Health Reform is Good for Small Business Employees

The audacity of Time to print these lies is incredible. By the time the so-called Health care reform is fully implemented, the anti-capitalist extremely burdensome regulations parts of it will DESTROY any small businesses fortunate enough to still be around.
Please understand this. The purpose of the health care reform act was NOT to reform health care but to increase the stranglehold the federal govt has on America and its citizens and to “redistribute the wealth”, the goal of ALL legislation introduced by Democrats these days.

We interrupt this rant from ricardo4max to let you know that there is another oil rig explosion south of NOLA off the coast.

And what good is being offered health care insurance if you can’t afford it? Repeal the so called Health Care reform act. There are so many other ways to improve health care and lower the costs. One is advertising the prices / costs of services, supplies, and prescriptions. Open market competition has never failed to reduce cost to the consumer. Get the federal govt out of the way.
And here’s something to think about. If no one had insurance and we all had to pay for any health related service we receive, would the prices go down? Would people start taking better care of them selves and practicing preventive medicine? Would the demand for services decrease so mush that price decreases would soon follow?
What if we also CLOSED THE BORDERS AND DEPORTED ALL THE FREELOADERS? What effect would that have on demand and thus on costs? Why do Democrats always have to make people MORE dependent on the federal govt and, in turn increase the size and power of the govt?

Despite the good news for small business employees contained in the Kaiser study, not all the data on the current situation is rosy. The study shows that several trends continue – employees have higher deductibles, higher co-payments, and are paying a higher percentage of their premiums than ever before. In 2010 premiums for job-sponsored family health insurance coverage increased 3%, which is fairly modest, but the share that employees pay jumped 14%.

Without a public option, people only have vampire squid companies to go to. There’s no bottom line since people can’t opt out. This was the whole reason why people wanted the public option, and this is exactly what will happen when people don’t have another choice. That is of course, ignoring the fraud perpetrated by hospitals when they mark up procedures or medicines and it is also ignoring the usual waste in spending by doing useless tests.
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Without reducing the cost of medical care, you can’t reduce the price of insurance. And without a reason to lower prices, insurance companies won’t lower them.
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As for logging $600 expenditures, that had no business being in a healthcare bill.

I guess the left wing environuts didn’t get enough propaganda from the first one.
And since when are facts a “rant”?
Answer: When they don’t support a left wing kook theory.

And as usual Ricky has zero facts to back up his rightwing nut rant…..

“As for logging $600 expenditures, that had no business being in a healthcare bill.”

Exactly what I just said. It wasn’t really a health care reform bill but a wealth redistribution bill. In this case it punishes small businesses.

Although I am a little reluctant to enter this fever swamp of invective, I would like to say after reading this post twice, that IMHO this is a first class piece of journalism. Thank you Kate.

No, it is mostly a health care reform bill, just with idiotic things tacked onto it. A far majority of the thing is about healthcare. I do agree with you that there are portions of the bill that don’t make sense in something billed as a health care overhaul.
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You can’t pretend that it isn’t about health care ricardo… you can acknowledge there were some idiotic things done in the bill. The responsible thing would be to lobby your congressman to repeal the things that are clearly harmful, while acknowledging the benefits of other parts of the bill.

I hope your pulling my chain.

Prove it!

Kate, just for the record, I am thinking you are thinking this health care is going to be free. Presumably the doctors and nurses serving these newly insured will want to be paid. Where is that money coming from? The employer? Let me guess, this is also going to create jobs?

No, it’ll raise prices. If you operate machines as part of your business, you have to keep maintenance in your budget. The price of using people to keep your business running also has maintenance fees. If businesses haven’t been factoring those fees into their bottom line, they’ll need to start doing so.

Yo, Ricardo

Not a lot of free time on my hands today, but just two quick points;

“… what if not one had health insurance…”

The Quick Answer: A lot more people would suffer and die. Is that the solution you had in mind?

“…deport all the freeloaders…

The Quick Answer: Every single restaurant meal and hotel stay would cost twice as much, assuming you could find a hotel and restaurant that could afford to stay open.

Kate, thanks for this update. BTW, now that this blog has nine reporters, are you and Adam going to rename this place “Kate Plus Eight”? Or has someone else claimed that title?
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Although your tea leaves see more coverage by small biz as noted, do you see an even bigger move by putting more people on Medicaid or other Robin Hood-esque Socialist Programs to steal from the rich public programs instead of still relying on biz’s? (Credit KT for bringing up the Medicaid issue earlier) Thanks for your thoughts, Kate.

That “extra paperwork act”, however, has GOT TO GO AND FAST.

Never mind the burden of the paperwork. It is an incentive for every business to minimize the number of vendors it deals with. What a bummer if you are, say, an independent contractor or small business bidding on a one-off job.

The small businesses that I have run were hamstrung by regulations too numerous to list. A full time employee would be needed to keep the operation legal if that is even possible. I suggest that anyone who thinks that running a small business in a competitive environment can handle some more laws and regulations had best try to run a business first and speak later. I do not mean furnishing a government agency with over priced materials or services. I mean a true competitive business.

Since the new health care regulations run out to some thousands of pages, are they meant to be read by the average American who has a three minuit attention span? All the laws to save us are killing us. Can we go back to when the main worry was a arrow from the disgruntled neighbors we moved in on?

The study shows that several trends continue – employees have higher deductibles, higher co-payments, and are paying a higher percentage of their premiums than ever before. In 2010 premiums for job-sponsored family health insurance coverage increased 3%, which is fairly modest, but the share that employees pay jumped 14%.”

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Based on this fact, how much longer will employees opt to have coverage? How many will we see dropping out?
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With the illegals who do not have coverage, will we see any change to how much the emergency rooms are being utilized as a “Doctor’s Office Visit”?
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Overall, what would for sake of argument or review of the study, will the repeal of the individual mandate on these percentages which RAND put out be? Did RAND take that very real possibility into account?
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Last but not least, what would the impact of insurance coverage cost be had Democrats allowed for the purchase of prescription drugs from outside of our American borders? And, what would have been the estimate of decrease in cost had the Democrats also listened to those of us who were calling for the implementation of State to State competition with the various Health Insurance Companies?

