Will union members be exempted from the “Cadillac” health-care tax?
62 thoughts on “That Will Increase Its Popularity”
So instead look at the 20 year projection; the Senate bill reduces the deficit much more in the second decade.
I will wait until the doors are unlocked, smoke has gone out the chimney and we have a new Pope, I mean, health care specification. Further, I reserve the right to remaind skeptical that some magical economy-of-scale is going to remove waste/fraud/abuse and make everything cheaper until it happens. Which means I guess I’ll get back to you in 10 years if this thing passes.
I’m pretty sure that all of the dozens of plans I considered in December (including the high-deductible HSA plan I chose) would have no trouble meeting this standard.
If they’re HMO/PPO plans, yes. Most of them run in the 80 to 90 range. Your HD plan, however, will not, unless we’re talking about the SB and it’s very generous and coveres a lot of things (like prescription benefit IIRC). HD plans in general won’t be legal because your HSA won’t be included in the actuarial value. Amendments introduced to remedy this have failed. The HHS Sec is going to be the dictator here on these fiddly bits, so gl.
This sets a floor, but does not make health insurance “one size fits all”.
Two or three sizes, then, if you must. The fact is that people are going to be asked to pay for pre-paid healthcare they neither need nor want. In reality, they will simply drop coverage because the penalty is an order of magnitude less than the premiums, and you can always sign-up later if you get sick.
So instead look at the 20 year projection; the Senate bill reduces the deficit much more in the second decade.
And I’m sure the 30 year projection would be even better, if they had bothered with it. But you forget, this is the CBO. They don’t have credibility. I simply don’t care what they project or over what time frame they make the projections. My view is that a 20 year projection where most of the good stuff happens in the second decade is a typical shifty, political trick that can be used to claim (for a time) that the CBO projections are still good, we just need to wait another decade to see the results. There are no consequences to being wrong and/or lying outright on those time scales.
“She’s alive and better because the existing system includes a law that bars employer-provided group health insurance plans from discriminating on the basis of pre-existing conditions.”
That’s false. The only legislation (not regulation) regarding preexisting conditions is HIPPA, and it only says that an insurance company may not go back any further than six months in a person’s medical records to determine whether a condition is preexisting or not.
If BCBS had gone by the letter of the law, my wife wouldn’t be alive right now (and if I had been counting only on them). Our company has more than one insurance option, and a friend of mine chose one which did in fact deny coverage to his spouse on the grounds of a preexisting condition. That is a whole other story, and fortunately has a happy ending.
Regarding pre-existing conditions, what precisely is the virtue in eliminating an insurance company’s option to decline this business. With guaranteed issue and community ratings, insurers will be faced with ‘expensive’ customers (i.e. customers asking for coverage wo already have conditions so expensive to treat that the insurer cannot possibly recoup their expenses), which they can only cover by insuring large numbers of ‘cheap’ customers (those relatively healthy or at least disinclined to consume large amounts of care) at low cost. Since a great truth of economics is that when something is free, we tend to consume more of it, insured individuals tend to consume far more healthcare than those without insurance, or with marginal insurance. The result is that bring more people into the system is likely over time to reduce profit margins on even cheap customers, thus limiting their ability to offset losses on expensive ones.
The result of this process is that over time, the insurers will drop out of the system, as there is simply no way to generate sufficient profits to stay in. Insurers are not a public service, they are a business, and without profit no business can survive. The only survivor over time will be the insurers with no profit concerns (can anyone spell ‘Government’), and even they will face enormous unfunded liabilities which can only be offset either through deficits or taxes. One need only look at any of the health insurance systems in the developed world (France is a superb example of this dynamic in action), and the deleterious impact they have on their host nation’s finances.
Forcing millions of young, health individuals into the system to subsidize the older, unhealthy ones is the only way that this nonsence can be made to work even over the short run, and certainly not beyond that. Take a good look at medicare’s finances, and you see this process at work…
Further, I reserve the right to remaind skeptical that some magical economy-of-scale is going to remove waste/fraud/abuse and make everything cheaper until it happens.
The CBO is not assuming anything of the sort, so if health reform does “bend the curve” of health care costs that will be an additional bonus.
But you forget, this is the CBO. They don’t have credibility. I simply don’t care what they project or over what time frame they make the projections.
When evaluating legislation it’s important to have the best possible forecasts of its future fiscal impact. If a professional, non-partisan projection is not good enough, what’s your suggestion?
There are no consequences to being wrong and/or lying outright on those time scales.
Why would the CBO want to lie? What’s in it for them?
That’s false. The only legislation (not regulation) regarding preexisting conditions is HIPPA, and it only says that an insurance company may not go back any further than six months in a person’s medical records to determine whether a condition is preexisting or not.
