will help people walk around with greater self-confidence in times of economic hardship... like right about now. The timing is certainly good for the plan to be 'socialized' (what a choice of term!) by the Representatives over the August break. They are coming home to a townhall near you. Be sure to go and ask questions!
  • ++ Mental health coverage is a good thing to have in the plan. Often the stigma of this has driven people away from seeking assistance when needed, and cost has been prohibitively high. Hopefully this will result in the correct type of care, and not a massive push of medicines.
  • Coverage for children, dental and eye care as part of the 'required' elements may result in a shift in the service model. It may lead to consolidation of these services into the service provider networks. This will be an interesting shift to observe.
.....Ease of Use
  • --  As with all government-run services, we can expect the emergence of new sets of rules to govern who, when, what of availing care services under the new service model.  If nothing else, for simplicity and uniformity of processes, medical institutions will drive to standardize their practices, and with that, the current Ease of Use (despite the barriers of gatekeepers, it has been easy by comparison to government-approvals) is likely to evaporate.
.....Continuity, Portability, Safety Net
  • ++  This is by far the BEST benefit of the proposals - all version of the proposals.  (It may bring a sense of relief and comfort that may actually lower the cost of health care! There are so many people worried and spending time worrying about healthcare)
.....Disconcerting areas
  • Advanced care consultation.  How will the government mandate this?
  • Provision for Govt to "ORDER" the start of end-of-life procedure.
  • Family planning, birth control... items will raise controversies.
Taxpayer/Insured/Business/Federal Government -- Financing the plan
  • +  While the Congressional Budget Office (CBO) is claiming that the plan will be self-funding and will eak out a profit to the tune of $9Billion over a period of 10 years! (that is not much in relation to the investment)
  • -- The cost of an initial investment of $1 Trillion.
  • -- It is unclear if the ongoing cost of sunk capital has been considered in the calculation of $9Billion and how much of the initial sunk capital will have been recovered by way of income from this program.
Insurance Provider Perspective
  • If I was an insurance company or had my family income from insurance company, I would not like this plan.
  • If I worked for an insurance company that sells medical insurance plans, I would start re-skilling and preparing for my next higher career ground. We can expect a lot of shake-down in the industry.
  • I wonder if insurance provider companies will find themselves introducing the government plan as option for their employees. [This comment is not in jest]  They may reduce their total operational cost!
    • Given that, how long do you think the Insurance industry will last?
  • Insurance industry will need to differentiate themselves on SERVICE - wow, what a concept.  I like this part.  (May be their billing/claims office will return your call in a week without your calling them 4 times).
State Government
  • The proposed plan will have major impact on the relative autonomy of the state government in operation within the state.
  • Demographics of a state will become extremely important determinant of Federal Government "funding"/handouts for this program.
  • What operational costs of the State Government have been considered in the plan? - In terms of details/specifics? In terms of costs?
  • The FedGov may have to introduce specific performance metrics to set uniform standards across states.  This may drive to greater uniformity across states for all insurance organizations, and may actually tear down the cross-border barriers eventually -- right now they are very much a function of existing rules and regulations.. and they may have to simply go away. This part will be interesting to watch as it will affect many licensed individuals in the insurance industry.
Employers
  • Certain cost factors are unclear. It would be helpful to have cost tables shared with the public so that the vast major of employers in this country -- the small businesses -- can assess the impact on ther fringe benefit structure and their cost multipliers... and eventually their margins, and viability.. and what effect they might have.
  • Can the employer avail the "penalty" program as an alternative to purchasing the insurance (it may actually be cheaper and simpler in some cases)
  • What if there is a gap in coverage, yet the employer has a plum offering elsewhere. Does it make up for the "floor minimum"? Who is the arbiter of these types of decisions?
  • What happens to the sunk costs in programs such as on-site gym, smoking cessation, etc. that are presently in progress.
  • It is unclear how much reporting is involved
  • What if an employee opts out? Who is responsible for reporting to the government? Will the employer be expected to function as the FedGov's watchdog? Will IRS become the health watchdog?
  • It will help small businesses grow across state lines without having to worry about the insurance coverage of employees in another state. This is a big plus.
Employer Groups - Chamber of Commerce
  • Smaller employers often purchase self-insurance collectively as a group via the  Chamber of Commerce. There may be opposition from the Chamber. This may result in some loss of vitality to the Chamber's role as a pivotal service provider to the small businesses.  The Chamber derives its income from these intermediary programs and sustains other 'free' services to its community of members. Viability of Chamber as a service provider to small business may be severely tested.
Economy
  • The plan once implemented (and I have no doubt some version of it will go through), will create massive shift in the nature of this economy.  I have lived in a "Democratic Socialistic Republic" called India where ration card was normal. I recall Many time standing in line for rice, wheat, and even going to the government-run hospitals.  We are not quite there, yet.
  • The land of opportunity is looking less so.
  • Lady liberty is sitting in the counseling chair. It is a discussion on "Advanced care" and she has a pensive look on her face.
Still thinking... I will revisit.