Kate Pickert:
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So many questions, where to start…?
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“According to the study, funded in part by a contract from the U.S. Department of Labor, once the Affordable Care Act is fully implemented, 95% of American workers will have health insurance through their jobs, up from 85% today. This increase, say the authors, will be largely driven by more small businesses offering coverage.”
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Sure, but coverage by itself means very little. If I have an insurance policy through my employer that covers 80 percent of a $100,000 medical price tag, it’s better than being on the hook for the full hundred grand, but, if I can’t pay the $20,000 difference, I’m still just as bankrupt. The difference between a Silver and a Gold plan is the difference between solvency and bankruptcy for middle class families.
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What is important is the actuarial value of that insurance is…how close it will be to junk insurance, in other words. Junk insurance is, according to COBRA law, health insurance that makes people pay a significant portion of the medical bill (like the Bronze plan’s 60%) while still charging them higher and higher premiums every month.
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Also, let’s be really clear: “fully implemented” means “at the end of the year 2016.” It seems this important piece of information –that we’re talking about at least six years from now– is nowhere to be found in your post.
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“The study shows that several trends continue – employees have higher deductibles, higher co-payments, and are paying a higher percentage of their premiums than ever before.”
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That’s interesting, given that the CBO put out a letter to Olympia Snowe saying this:

In general, however, small employers would provide plans with a greater amount of coverage than Bronze plans, as they do under current law.
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The average premiums in 2016 for plans provided by small employers cited in the recent analysis by CBO and JCT—about $7,800 for single policies and $19,200 for family policies —differ from the amounts cited above for individual Bronze policies primarily because the average actuarial value of coverage purchased by small employers would be substantially higher than the Bronze level (about 85 percent, CBO estimates, rather than 60 percent). The premiums for specific employers could deviate significantly from those averages for various reasons.

So, what gives, Kate Pickert?
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How can the CBO assure the Senator from Maine (and the rest of us) that small business group policies will tend, on average, away from junk insurance actuarial values, despite evidence like that cited below?

Trends in Underinsurance and the Affordability of Employer Coverage, 2004–2007
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June 2, 2009
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Authors: Jon R. Gabel, M.A., Roland McDevitt, Ph.D, Ryan Lore, Jeremy Pickreign, M.S., Heidi Whitmore, M.P.P., Tina Ding
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Journal: Health Affairs, June 2, 2009 28(4):w595–w606
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Synopsis
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A study of trends in employer-sponsored health insurance found that plan enrollees’ out-of-pocket expenses grew by more than one-third between 2004 and 2007, affecting some 161 million Americans in all types of plans. Those who are sicker and poorer are often underinsured.

And, if we look to news events for evidence confirming these trends, we find this sort of thing going on:
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http://pnhp.org/blog/2010/05/24/unitedhealthcare-agrees-to-offer-junk-insurance-to-millions-of-restaurant-workers/

NRA partners with UnitedHealthcare
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By Paul Frumkin
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Nation’s Restaurant News
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May 21, 2010
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The National Restaurant Association said it has partnered with insurance giant UnitedHealthcare in an effort to make health care coverage more accessible and affordable for foodservice operators and their employees.
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The initiative, called “Restaurant Health Care Alliance,” could help provide coverage for the 4 million to 6 million restaurant employees who currently are without insurance, according to Dawn Sweeney the NRA’s president and chief executive. The industry employs about 13 million people.
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“We’re looking at developing a continuum of products,” Sweeney said Friday during a press conference in Chicago announcing the alliance. She said plans could range from discount cards for those employees “who aren’t ready to purchase full health insurance all the way to comprehensive coverage.” Prices could start as low as $100 a month, she added.
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Mike Gibbons, the NRA’s chairman of the board, noted that the partnership with UnitedHealthcare would help alleviate the financial burden that national health care reform will put on the restaurant industry.

“The cost of health care reform could be potentially devastating,” he said. “The alliance will give lower cost health care alternatives.”

What do you suppose is happening, Kate Pickert?
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It sure seems as if the trend is toward the expansion of junk insurance along with an increase in premiums for small business employees, doesn’t it?
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If so, how do you suppose the CBO got it so wrong?
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Come to think of it, why would you title this post
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“Good for Small Business Employees”
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when it’s not clear at all that “extending coverage” by law –without simultaneously guaranteeing by law that small business group plan policies aren’t junk insurance– won’t stop current trends toward soaking those small business employees (and everybody else without Gold plans) when they have medical issues?
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Don’t you think that the evidence suggests that premium-hiking, payout-scrimping private coverage alone isn’t really that Good for Small Business Employees, Kate Pickert?
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I’m not suggesting that you’re a shill, far from it, but why does this post manage to make you sound like you’re in the business of selling the inaccurately named “Affordable Care Act?”

I gave up my small business when I was diagnosed with Crohn’s disease because I could not afford the cost of health care, as much as $50,000 in medical bills in just one year and easily $200,000 in total.
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Now I have a state government job with health care provided by the state. Instead of contributing to the state economy I am being paid off it.
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If there was reform earlier instead of getting paid off tax dollars I may still be running my business and contributing to the economy through sales tax and hiring employees. If you do not believe this was needed than you are either anti-small business or just another Obama basher with a miserable soul.

I thought we all are supposed to report all our earnings on our tax returns as good citizens of the USA. Why should we need to report on each other? I think the government assumes we are all tax cheats because they are of a mind to cheat themselves.

Kate Pickert:
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These:
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1) “what would the impact of insurance coverage cost be had Democrats allowed for the purchase of prescription drugs from outside of our American borders?
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2) “And, what would have been the estimate of decrease in cost had the Democrats also listened to those of us who were calling for the implementation of State to State competition with the various Health Insurance Companies?”
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are questions worth answering, no matter who is asking.
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Do you have any information on models run with these types of factors introduced, and any conclusions drawn? Didn’t the CBO do any work on the PPAC Act with the Dorgan Amendment left in, for example?
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The Federal government did run the numbers through these sorts of models, right? If not, then somebody must have, am I correct, Kate Pickert?
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Do you happen to know anything about this –or somebody who does?