HIPPA is the law in question, and it says more than that. Under HIPPA (aka Kennedy-Kassembaum, signed by Clinton in 1996 and no doubt opposed by many of the people opposing health reform today) when a condition has been treated in the previous six months the insurer is required to cover it after an exclusion period. So while it was good of BC/BS to cover your wife’s condition immediately, if she survived they were going to have to cover it eventually, because of HIPPA.
I find it amazing that you would oppose extending that same protection to people in the individual insurance market, especially when you know firsthand that not all insurers are as generous as BC/BS was in your case.
One need only look at any of the health insurance systems in the developed world (France is a superb example of this dynamic in action), and the deleterious impact they have on their host nation’s finances.
Huh? France spends half what we do on health care, and their people get better care. We should be so lucky.
“I find it amazing that you would oppose extending that same protection to people in the individual insurance market, especially when you know firsthand that not all insurers are as generous as BC/BS was in your case.”
I oppose having the government point a gun at someone and tell them to pay for someone else’s health care. That includes my wife, my kids, or me. I would not have committed armed robbery to pay for my wife’s operation, but would have found a way to pay for it no matter what.
If you find THAT amazing, I would say that explains why we will never agree on this. And I wouldn’t trust you as far as I could throw you.
One more thing. If BCBS or its equivalent had not been available, I would have found another legal way. I have always found a legal (and moral) way, and this would have been no different.
But when the government becomes the “single payer” and decides it is not going to pay, there will be no alternatives. Trying to go outside the system will be illegal, and could very well land you in jail (where you couldn’t do anything if you tried).
I have every reason to believe that under Obama care, my wife would not have been treated at all until it was too late to do anything. We had to force the issue as it was, since the medical community ignores heart problems in young women. But we did it, and were able to do it because there are many, many options (competing options, in fact) in medical care. If there are no options, we’re all screwed.
I oppose having the government point a gun at someone and tell them to pay for someone else’s health care. That includes my wife, my kids, or me.
So you oppose HIPPA (and Medicare, and Medicaid)? But you were willing to take advantage of insurance coverage that might not have been there were it not for HIPPA? Will you decline Medicare benefits when the time comes?
One more thing. If BCBS or its equivalent had not been available, I would have found another legal way. I have always found a legal (and moral) way, and this would have been no different.
Do you have super powers? Or are all the millions of people who have not been able to legally get required coverage inferior human beings?
I have every reason to believe that under Obama care, my wife would not have been treated at all until it was too late to do anything.
Your “every reasons” are paranoid delusions. HIPPA required insurance companies to cover sick customers in the group market (i.e. most of them), and people did not start dying in the streets. Requiring coverage for sick people in the individual market won’t be the end of the world either.
“Do you have super powers? Or are all the millions of people who have not been able to legally get required coverage inferior human beings?”
Neither. I have always been able to take care of my financial needs, as can almost anyone else who is willing to put in the work to do so (at least in a free country). I would have paid for it myself. It was only $100,000. I’ve raised more than that in a few days when I needed to. While there are people who genuinely cannot do so, they don’t go without medical treatment in this country.
I took the BCBS deal because it was there. Who wouldn’t? But if there had been any six month restriction, I would not have been able to wait. She’d have been beyond help by then.
I’m providing for my own future, and don’t plan to depend on Medicare unless the law doesn’t permit me to do otherwise (which is the intent).
“Your “every reasons” are paranoid delusions.”
I don’t think you understood (or perhaps didn’t read) what I wrote. We spent 14 years going from doctor to doctor to get them to figure out what was wrong with my wife. But doctors, especially male doctors, dismiss young women who complain of heart problems. It wasn’t until a renowned electrophysiologist who told us that she didn’t have a particular problem when the diagnostic report he had just received, and was sitting on the table between us, said exactly the opposite, that I blew up. I demanded that her group cardiologist actually look at some of the test results he had ordered, and when he did he finally, he meekly admitted that she didn’t have much time left. Followup consultations with three surgeons and two cardiologists confirmed it. The only difference was that they knew she actually did have a problem before looking at the test results, and didn’t just glance at them without reading them (as they had done for the past 14 years).
When we have “healthcare for all,” the government will decide what it will and will not pay for. It will probably do so on the advice of one, or at most two, doctors. Judging by the experience we had in the U.S. system as it is today, that would have been the end of it. The first doctor or two would have dismissed her, as they actually did for more than a decade, and the government wouldn’t pay for it. One won’t be allowed to pay for it oneself, under the system envisioned by Obama.
But that’s okay. They’d tell her to take a pain pill. Just like Obama himself said.
It is quite disturbing when you see someone like David who would advocate for an election which exclude certain members of the community from participating. and he still happy to call it election and democracy!!!!
isn’t this a clear example of the double standard that made the Arab public not to trust the West?
while at the same time you don’t hear anyone calling for banning right wing parties in Europe(BNP and Sien Fain) and Israel(Lieberman’s Party) from participating election….
