Thank gawd, some serious analysis of HR3962 at last!* Plenty of detail from letsgetitdone at FDL. Go read the whole thing; I'll just excerpt this:
The thing that sets this bill apart from most, is that it specifies two distinct periods in which the legal structures created by the bill will be different. The first period is from January 1, 2010 to the date in 2013 when the exchange, the public option, the mandates, the subsidies, and the outlawing of denials due to preexisting conditions become relevant, and the period thereafter, when most of these conditions take effect, and when eligibility for the exchange and the public option will be gradually expanded.
I’ll begin this analysis and evaluation with the first “band-aid” period. ...
In evaluating the band-aid period aspect of the House bill, there are a few key points that really stand out. First, the very fact that there is a “band-aid” period is a grievous problem with this bill. It does two things. First, it ensures that there will still be roughly 31,000 fatalities per year during the band-aid period, a total of 108,000 dead throughout the period, still 2/3 of the present number of fatalities forecast without a bill. To the people who have no insurance and who will die because they don’t have it, the House is saying: “help is on the way: just hang on until 2013, or alternatively you can pay the enormous cost of individual health insurance in the high-risk pool – if you can afford it before the subsidies kick in.”
Second, the “sunshine provision” in the band-aid period, rather than persuading us that it will be effective in meeting the problem of insurance cost increases, is so weak that it tells us the opposite: namely, that Congress is just giving lip service to the idea that insurance cost increases must be regulated and minimized during this period, and that we can probably expect insurance cost increases of between 40% and 50 % over the band-aid period.
Yep. Murder by the greedy. That's what "progressives" on the access blogs like Open Left have "patiently explained" to us "little single payer advocates" that we have to accept. Why should we?
Of course, there are two curious incidents of dogs not barking in the night time:
1. The real change doesn't kick in 'til 2013;** before that, it's Band-Aids. That tells you that Obama doesn't want to run on the bill. And what does that tell you?
2. The access blogs aren't going all triumphal, even though the bill has the semantics -- the words "Public Health Insurance Option -- they've been demanding. And what does that tell you?
NOTE * Leave it to the single payer folks; I did a quick tour of the access blogs, like Open Left, and nothing, of course. After all, it's only the lives of the unterbussen that are at stake, and they're probably racist anyhow.
NOTE ** Remember when the public option crowd explained that the 2013 date was just for the purpose of making CBO estimates, and wasn't a real date? Oh, well...
UPDATE To be fair, WKJM
has a post on HR396's page count. Way to go.
- lambert's blog
- Login or register to post comments
- 1+[CSE]+#b94+
Front page
Comments
Nice, Except...
I noticed that he isn't familiar with the current situation regarding:
"4. ENDS RESCISSIONS — Prohibits insurers from nullifying or rescinding a patient’s policy when they file a claim for benefits, except in the case of fraud."
Currently, the insurance companies are using the "fraud exemption" for rescission. They aren't simply canceling, they claim that people lied on their applications by not including pre-existing conditions, like acne, which is why the company won't cover the costs of cancer and then cancel the policy.
This same rescission language already exists in several jurisdictions, and it isn't effective at stopping the practice because individuals have to take the insurance companies to court to do anything about it.
To be effective, the insurance companies would have to be forced to prove their fraud claims in court, and they would have to pay for treatment until the case is settled. If they prove their case, they would be awarded their costs. IOW, put the burden of proof on the insurance companies, rather than on the individuals as happens now.
another suggestion re rescissions
prevent the insurance companies from asking about pre-existing conditions. that way there is no fraud, intentional or not.
in MA i think we have pretty good protections. and we are NOT asked about pre-existing conditions. age, sex, home zip code. that is all the info they can ask before quoting a policy premium.
Exactly
and I was going to note the same thing. Unless there's other language somewhere, this doesn't change much, if anything. Insurers already can't nullify or rescind a policy for no reason - they have contractual obligations THe way they get around those obligations is to claim "fraud" and, at least under state law in a lot of states, all that means is they have to show some sort of misrepresentation somewhere on the application, it doesn't have to be relevant to the claim.