When government backed insurance, Medicare and Medicade, became a reality, all health care costs and health care insurance outlays from any source started to increase at a rapid pace. The simple reason is that business of any kind sees the government as an unlimited source of revenue if they can just tap into the cash flow.

Insurance plans and such have a communist flavor to them and so will be doomed to fail. These plans do not have the adversarial nature of a competitive market. Unfair advantage will enure to someone. Medical workers and all health care administrators are the current overpaid lot. There is no competition. Just a make as much as possible approach to the whole system. That is not competion which strives to limit the competitors by pricing out the inefficient.

Stuart, the point about shopping outside of your state I’ve read a bit on. The arguments against (or for the separation by state) had to do with various laws implemented by states for health care requirements.
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Essentially, if the state passed laws that required Health Care companies to operate a certain way within their borders, it caused complications when a person in that state bought health care elsewhere. It was also reasoned that if one state tried to improve their healthcare by mandating something that would cause the price of healthcare to rise (along with the benefits), individuals in the state would go shop elsewhere, bankrupting the firms inside the state over time. Eventually all of the insurance companies would drift to the states with the lowest level of regulation and states would be unable to regulate health care within their borders. That was the argument I garnered from various articles and studies I read months ago, so I apologize for the lack of sources.
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On the first point I don’t have much to say. It probably has something to do with regulation & the FDA, on top of a certain amount of corporate protectionism that ought not exist.

“ if one state tried to improve their healthcare by mandating something that would cause the price of healthcare to rise (along with the benefits), individuals in the state would go shop elsewhere, bankrupting the firms inside the state over time”
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Doesn’t the PPAC address that issue by indicating minimum nationally-set standards for State Exchanges?

Yea drive down the demand, that will drive down the cost, so more can afford it, to drive up the demand, to drive up the cost, so that will drive down the demand, to drive down the cost, so that more can afford it, to drive up the demand, to drive up the cost, to drive down the demand, to drive down the cost.
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Love that free market solution to a National disgrace.

” I suggest that anyone who thinks that running a small business in a competitive environment can handle some more laws and regulations had best try to run a business first and speak later.”
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This means that it is my turn to speak.
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Thank you so much for giving me the floor.
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Unfortunately for you, I am not at all a conservative and will tell you that, also, working with small businesses for a living right now that the only people why wine and cry about government regulations are people who can not win over clients/customers, are underfunded from the start, do not know about the field they are starting a businesses in well enough or got sideswiped by a recession. From there, these under prepared, underfunded, inept, under capitalized or just unlucky would be business owners look longingly at the amount the pay in worker’s comp, taxes and social security and imagine how wealthy they would be if all of those things were free.
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Sorry, I am self employed. I have been most of my life and I was a business owner when I was 24 and 25 years old.

“Answer: When they don’t support a left wing kook theory.”
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Correction: when it is contradicted by facts.
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Contacting businesses and finding out if they offer Health Care or not and comparing the same numbers to the previous year makes this a matter of facts, not opinions.
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Pretending that this is not true is like you demanding that we all say that the sky is red and ocean is made of orange juice.
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Now that this fact has been determined, you can be sane and either state: 1) how something else, not HCR, caused this or 2) Why a tax law encouraging health insurance is so bad that additional people insured by small businesses is not worth the price.

“One is advertising the prices / costs of services, supplies, and prescriptions.”
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Actually this is a part of Health Care Reform with an ad done by the president himself and posted here on Time.
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“Open market competition has never failed to reduce cost to the consumer.”
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We have open market competition within every state and no federal licensing of the process. So, unless we make licensing health insurers into a federal project rather than a state one, this can not happen.
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“Get the federal govt out of the way.”
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Like I said, the federal government has nothing to do with licensing health insurance. That is a state’s rights issue and remains in the hands of the states.
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“And here’s something to think about. If no one had insurance and we all had to pay for any health related service we receive, would the prices go down? Would people start taking better care of them selves and practicing preventive medicine?”
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No.
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If that were the case then states with no car insurance would have the least accidents. If you are driving head on right towards me on a road, my thoughts are that I do not wish to hurt myself nor my car as a matter of principal. If there is a car accident, then I think about having insurance.
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For health, if I get a call or letter from a regular GP to come in for a visit, I will get information on preventive medicine and stay healthier.
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With no health care, I will, as I have, stayed away from doctors for year after year after year and may discover that I have been very ill for a long time.
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So, the answers are: already done (we have a government owned web page for this), never done to be undone (the federal government always left it to the states to license health insurers and, therefore, have nowhere to “get out of the way” of), and you have it totally backwards.
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Since illegals are not covered by Health Insurance, that point made no sense. If we block people from coming to the US where they can not go to a doctor as is, then they will, still, not go to the doctor.

Sorry, I am self employed. I have been most of my life and I was a business owner when I was 24 and 25 years old.

Oh please Rev Jim, spare us. You are a college dropout, a failed taxi driver, used car salesman and rejected public servant who now peddles RE. Let’s not try to romanticize it like you were building Google or Apple out of your garage. You whined that you had to drop out of college because the stingy Republican-led governments weren’t providing you with free money to attend.

Rev Jim flip the page on your talking points, he was talking about oil and gas explosions. I guess to satisfy the left we should stop producing both that would solve the problem.

“Kate, just for the record, I am thinking you are thinking this health care is going to be free.”
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Nobody believes this.
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In all cases when a business takes on a new expense it gets passed onto consumers.
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So, instead of paying it in taxes, we pay for it in stores, gas stations – everywhere we purchase anything.
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However, the previous system already provided for the uninsured with no preventive care at all. All sick people are, by law, allowed to go to hospitals for care. When they do, their is not magic to pay for them, they are paid for when the bill is sent to insured when they, also, go to that same hospital.
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So, before you paid for the uninsured when they were very ill through your health insurance companies and through hospitals. Now you pay for health insurance providing preventive medicine far cheaper every time you purchase any good or service.
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There is a huge difference between “free” and costs less.
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The price increases you will pay for everything from shoes to coffee will be far less than the amount you have been paying for hospitals your insurance company paid for giving “free” care to the uninsured when the uninsured are very ill.