Its seems like basic western value to support democracy only if it is going to produced the desired winning party. otherwise democracy doesn’t matter.
I will wait until the doors are unlocked, smoke has gone out the chimney and we have a new Pope, I mean, health care specification. Further, I reserve the right to remaind skeptical that some magical economy-of-scale is going to remove waste/fraud/abuse and make everything cheaper until it happens. Which means I guess I’ll get back to you in 10 years if this thing passes.
If they’re HMO/PPO plans, yes. Most of them run in the 80 to 90 range. Your HD plan, however, will not, unless we’re talking about the SB and it’s very generous and coveres a lot of things (like prescription benefit IIRC). HD plans in general won’t be legal because your HSA won’t be included in the actuarial value. Amendments introduced to remedy this have failed. The HHS Sec is going to be the dictator here on these fiddly bits, so gl.
Two or three sizes, then, if you must. The fact is that people are going to be asked to pay for pre-paid healthcare they neither need nor want. In reality, they will simply drop coverage because the penalty is an order of magnitude less than the premiums, and you can always sign-up later if you get sick.
So instead look at the 20 year projection; the Senate bill reduces the deficit much more in the second decade.
And I’m sure the 30 year projection would be even better, if they had bothered with it. But you forget, this is the CBO. They don’t have credibility. I simply don’t care what they project or over what time frame they make the projections. My view is that a 20 year projection where most of the good stuff happens in the second decade is a typical shifty, political trick that can be used to claim (for a time) that the CBO projections are still good, we just need to wait another decade to see the results. There are no consequences to being wrong and/or lying outright on those time scales.
“She’s alive and better because the existing system includes a law that bars employer-provided group health insurance plans from discriminating on the basis of pre-existing conditions.”
That’s false. The only legislation (not regulation) regarding preexisting conditions is HIPPA, and it only says that an insurance company may not go back any further than six months in a person’s medical records to determine whether a condition is preexisting or not.
If BCBS had gone by the letter of the law, my wife wouldn’t be alive right now (and if I had been counting only on them). Our company has more than one insurance option, and a friend of mine chose one which did in fact deny coverage to his spouse on the grounds of a preexisting condition. That is a whole other story, and fortunately has a happy ending.
Regarding pre-existing conditions, what precisely is the virtue in eliminating an insurance company’s option to decline this business. With guaranteed issue and community ratings, insurers will be faced with ‘expensive’ customers (i.e. customers asking for coverage wo already have conditions so expensive to treat that the insurer cannot possibly recoup their expenses), which they can only cover by insuring large numbers of ‘cheap’ customers (those relatively healthy or at least disinclined to consume large amounts of care) at low cost. Since a great truth of economics is that when something is free, we tend to consume more of it, insured individuals tend to consume far more healthcare than those without insurance, or with marginal insurance. The result is that bring more people into the system is likely over time to reduce profit margins on even cheap customers, thus limiting their ability to offset losses on expensive ones.
The result of this process is that over time, the insurers will drop out of the system, as there is simply no way to generate sufficient profits to stay in. Insurers are not a public service, they are a business, and without profit no business can survive. The only survivor over time will be the insurers with no profit concerns (can anyone spell ‘Government’), and even they will face enormous unfunded liabilities which can only be offset either through deficits or taxes. One need only look at any of the health insurance systems in the developed world (France is a superb example of this dynamic in action), and the deleterious impact they have on their host nation’s finances.
Forcing millions of young, health individuals into the system to subsidize the older, unhealthy ones is the only way that this nonsence can be made to work even over the short run, and certainly not beyond that. Take a good look at medicare’s finances, and you see this process at work…
Further, I reserve the right to remaind skeptical that some magical economy-of-scale is going to remove waste/fraud/abuse and make everything cheaper until it happens.
The CBO is not assuming anything of the sort, so if health reform does “bend the curve” of health care costs that will be an additional bonus.
But you forget, this is the CBO. They don’t have credibility. I simply don’t care what they project or over what time frame they make the projections.
When evaluating legislation it’s important to have the best possible forecasts of its future fiscal impact. If a professional, non-partisan projection is not good enough, what’s your suggestion?
There are no consequences to being wrong and/or lying outright on those time scales.
Why would the CBO want to lie? What’s in it for them?
That’s false. The only legislation (not regulation) regarding preexisting conditions is HIPPA, and it only says that an insurance company may not go back any further than six months in a person’s medical records to determine whether a condition is preexisting or not.
HIPPA is the law in question, and it says more than that. Under HIPPA (aka Kennedy-Kassembaum, signed by Clinton in 1996 and no doubt opposed by many of the people opposing health reform today) when a condition has been treated in the previous six months the insurer is required to cover it after an exclusion period. So while it was good of BC/BS to cover your wife’s condition immediately, if she survived they were going to have to cover it eventually, because of HIPPA.