-- Edited by Sanders on Tuesday 4th of August 2009 04:20:21 PM

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Democracy needs defending - SOS Hillary Clinton, Sept 8, 2010
Democracy is more than just elections - SOS Hillary Clinton, Oct 28, 2010

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Project Vote Smart - Stay informed and engaged!


Diamond

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RE: Congress' own healthcare benefits: Membership has its privileges (LA Times 8/2/09) - Another thread on this Forum


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Sanders,  Great research!

I feel that the "-" (minuses) that you have listed are deal breakers, so to speak.  This is a horrible bill.  It is meant to level the "playing field" for all. 

This hits the seniors and people with health issues now the most.  It may not affect many us directly right now, but it will in the future, as we all will be seniors one day.  And, actually it does affect us now . . . as we watch the seniors in our lives unable to get the healthcare that they deserve.  I can not imagine and DO NOT want to.  From what I understand, even if you can afford your own care, you are not allowed to pay for it . . . the government will not allow it. 

I do not want anyone making personal decisions for me or anyone else in my life, especially the government.  The audacity of requiring counseling sessions for end-of-life . . . who do they think they are . . .  This is America!

I suspect many doctors will stop practicing medicine.  The system will be overloaded with new patients.  It would be a nightmare.

Just my thoughts.

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Diamond

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Calico, Yes, I am beginning to feel so too. I have held my tongue on this.. and really want to be fair and balanced in my views.

The difficulty for me in embracing this Act is from a combination of factors.

While there are some people not covered with health insurance, instead of correcting that void that ails the social infrastructure, the Act goes to "correct" a structural item in the Insurance market.

To do so would be ok provided it is done correctly including respecting the interests of private parties and that includes insurance companies that have been functioning lawfully within the confines of the rules and regulations that the government has established.

Small tweaks in these regulations can yield big results that the government and the industry can embrace to achieve the structural changes needed.
For example, opening the borders of states to increase competition among insurance companies - would be one such measure.

For the government to come in as an "exemplar" private player in the Insurance market is presumptuous and preposterous, when it has woefully failed to handle the basic product it vends - the currency - in a similarly structured model that it calls the Federal Reserve System.

Meanwhile, the resulting model is still short of Universal.. while excessively invading into the privacy of all citizens, and promising to become prescriptive on what is and is not covered, and what is and is not going to be 'ordered' in late stage treatment/end of life determination. It is a change in direction in philosophy for this country that I believe the citizens will have a very difficult time embracing -- Americans are fundamentally reluctant to let in the neighbors indoors (not that I agree with this amount of distancing and seclusion in the society), let alone the government. Can you imagine the lamenting to come when they realize what is lost.. and that will not happen until 2013, when it is either (a) someone else's first term or (b) Pres.Obama's second term (and he may not care much what people think by then and be left with 3 years to "fix" the message).

The insurance industry DOES require reform... but such reform does not require that Government enter the sector as a player. If it does, it will be extremely difficult to back out of it. There is no "sunset" clause on healthcare being transferred to the government.

Yes, I believe having government insurance as a safety net will result in people feeling a great sense of relief. However, it does not have to be offered by the government itself. It can be government subsidized. There are ways to cull the problem without government setting its big bootie into all affairs, particularly when the economy is ailing..

The economy has the cancer of socialism introduced by the Fannie Mae and Freddie Mac. More socialism is not the solution. Inventive approaches that have structural impact can be developed within the confines of existing infrastructure.. The current administration need only look at Hillary Clinton's 2008 proposal to see how to do it. The only question is whether they can set aside the big egos and put citizens and the economy first ahead of the altruistic far left entitlement mentality.