” I think the government assumes we are all tax cheats because they are of a mind to cheat themselves.”
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First, I never, ever heard of a business owner who does not take receipts for every business related transaction over $5 for taxes (self employed I have receipts for every subway ride which is work related).
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Second, if you are already paying your full share of taxes, then getting tax cheats means that the government can cover it’s bills without raising your taxes.

“Doesn’t the PPAC address that issue by indicating minimum nationally-set standards for State Exchanges?”
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Stuart,
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This is the reason that the federal government regulates anything instead of leaving it to the states. Standard Oil – the turn of the 20th century monopoly – was one of the first times that the federal government stepped in since each state had different anti-trust laws and Standard Oil found a way to manipulate all of them in order to use them to squash competition instead of protect it.
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The only way that crossing state lines would work is if all of the states lost the power to regulate in favor of a federal regulatory agency. Starting new federal agencies is cumbersome and closing down state agencies is, also, cumbersome. It would further enrage anti-government wingnuts who love states rights unless a state or local government is doing something liberal like NYC following the First Amendment and allowing a Mosque in downtown.
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It would either lead to a near monopoly in a low regulation state or force the federal government to grow more while shutting down state agencies.
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If these insurers really wished to be in all 50 states, they would follow Blue Cross Blue Shield and get registered in all 50 states.
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For non-regulator reasons, it may not be logistically worth their while to open up offices in many states. So, the overriding of state laws and allowing cross-state insurance may not result in many firms crossing state lines at all.

Stuart,
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I am very unsurprised by the fact that bronze or, more like tin health insurance plans are the ones growing, but, it is a big step in the right direction.
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Maybe the next health care debate will be in another 16 years (as it was 16 years since the failed Clinton plan) and will include both a public option and specifying that it must be at least “silver” if not a a “gold” plan for employees.
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When Reagan was the first president I remember clearly (I was 8 going on 9 when he was elected) seeing government do anything at all useful for the people is just such a pleasant surprise for me that, for now, I am not complaining.

“This is the reason that the federal government regulates anything instead of leaving it to the states.”
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I am aware of this.
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“Standard Oil – the turn of the 20th century monopoly – was one of the first times that the federal government stepped in since each state had different anti-trust laws and Standard Oil found a way to manipulate all of them in order to use them to squash competition instead of protect it.”
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Yes, that’s true. I am aware of “Standard Oil Co. of New Jersey v. United States,” and that the Sherman Anti-Trust Act was invoked to limit its size.
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Health insurers enjoy special exemptions from anti-trust laws, however, from the McCarran–Ferguson Act, which allow them to fix prices in practice, so I’m not sure why you found the Standard case relevant outside of illustrating the applicability of the Commerce Clause.
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The only way that crossing state lines would work is if all of the states lost the power to regulate in favor of a federal regulatory agency.
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Right, just as the Commerce Clause permits. Of course.
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Starting new federal agencies is cumbersome and closing down state agencies is, also, cumbersome.
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“Starting new federal agencies?” Why would that be necessary? HHS is the agency vested with broad new regulatory powers under the recently passed PPAC, which is why they’re overseeing the risk pools and State Exchanges…speaking of which, that’s the “cumbersome” process that will take until 2016 (if on time) to implement.
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Basically…so what?
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That’s my point, the PPAC did all of that.
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“ It would further enrage anti-government wingnuts who love states rights unless a state or local government is doing something liberal like NYC following the First Amendment and allowing a Mosque in downtown.”
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What does that fact have to do with anything? The question was about cost, not popularity.
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“It would either lead to a near monopoly in a low regulation state or force the federal government to grow more while shutting down state agencies”
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I see, it seems that you are unfamiliar with the near-monopolies that already exist as a result of the McCarran–Ferguson exemptions.
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As a result of the PPAC, the Federal government already is “growing” in terms of the scope of its authority with respect to health care administered privately and publicly by the states:

Effective September 23, 2010
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* Children will be permitted to remain on their parents’ insurance plan until their 26th birthday.[40]
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* Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.[41][42]
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* Insurers are prohibited from charging co-payments or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans.[43]
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* Insurers’ abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.[30]
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* Insurers are prohibited from dropping policyholders when they get sick.[30]
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* Insurers are required to reveal details about administrative and executive expenditures.[30]
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* Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[30]
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* Indoor tanning services are subjected to a 10% service tax.[30]
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* Medicare is expanded to small, rural hospitals and facilities.[30]
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* A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.[30]
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* A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention.[30]

It seems that taking on more regulation that would “force the federal government to grow more” isn’t as great of a step as you’re making it out to be.
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“If these insurers really wished to be in all 50 states, they would follow Blue Cross Blue Shield and get registered in all 50 states.”
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Who cares what insurers wish or don’t wish for?
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If these insurers really wished for it, they could use the anti-trust exemptions afforded them by McCarran–Ferguson to carve out state-by-state cartels, and divide up the entire US market into competition-less, price-fixed fiefdoms, and lobby Congress to pass laws compelling consumers to purchase their anti-competitive system’s products…oh wait, they’ve already done that.
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“For non-regulator reasons, it may not be logistically worth their while to open up offices in many states. So, the overriding of state laws and allowing cross-state insurance may not result in many firms crossing state lines at all.”
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You’re correct, the prospect of giant (essentially) private utility companies crossing state lines to compete instead of setting up government-sanctioned rent-seeking zones of non-competition doesn’t seem too likely, given past performance.
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That said, it seem as if HHS under the new PPAC does address the “race to the bottom” issue with broad new regulatory powers, so there isn’t really much cogent rationale for dispensing with McCarran–Ferguson, and letting Alabamians have a shot at trying Minnesotans’ health insurers out. If customers are free to buy highly Federally regulated insurance from a vastly expanded pool, don’t you think your point is now moot, and won’t consumers have potentially benefited from having more stores from which to choose, as it were?
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Wouldn’t the price of insurance have dropped, in other words, even as the new federal regulatory framework did away with the race to the bottom?