I find it amazing that you would oppose extending that same protection to people in the individual insurance market, especially when you know firsthand that not all insurers are as generous as BC/BS was in your case.
One need only look at any of the health insurance systems in the developed world (France is a superb example of this dynamic in action), and the deleterious impact they have on their host nation’s finances.
Huh? France spends half what we do on health care, and their people get better care. We should be so lucky.
“I find it amazing that you would oppose extending that same protection to people in the individual insurance market, especially when you know firsthand that not all insurers are as generous as BC/BS was in your case.”
I oppose having the government point a gun at someone and tell them to pay for someone else’s health care. That includes my wife, my kids, or me. I would not have committed armed robbery to pay for my wife’s operation, but would have found a way to pay for it no matter what.
If you find THAT amazing, I would say that explains why we will never agree on this. And I wouldn’t trust you as far as I could throw you.
One more thing. If BCBS or its equivalent had not been available, I would have found another legal way. I have always found a legal (and moral) way, and this would have been no different.
But when the government becomes the “single payer” and decides it is not going to pay, there will be no alternatives. Trying to go outside the system will be illegal, and could very well land you in jail (where you couldn’t do anything if you tried).
I have every reason to believe that under Obama care, my wife would not have been treated at all until it was too late to do anything. We had to force the issue as it was, since the medical community ignores heart problems in young women. But we did it, and were able to do it because there are many, many options (competing options, in fact) in medical care. If there are no options, we’re all screwed.
I oppose having the government point a gun at someone and tell them to pay for someone else’s health care. That includes my wife, my kids, or me.
So you oppose HIPPA (and Medicare, and Medicaid)? But you were willing to take advantage of insurance coverage that might not have been there were it not for HIPPA? Will you decline Medicare benefits when the time comes?
One more thing. If BCBS or its equivalent had not been available, I would have found another legal way. I have always found a legal (and moral) way, and this would have been no different.
Do you have super powers? Or are all the millions of people who have not been able to legally get required coverage inferior human beings?
I have every reason to believe that under Obama care, my wife would not have been treated at all until it was too late to do anything.
Your “every reasons” are paranoid delusions. HIPPA required insurance companies to cover sick customers in the group market (i.e. most of them), and people did not start dying in the streets. Requiring coverage for sick people in the individual market won’t be the end of the world either.
“Do you have super powers? Or are all the millions of people who have not been able to legally get required coverage inferior human beings?”
Neither. I have always been able to take care of my financial needs, as can almost anyone else who is willing to put in the work to do so (at least in a free country). I would have paid for it myself. It was only $100,000. I’ve raised more than that in a few days when I needed to. While there are people who genuinely cannot do so, they don’t go without medical treatment in this country.
I took the BCBS deal because it was there. Who wouldn’t? But if there had been any six month restriction, I would not have been able to wait. She’d have been beyond help by then.
I’m providing for my own future, and don’t plan to depend on Medicare unless the law doesn’t permit me to do otherwise (which is the intent).
“Your “every reasons” are paranoid delusions.”
I don’t think you understood (or perhaps didn’t read) what I wrote. We spent 14 years going from doctor to doctor to get them to figure out what was wrong with my wife. But doctors, especially male doctors, dismiss young women who complain of heart problems. It wasn’t until a renowned electrophysiologist who told us that she didn’t have a particular problem when the diagnostic report he had just received, and was sitting on the table between us, said exactly the opposite, that I blew up. I demanded that her group cardiologist actually look at some of the test results he had ordered, and when he did he finally, he meekly admitted that she didn’t have much time left. Followup consultations with three surgeons and two cardiologists confirmed it. The only difference was that they knew she actually did have a problem before looking at the test results, and didn’t just glance at them without reading them (as they had done for the past 14 years).
When we have “healthcare for all,” the government will decide what it will and will not pay for. It will probably do so on the advice of one, or at most two, doctors. Judging by the experience we had in the U.S. system as it is today, that would have been the end of it. The first doctor or two would have dismissed her, as they actually did for more than a decade, and the government wouldn’t pay for it. One won’t be allowed to pay for it oneself, under the system envisioned by Obama.
But that’s okay. They’d tell her to take a pain pill. Just like Obama himself said.
It is quite disturbing when you see someone like David who would advocate for an election which exclude certain members of the community from participating. and he still happy to call it election and democracy!!!!
isn’t this a clear example of the double standard that made the Arab public not to trust the West?
while at the same time you don’t hear anyone calling for banning right wing parties in Europe(BNP and Sien Fain) and Israel(Lieberman’s Party) from participating election….
Its seems like basic western value to support democracy only if it is going to produced the desired winning party. otherwise democracy doesn’t matter.