"Do what you feel in your heart to be right -- for you'll be criticized anyway. You'll be damned if you do, and damned if you don't. " - Eleanor Roosevelt
Incrementalism
I decided to give the access bloggers the benefit of the doubt, as an exercise in perspective. As I see they see it (all those arguments that progress builds on previous progress), they are taking the long view: eventually (twenty years on? fifty?), step by step, all of these flaws will be corrected and we will have arrived at reasonably priced health care for all. In a hundred years, everybody now alive will be dead anyway. (Meanwhile, they and theirs have health insurance or are young and healthy, so it's not urgent for them.)
It's a historical perspective—some suffering and personal tragedy along the way, but what can you do, and at least some people get relief now. To push for everything at once would delay the first, foundational steps.
Does this make sense?
yes it makes sense
a possibility: expanding medicare a few years at a time [this year the 55-65 year olds, next year the 45-55 year olds, for example] until all are covered would be incrementally building on previous progress.
another: we have the vha, the ihs, medicare, and medicaid. adding a fifth public option to these 4 already-in-place publicly-funded plans and putting all the uninsured in that pool would be another increment in the right direction too.
yet a different path of incrementalism: about 50% of the population is covered by private insurance. about 35% of the population is covered by one form or another of govt insurance. about 15% of the population has no insurance. put that 15% into medicare tomorrow and voila! everybody has [ostensibly] a way to pay for the care they need. allow those who are being screwed over by their private insurance to transfer into medicare too and voila!
all of these would stop the worst of the killing of uninsured/underinsured people fairly quickly, but would need more work later on to keep them sustainable [adding in cost controls would be very important]. all kinds of increments available, no need to wait 100 years, or even 20 to finish the job.
the bills we got instead are all about entrenching the insurance industry in health care and they are being sold by some very smooth operators as 'incremental reform' to a lot of very good-hearted people who believe that incrementalism really is the best way to go.
on incrementalism
i think it got this one from t.r. reid.
in healthcare reform, incrementalism is like jumping half way across a canyon. it doesn't get you any closer to the other side.
medicare advantage
medicare advantage needs to be killed too.
have i mentioned recently how much i hate the dems for their privatization policies?
kill it dead with fire!
And as for mentioning how much you hate the Dems for their privatization policies, have I mentioned recently how much I agree with you about that?
We can't afford not to have single-payer!
These are such good ideas,
I'm withdrawing my provisional assumption of good faith. They just want to give Obama a win.
There is, in addition, no evidence that health exchanges work
and public option advocates won't explain how the plan is administered. See the exchange here; the HCAN answer isn't compatible with a "good faith" assumption at all.
NOTE "Work" is not the same as "polls well," needless to say. Show me the saved money and the saved lives!
First they ignore you, then they ridicule you, then they fight you, then you win. -- Mahatma Gandhi
I would rather nothing change without single payer.
I have not seen anything written by people that can analyze this stuff that indicates to me that I am not seeing one enormously expensive con job.
That is the only thing that this bill changes. Now cold blooded murder by the insurance companies are not going to be tolerated some time in the dim and distant future. Whoop de freaking doo.
There is nothing in this BS that could not be accomplished better and faster by arresting the presidents of the major insurance companies and charging them with cold blooded murder. True, yes, if you like, you can add in bribery, blackmail, conspiracy to commit murder and a whole lot of RICO charges.
Other than that the uninsured are fucked as well as the insured who are not guaranteed a cap on the thieves' charges.
Gee, mr gutless in the white house can wiretap anyone. How about tapping the phones on every one of the members of the white house, the congress and the whores for the insurance industry.
Nope, gutless won't do that on principle. He can't even conceive of it because he is an expert in Constitutional law. Uh, sorry gutless we dropped the constitution about 9 years ago. Uh, wake up, you third rate thinker, you can simply have all of the Republican party picked up and thrown into Gitmo with total cover because of what the previous administration did.
Yeah, that's right. 60 votes shit, you pick up 40 Republicans and throw them in prison for life with no charges and you could deliver single payer in a heartbeat, you could end the idiot wars the same afternoon.
You could be great, but you won't be, because you are simply a worthless damn lawyer with no damn guts.
Other than defending and attempting to increase the president's power exactly what has that shit Holder done? Nothing, absolutely nothing. I could draw up a list of over 1,000 criminals that should be under indictment off the top of my head, but all I see is Holder pushing more power to gutless, more power to gutless, more power to gutless. Hey, Holder, give gutless a spine, he has all of the power and more that he can or will use.
Yep, those uninsured gotta die for the shits in Washington.
Really a great little plutocracy you oligarchs got here, be a real damn shame if something happened to it.
Self exile