“it is a big step in the right direction”
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No, it’s a big step in the wrong direction.
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Insurance that doesn’t pay out is a scam, you know that.
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Junk insurance that doesn’t work when people really need it is anti-consumer and wrong for the economy as a whole.
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A big step in the direction of a proliferation of sh*tty plans is a big step in the wrong direction…the Third Way direction. It’s incompetence. It’s ideological incompetence.
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“Maybe the next health care debate will be in another 16 years…”
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Dude, we don’t have that long before health care eats up 25 percent of our nation’s wealth a year. We can’t wait for a “debate,” economic circumstances just won’t permit it.
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“seeing government do anything at all useful for the people is just such a pleasant surprise for me that, for now, I am not complaining”
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Jesus Christ, talk about lowered expectations!
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For me, seeing the government do “anything at all useful” –instead of solving real problems once and for all– is a tragically familiar experience, as it is for most Americans.
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It’s not a “pleasant surprise.” It’s another f*ck up. It’s health care Katrina. It just proves to people that the system doesn’t work, and that government is part of the problem.
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When proponents and apologists trot out the “31 million people who are now covered,” that’s like neo-conservatives replaying the “25 million Iraqis who are now free.” It’s a dishonest sales pitch.
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For all of its drawbacks, for all of its problems, the Iraq war did help some people. The bank bailouts did work for some people. Hey, the Republicans passed Medicare Part D, which did improve the lives of some people.
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There are plenty of examples of enterprises apologists can use to say “See? It’s not all bad…some people are better off than if we had done nothing….”
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The difference between the reality-based community and tribal partisans is that we can see that sort of rationale for what it is: a sales pitch for –or what people need to believe about– a big step in the wrong direction.

As long as private insurance companies remain as part of our system, except possibly as a supplement, reform will be limited.
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I have mentioned before that I worked at the Health Insurance Plan of California from its inception. It was a legislatively mandated plan to offer health insurance to small businesses. It lasted 10 years and enrolled over 200,000 people. It did not allow underwriting for pre-existing conditions. The one rule was that the company enrolling its employees must be legitimate and have 2 or more employees and no more than 50. At renewal, the company could enroll up to 100 employees.
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The premiums were monitored by the state. A number of ins. companies (Kaiser, Aetna, etc.) joined in the plan. Providers were part of their regular groups. Deductibles and co-pays had to be the same for all insurance companies. HMO and PPO coverage was offered.
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The plan was quite successful until the insurance companies became discontented with their profit margin. The lobbying began. The degradation of the plan began. It was destroyed by a complacent government, a weak governing board, and greed.
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As long as private insurance companies remain as part of our sytem, except as a supplement, reform will be limited…or impossible.

Ricardo, your biggest problem is that you’re oversimplifying the process.

Yes, free market principles generally work in most industries. The problem is more complex than that, though, and cannot simply be solved through pure-capitalist models.

Here are some of the most obvious complexities:

1. This is isn’t a primarily B2C marketing, it is a B2B2C — there is a middle-man, and consumers have little to no choice as to which company they want to provide their health insurance (if they’re getting it from an employer). This in and of itself defeats the premise that it can be solved through competition (there’s no competition if you don’t have a say in the plan).

2. Health care (and by extension, health insurance) is not a market of goods or services exclusively. It’s a complex product that you’re buying at a price that is dictated, and not set by market forces. If you go to the hospital for an emergency operation and they say it will cost $1000, you can’t simply tell them you’re going to “shop around” for the best price and leave — again, health care (and, health insurance) is not rooted in the same principles that the idea of capitalism requires to work.

3. There isn’t perfect information. No one but doctors and insurance agents generally know every nuance of the health care service and health insurance plans that are provided. Again, as part of the definition of capitalism, it is required for consumers to have a perfect knowledge of the product they are buying and the market within which it exists. This is obviously not the case (either for CARE or INSURANCE).

As is usually the case, mr zechman not only addresses the post at hand with very informative information, but also asks very pointed questions to the journalist who posts his/her article.
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I will be waiting for Ms Pickerts reply.

“Dude, we don’t have that long before health care eats up 25 percent of our nation’s wealth a year. We can’t wait for a “debate,” economic circumstances just won’t permit it.”
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The problem is, Stuart, that the right wing talk machine has made this partial success into a reason to toss out Democrats as fast as possible.
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Right now being in favor of additional health care reform is like being a Southern Politician in favor of civil rights in the 1960s: they’ll adore you in the history books but you can pucker up and kiss your job goodbye.
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If there were some decent media coverage counteracting right wing lies like Death Panels, 16,500 Armed IRS agents, “government takeover” this would make this a sweeping victory for the Democrats which would cost the Republicans their seats for voting against it.
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As far as I am concerned, it should have been passed right the first time.
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It reminds me of Civil Rights. First there was emancipation. Then there were setbacks for another eighty years. Then the desegregation of the armed forces. Finally, more than 100 years later there was legislation which really did prevent Jim Crow laws and made discrimination illegal.
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America has a very easily frightened and easily manipulated population who fear change and anybody who looks different or prays in a different church than they do. These are the ones who get manipulated by Fox, Beck and the AM radio crowd and make sure that no good deed goes unpunished.
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With that as our opposition and almost no good media from the left to publicize things like HCR – especially single payer (the best – which should be an easy sell, but is not wanted by the fearful Fox watchers) we may have to wait 16 years for another movement to gain momentum.
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If the Republicans gain a majority in either house, then everybody in the Democratic Party running for office would rather cut their tongue out than say “health care reform” for at least another ten years.
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“Jesus Christ, talk about lowered expectations!”
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With 30 years of right wing government, how can I not have reduced expectations?

How do we know the truth? Who should we believe?