The solution in the simplest of terms are the following:
- open the state borders for insurance firms to compete
- open the Congress's smorgasbord of insurance plans
- subsidize and phase out subsidies for lower income category
- increase supply of qualified doctors
- reduce administrative costs
- reward lower priced+higher quality medical service provider with appropriately structured tax exemption and incentives.
- develop reporting requirements for the non-profits comparable to the for-profit sector.

Our economy has sound principles.... and can shine and succeed, provided we do not muck with it constantly to achieve ends that are inconsistent with the factors that drive the principles of the economy... and that holds for all sectors.

=========

I would like to read other counter-balancing perspective on this that is thoughtfully presented and considers the soundness of the economy as a factor in the reform/overhaul.

-- Edited by Sanders on Tuesday 4th of August 2009 04:13:19 PM

__________________
Democracy needs defending - SOS Hillary Clinton, Sept 8, 2010
Democracy is more than just elections - SOS Hillary Clinton, Oct 28, 2010

Madam Secretary Blog at ForeignPolicy.com
Project Vote Smart - Stay informed and engaged!


Platinum

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I am for the plan that HILLARY had as it was cheaper and covered more people. Barring that I am for HR676. Obama's plan is not single payer, it costs more money and it panders to the people who donated huge sums of money to him as pay BACK.

This is not "universal" health care and it's expensive the way this bill is written. The only reason this bill is written the way it is, is so Obama can say he was the one who "reformed" health care with one hand while STILL leaving huge loop holes for you and me to get cut off our insurance if those companies still want you cut off. It is not medicaid or care for all. In fact he is cutting those programs to pay for this one which to me is ruthless and disgusting.

I'm more left than many of you and I want universal health care that works just like what Hillary wanted. This is not that. I dont care who stops this but, it must be stopped so whether your argument is that you think it's socialism or whether your argument is a progs view that it's not HR676 which Obama and Pelosi have pretty well killed then as long as it is stopped I'm fine with that.

The irony is that really this plan if it passes will more than likely ensure that we will never, ever have universal health care or anything even resembling those programs. We will have a mish, mash that works as well as the HMO"s do to protect and to provide services for health care and that's it. When this plan won't work it will be pointed to as "universal health care and how it won't work" to stop any future efforts.

This is not universal health care! It is a sell out of that dream Hillary had and I disgusted with it.

Yes, Obama said he was for "single payer" and then he lied and flip flopped. You can find two videos out there of this. One like the one above and another where he has totally back tracked and indeed one website did so to show what a liar he is. He was asked at the question and answer why no one in favor of HR676 was invited to ask him questions at all, even though he had previously supported single payer and that person was strong armed out of the question and answer period! There is a You Tube of that too.

I am a member of many groups trying to get HR676 passed for quite some time now and none of them are happy with this so called "plan" of Obama's.

It's a sell out. It won't work whether you are for or against single payer. This entire plan is a bust!

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silver

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Updated first post in this thread to include link to Hillary's "American Health Choices Plan"

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My "Blue Dog" Dem Congressman, Eric Massa gives a reason why he won't vote for this Bill:

Corning, NY StarGazzette

"I will not vote for something that I perceive will destroy Medicare," Massa, a Democrat from Corning, said in an afternoon meeting with the editorial board of the Star-Gazette.

Massa said many points have been made in support and opposition to the bill, HR 3200.

"One of them is that we're going to fund health care reform largely through savings," he said. "Well, those savings largely come about by reducing payments to Medicare providers. That means doctors will start saying, 'I'm sorry, I don't accept Medicare unless you have a Medicare supplement plan.'

"That, by the way, is why the private health insurance industry loves this bill, because it will drive about 40 million Americans into the private health insurance industry to have Medicare supplements to be able to then take advantage of their remaining Medicare benefits."

Massa, seven months into his first two-year term in the 29th Congressional District seat, said he was met earlier in the day, in the Rochester suburb of Pittsford, by protesters who criticized his stand in opposition to President Barack Obama on health care reform. Massa said he, and the current plan, remain the targets of those who inaccurately say, among other things, that reform will include abortion on demand.

"We are being assaulted by an incredible lack of truth and veracity in what this is all about," he said.

****************************************************************

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Platinum

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I only have one thing to say. Does this bill also force all government to be in the same plan? Do Obama, his family, Pelosi, kennedy, all congress and senate, ect, have to be part of it too?

If not, then dump the mess.

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