Just to let everyone know, ProCon.org, a free, nonpartisan, public service website has just launched a new site on the pros and cons of the March 2010 health care reform. Take a look and find out some answers: Is the health care reform good for America? How will this legislation impact the lives of all Americans?

The site, Health Care Reform ProCon.org (http://healthcarereform.procon.org), presents 34 questions regarding the March 2010 health care reform laws along with responses from over 150 experts including President Barack Obama (pro), former Alaska Governor Sarah Palin (con), Speaker of the House Nancy Pelosi (pro), House Majority Leader John Boehner (con), AARP (pro), US Chamber of Commerce (con), New York Times (pro), Wall Street Journal (con), along with many physicians, economists, government officials, medical organizations, and dozens more.

If you are looking for a concise, easy to understand, and unbiased source of information about the health care reform bill(s) then please take a look at http://healthcarereform.procon.org.

“Experts?”
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“over 150 experts including President Barack Obama (pro), former Alaska Governor Sarah Palin (con)”
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Is this a joke site?

april, you are 100% correct on this. HCR, as it is currently written, has no chance at being successfully implemented! First, Obama sold out to big pharma, taking pharmaceuticals out of the equation, then he sold out to the insurance companies, so two of the most significant cost escalators are elevated to partnership in this fraud called reform. He has angered physicians by refusing to even consider tort reform and he has alienated seniors by cutting 313 billion from medicare. So much for listening to the people, 51% still oppose HCR and that number will increase quite significantly, as people start seeing precipitous increases in their premiums. This bill will damage the democrats in November and we can only hope that a repeal is coming, shortly thereafter.

“Obama sold out to big pharma, taking pharmaceuticals out of the equation, then he sold out to the insurance companies, so two of the most significant cost escalators are elevated to partnership in this fraud called reform.”
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I really, really, really wish I could find some factual basis for disagreement with this…but I can’t.
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I know that I don’t agree in the slightest with Earl’s politics or goals or worldview, but he’s basically stating unimpeachable facts, like “the sun sets in the west” or “a closed-door deal was reached with PhRMA by the Administration:”

Internal Memo Confirms Big Giveaways In White House Deal With Big Pharma
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First Posted: 08-13-09 11:10 AM | Updated: 09-13-09 05:12 AM
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A memo obtained by the Huffington Post confirms that the White House and the pharmaceutical lobby secretly agreed to precisely the sort of wide-ranging deal that both parties have been denying over the past week.
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…the White House agreed to oppose any congressional efforts to use the government’s leverage to bargain for lower drug prices or import drugs from Canada — and also agreed not to pursue Medicare rebates or shift some drugs from Medicare Part B to Medicare Part D, which would cost Big Pharma billions in reduced reimbursements.
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In exchange, the Pharmaceutical Researchers and Manufacturers Association (PhRMA) agreed to cut $80 billion in projected costs to taxpayers and senior citizens over ten years. Or, as the memo says: “Commitment of up to $80 billion, but not more than $80 billion.”

http://www.huffingtonpost.com/2009/08/13/internal-memo-confirms-bi_n_258285.html
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What can I do?
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I’m a member of the reality-based community, so, like my fellow liberals, I’m compelled to acknowledge reality.
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Why are establishment Democrats forcing me to acknowledge any validity at all of what movement conservatives say?
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I hate intellectual honesty, sometimes, I really do…

You know, you really make some decent points, but this:
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“It reminds me of Civil Rights. First there was emancipation. Then there were setbacks for another eighty years. Then the desegregation of the armed forces. Finally, more than 100 years later there was legislation which really did prevent Jim Crow laws and made discrimination illegal.”
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is not one of them.
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This is nothing like Civil Rights, or women’s suffrage, or marriage equality.
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Would you apply the same standard of measurement to the insanely costly Iraq occupation?
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Would you say
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“Hey, it’s like Civil Rights. First there was an end to active combat missions. Then there was setbacks for 80 years. Then something else happened, and we pulled our forces and private contractor army out a little more…”
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Of course you wouldn’t, because these sorts of policies aren’t remotely similar to social movements toward equality. Equality isn’t the same kind of problem to solve as national defense or health care infrastructure. One involves changing policies, the other involves changing the nation.
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Somehow you got “it’s like Civil Rights” in your head, and I can’t help wondering if that has anything do with the incredibly similar line that was pushed by certain Democratic operatives during the debate, seemingly in order to shame movement liberals into “waiting” for supposed improvements to come, the implication being “If poor black folk can wait their turn, why can’t you?”
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Pushing narratives like that seems to turn off parts of certain liberals’ brains during times of uncertain support, such that “rapidly running out of resources” problems can be confused with “historical struggle” problems by otherwise intelligent people. That’s why Democratic operatives who are savvy enough to how liberals work seem to exploit those kind of lines.
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Only the Democratic establishment uses rhetoric that suggests the entire country has to become something different, otherwise sane policy can’t be passed with overwhelming Democratic majorities…even ultimately using Reconciliation! Only the centrists repeat the line that 60-something percent popular policies –like the public option passed by the House– need Alabamians to have embraced socialism in order to be politically feasible.
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Because liberals are so familiar with “the long struggle” rhetoric, we tend to accept a lot of that at face value, when we don’t necessarily have to.
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Imagine if the New Democrats –Hillary, Obama, Edwards are all New Democrats, by the way– had told us before the ’08 election that health care was going to be just like Civil Rights, as in we were going to have to wait 80 years until the country was ready for it.
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Imagine if the ’06 Democrats had ran on ending the Iraq war…just over the long haul, you know, like Civil Rights.
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You know exactly what our response would have been!
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Please, patricksartor, you’ve got to consider the notion that this is nothing whatsoever like “Civil Rights.”
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It’s more like we’re on the Titanic.

“You whined that you had to drop out of college because the stingy Republican-led governments weren’t providing you with free money to attend.”
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No, I just wanted the student loans which were available from the Roosevelt Administration through the Carter Administration which you used to to pay for your education which, according to your own posts mostly consisted of gulping down sour mash.
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I am not a failed anything and never sold used cars.

” I guess to satisfy the left we should stop producing both that would solve the problem.”
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First, he was bringing up what is or is not a “rant”
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Second, until the alternatives are on the market, there is nobody running for office nor any political campaign to stop all fuel exploration.
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Also, those boogieman under your bed who want to redistribute wealth are, also, only in your head.

ricardo opened this thread with a comment all about HCR

“The question was about cost, not popularity.”
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If all people seeking office were self sacrificing saints who have no problem with being booed out of office to do the right thing I would agree with you.
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However, most office seekers are absolutely nothing like this and, if you feed the right wing a fact that HHS would need to hire hundreds or even thousands of more people and make state agencies obsolete, you must pucker up and kiss your job goodbye since irrational voter fears of the federal government will cost you your job.
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In a perfect world with a benevolent dictatorship (if one ever really existed in reality) or saintly office seekers only these changes would make sense. If our people lacked their fear of the federal government, this, also, would be true.
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Unfortunately this is not how our country is. We have many fearful people who will come out in droves to throw out anybody who expands the federal government as you proposed.

“Please, patricksartor, you’ve got to consider the notion that this is nothing whatsoever like “Civil Rights.”
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In the fact that, despite how obvious it is that it is the right thing to do people with their fears will not let it happen.
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During Civil Rights it was the Dixicrats. Today they are the Blue Dog Democrats.
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By no means is this a statement of what I wish or believe should be true, but, the sobering reality of what is: those who feared racial equality for a century were as controlled by those false fears as those in fear of government.
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“It’s more like we’re on the Titanic.”
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No, that was the Bush Administration.
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This is like a trip to Australia riding on the Staten Island Ferry – pathetically slow and, for such a long trip, very uncomfortable.
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Find me some saints who will happily kiss their jobs goodbye after voting for real HCR and I will be thrilled to not only vote for them but work for their campaign.
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Until you find some, we are riding the Staten Island Ferry across the Pacific not even half way to Hawaii.

Why are establishment Democrats forcing me to acknowledge any validity at all of what movement conservatives say?
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I hate intellectual honesty, sometimes, I really do…

I am neither a modern-day “liberal” nor “conservative” (although I consider myself to be both in literal sense)
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Yet I, too, don’t like it when others take my agreement with arguments they make, and use it as vindication of what I see as their incorrect, destructive assumptions masquerading as conclusions.
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I see, though, that you usually are able to also well articulate the more correct analyses. Thank you.

in this case, for instance, the question is:
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WHY did Obama do what appears to be a sell-out to big pharma and the insurance companies, so that two of the most significant cost escalators seem to have been elevated to partnership in something labeled “reform”, making it then appear to be a fraudulant reform?
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The “movement conservatives say” that it is such things as that Obama wants to turn the USA into a Socialist State, etc. In other words, that it is part of a grand conspiracy against the American people.
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I think that is quite unlikely. But until “establishment Democrats” are willing to tell what was REALLY behind these things, and no one who ought to know refutes that story, we are all left conjecturing.
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Who knows? The truth might be something so different from anything that has yet been proposed, and it could either be shocking or boring.

I just found this on Gallup regarding Health Care Reform.
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It shows opinions over time.
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http://www.gallup.com/poll/4708/Healthcare-System.aspx
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It appears to me as if the anti-HCR propaganda was so strong that it changed people’s opinions dramatically.
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Since it’s passage there has been extremely small changes in opinion so far.
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What supporters of single payer and other more useful HCR need is a huge public relations campaign since the forces of the right are so incredibly strong.
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I have no idea why anybody would think that somebody who got the endorsement of a career Tort Lawyer – that is John Edwards endorsed Obama – would ever touch tort reform with a ten foot poll, but, this is a weak bill which has far, far too little government.
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I have no idea how to undue these false fears the right wing has brought into this debate, but, for as long as they are there, there will not be anywhere near enough Democrats with backbones to change things.

I run a small tax accounting practice. I’m acutely aware of the onerous regulations involved with the new health care program (but then onerous regulations are nothing new to civilized societies…and they sure beat the alternative which is a lack of civilized society). I’m also acutely aware of how impossible it is to get health care if you’ve ever been seriously ill (aka a pre-existing condition) and you don’t work for a giant corporation. The legislation, for all its flaws, has done a lot to fix the second problem.

Without reform, we were rapidly heading toward a country consisting of nothing but giant corporations because nobody who’s ever had so much as a headache would be able to get health insurance thanks to the steadily expanding net of pre-existing conditions. This would mean a serious shortage of new businesses to introduce new innovations. It would also mean the eventual death of American corporations because the high costs of the American health care system make US companies less able to compete on the global scale where other developed nations have efficient health care systems that don’t consume corporate resources. In short, pre-reform, the health care system was a cancer steadily killing the entire country.

Post-reform, it’s certainly no picnic. The legislation is a mess. The simple solution would have simply been to allow anybody to enroll in Medicare if they want. If you don’t like government run health-care, you don’t have to enroll. But if the private market doesn’t want you, then you’ve got that to fall back on. But ironically, the health insurers used the Tea Partiers to help them make this solution politically impossible (even the many TPers actually use and like Medicare…but want the government to stay out of it…go figure). If you want something simple, lobby for single-payer. Somehow I don’t see that happening in the US anytime soon.

Class.
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You’ve made exactly the same point I was but with far more specific experiences and expertise than I have.

sometimes it is best to simply make it clear what one’s assumptions and what ones questions are, and ask if anyone with standing on the issue has a grasp on their vailidity and answers.
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We might remember there are a lot of people viewing this site that do not comment because they don’t want to join in the jousting. We might consider that they are from a diversity of walks of life, and, therefore, for every angle there is a good possibility that a good “expert” on it is looking on.
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Like Fiskin’s algorithm relies on, there is wisdom in random samplings of diversity.

“Without reform… It would also mean the eventual death of American corporations because the high costs of the American health care system make US companies less able to compete on the global scale where other developed nations have efficient health care systems that don’t consume corporate resources.”
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You’re right, the exorbitant price of US health care is found nowhere else in the developed world, and is a terrible drag on our economy, in addition, obviously, to burdening so many individuals.
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But it seems as if you’re suggesting that the high price of US health care –$7,300+ per person, as opposed to the OECD average of $3,000 per person ( http://static.seekingalpha.com/uploads/2009/7/5/saupload_f2.JPG ) has been or will somehow be reduced because of the PPAC Act.
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You write:
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“…pre-reform, the health care system was a cancer steadily killing the entire country.”
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, and that’s true, the high cost of US health care is surely destroying our way of life. Some might call it the iceberg headed toward our Titanic, but deadly cancer is a good enough metaphor.
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“Pre-reform”, though, means an average price tag per person of $7k plus.
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How much will it cost per person in 2016, now that reform has saved the day?
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How much less than $7,000 per person will it be, once the cancer on our nation is in remission?
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Mind you, I don’t care if we have a “simple” system like single-payer or not, all I care about is that we stop bankrupting our people, and destroying the productivity and innovation that used to characterize America. All I’d like is an end to being ripped off like nowhere else in the post-industrialized world.
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So, now that we have reform, how much are we expected to pay per person in 2016, when the whole thing is supposed to be said and done?
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$3,000? $4,000 like France or Germany?
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$5,000? $6,000?
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Will we at least hold steady at $7k, do you suppose?
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Or will reform have done nothing whatsoever about the cancer that’s killing the American way of life?
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What do reputable projections indicate?

This has been happening in PA with the HMO’s offered through medicaid. Medicaid was once a “fee-for-service” program in which a medicaid recipient went to the doctor and the doctor in turn billed the state. But part of Clinton’s welfare reform put medicaid in the hands of private insurance companies. All of a sudden PA had several small insurance companies vying for the medicaid dollars. PA paid these companies “X” dollars for each medicaid recipient they enrolled. Many of them offered more than medicaid had traditionally offered. One gave away car seats and cribs to pregnant women, but the health coverage they actually offered was deplorable. Another did not allow for emergency room visits under any circumstances without approval from the PCP.
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It got so bad and PA’s costs were rising so much that PA finally developed their own medicaid advantage plan. Its a medicaid HMO owned and operated by the welfare office, it actually has kept costs down and still manages to offer more than traditional medicaid.
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The fight now is to put public mental health back into the hands of the welfare department rather than the private insurance company which wants more and more state dollars while cutting needed programs every year.

Good questions Stuart. All I know is that I often struggle to afford my medications. I’m disabled and work full time for a non-profit health provider. And I struggle. But my employers pays over $400 a month in premiums just to cover me, I pay another $100+. But with my medication co-payments, one of my medications being off formulary, ect., I struggle each and every month to stay healthy.
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Ironically, when I returned to the workforce a little more than 2 years ago, I could have stayed on medicaid under a buy-in program called medical assistance for workers with disability (MAWD). Under medicaid I had been paying less than $1. for each prescription and my premiums for MAWD would have lower than what I’m paying Blue Cross. But I wanted the Blue Cross. I wanted to be able to see any doctor I chose without asking “Do you take medical assistance”. I can only go to my new doctors of my choosing when I can afford to do so. In the past 2 years I’ve canceled or postponed nearly half my appointments.

Is RAND guaranteeing its results?

NO.

Total BS .. another OWEbama LIE.

Is RAND guaranteeing its results?

NO.

Total BS .. another OWEbama LIE.

Read more: http://swampland.blogs.time.com/2010/09/02/health-reform-is-good-for-small-business-employees/#comment-196929#ixzz0yQcqJPOw

RAND guaranteeing its results?

NO.

What BS .. another OWEbama LIE.

Lenin, Stalin, Fidel and Ho would be proud of you. Way to go. Be sure to bow down to MESSiah.

“I wanted to be able to see any doctor I chose without asking “Do you take medical assistance””
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Of course that’s what you wanted. That’s about one of the most normal, understandable things I’ve ever heard.

russpoter1
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He is saying that he would start a business.
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Then you bring up the names of communists.
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How about “Adam Smith, John D Rockefeller, Bill Gates, way to go.”
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That would make sense since none of the people you mentioned started businesses.

“RAND guaranteeing its results?

NO.

What BS .. another OWEbama LIE.”
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Correction:
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RAND guaranteeing its a factually correct study?

YES.

What BS .. another case of Wingnut conspiracy theories.”
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Now that would make sense.
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Russ, do you, also, believe that aliens killed JFK and Mulder and Scully uncovered it on the X-Files?

NFIB is 100% against OWEbama.

http://www.nfib.com/press-media/newsroom-article/cmsid/50136

So much for what you know.

Q: How long until the first big OBAM-FRAUD from this BS is reported?

A: Jan. 2, 2011.

DELIVER A THOUSAND CUTS — MAKE THIS B.S. DIE — MAKE OWE-BAMA SUFFER as much as the working class.

HEY KOS-TROLL

RAND guaranteeing its results?

NO.

What BS .. another OWEbama LIE.

Russ,
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You are displaying signs of mental illness.
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Rand did a study.
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These are the results.
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If you deny these facts that is not my problem.
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If you wish to pretend that the fact that more small businesses are buying health insurance – including those not mandated to – is just a coincidence, then prove it or STFU.
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Otherwise acknowledge that this is the result of the legislation you were against.

“So much for what you know.”
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You sent a six month old article from a very conservative organization about the never passed public option.
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Now I do know, Russ, you haven’t followed the news since January.

I am sure you beleive the PROPAGANDA your writing and that in itself is scary.. HOWEVER you are INCORRECT.. which will be proven shortly.. and those are JUST your PERCENTAGES.. than we have the fact that WE THE PEOPLE .. don’t want the GOVERNMENT MANDATES.. but I digress the COST will CONTINUE to go up as long as HOSPITALS are allowed to be FOR PROFIT and BIG PHARM keeps contributing to our POLITICIANS and those same POLITICIANS REFUSE to control prices on the drugs they sell but they won’t fact is they give them our TAX dollars in the form of GRANTS.. why would they NOT take advantage of the PEOPLE??