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Understanding the "new" Kennedy health care bill

Discussion in 'U.S. Politics' started by Little-Acorn, Jun 9, 2009.

  1. Little-Acorn

    Little-Acorn Well-Known Member

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    Here's an analysis by Keith Hennessey. I've read thru about 2/3 of the bill so far, and this jives pretty closely with what I've seen in it, though it's painful to have to slog through all that governmentese.

    Most striking thing about it, is its statement that none of these government health care plans are mandatory - they are all optional, the bill says. Sure they are... except that if you opt not to join, you have to pay a heavy fine (they call it a new tax), and have to keep paying and paying, for what you are NOT receiving.

    So when some talking head tells you "You don't have to do this if you don't want to, it's all your free choice", ask him if you also don't have to pay the "new tax" when you decline the government health care "option".

    Some things I haven't seen in this bill, or in this analysis:

    1.) If a doctor recommends an expensive procedure (MRI, Caesarian section, etc.), what are the chances the government will veto it for being "too expensive"?

    2.) If they do veto a procedure, and you still want it, and you volunteer to pay for it yourself, are you forbidden to do so? If you are, what is the penalty for doing it?

    3.) If a doctor volunteers to treat you for direct payment (i.e. you pay for treatement with your own money), is he forbidden to do so? What is the penalty?

    4.) It's commonly said that there are presently 50 million Americans who don't have health care coverage. One goal of this bill, is to provide it for them, in addition to the rest (250 million). Yet another goal is to LOWER overall costs. How do we propose to increase the services provided by 50 million more people, while LOWERING costs? Will the result be quotas, where some services are refused? Long waiting lines, like those presently endured by England and Canada?

    5.) How much will all this cost?

    6.) Who will pay for it? Since everyone gets the same level of treatment, will everyone pay an equal share of the costs?

    All these "details" are missing from the parts I have read. Yet they are extremely important parts of any plan. Has anyone seen the answers to these questions? What are they?

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    http://keithhennessey.com/2009/06/08/kennedy-health-bill/

    Understanding the Kennedy health care bill

    Over the weekend a draft of Senator Kennedy’s (D-MA) health care bill leaked. After playing with Adobe Acrobat, here is the text of the draft Kennedy bill as a text file ( http://keithhennessey.com/wp-content/uploads/2009/06/kennedy_health_bill_draft.txt , 173 K), and as a single Acrobat file ( http://keithhennessey.com/wp-content/uploads/2009/06/kennedy-draft.pdf , 3.4 MB). Unlike the leaked version, both of these are searchable.

    Calling it the “Kennedy” bill is something of an overstatement. Senator Kennedy chairs the Senate Health, Education, Labor, and Pensions committee, and his staff wrote the draft. By all reports, however, Chairman Kennedy’s health is preventing him from being heavily involved in the drafting. Senator Reid has designated Senator Chris Dodd (D-CT) to supervise the process, but as best I can tell, it’s really the Kennedy committee staff who are making most of the key decisions. For now I will call it the Kennedy-Dodd bill.

    As the committee staff emphasized to the press after the leak, this is an interim draft. I assume things will move around over the next several weeks as discussions among Senators and their staffs continue. This is therefore far from a final product, but it provides a useful insight into current thinking among some key Senate Democrats.

    Here are 15 things to know about the draft Kennedy-Dodd health bill.

    1. The Kennedy-Dodd bill would create an individual mandate requiring you to buy a “qualified” health insurance plan, as defined by the government. If you don’t have “qualified” health insurance for a given month, you will pay a new Federal tax. Incredibly, the amount and structure of this new tax is left to the discretion of the Secretaries of Treasury and Health and Human Services (HHS), whose only guidance is “to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”

    2. The bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.

    3. In the Kennedy-Dodd bill, the government would define a qualified plan:

    1. All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

    (snip)

    4. Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.

    5. Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.

    (snip)

    7. People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.

    8. People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area

    9. There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.

    10. Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.

    11. States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.

    12. Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.

    13. The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.

    14. The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”

    15. The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

    This would have severe effects on the more than 100 million Americans who have private health insurance today:

    * The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”

    * Health insurance premiums would rise as a result of the law, meaning lower wages.

    * A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.

    * You would find a tremendous new disincentive to switch jobs, because your new health insurance may be subject to the new rules and would therefore be significantly more expensive.

    * Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.

    * Far more than half of all Americans would be eligible for subsidies, but we have not yet been told who would pay the bill.

    * The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.

    * The Secretary of HHS could mandate that you provide him or her with “any such other information as [he/she] may prescribe.”

    I strongly oppose this bill.
     
  2. Little-Acorn

    Little-Acorn Well-Known Member

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    Some people are comparing this to Hillarycare during her first administration in 1993, but I believe there's not enough details in this Kennedy bill, to make the comparison. Large chunks are missing here.

    Hillary tried to nationalize the health care industry back in 1993, of course, and got hooted out of town as a result.

    Hillary made two mistakes in 1993:

    1.) She put all the details in the very first bill, instead of leaving them out as this bill does, so people had nothing to object to and then putting them in at the last moment as this bill seems intent on doing.

    2.) She published a book describing it, again in full detail. This was probably the biggest political mistake in her career. Liberals always try to govern against the will of the people. Apparently Hillary made the mistake of thinking that since she liked socialized medicine so much, regular Americans would like it, too. The bill was resoundingly rejected, and Democrats got tossed out of every majority in government at the next election, for the first time in generations.

    Looks like Teddy isn't making the same mistakes twice. Lots of missing details here, nothing that really says how this will be implemented. He's concealing his real plans from the voters as long as he can, so that when they are finally put in (maybe after House and Senate have each approved "their" versions and it goes to the final Reconciliation committee), voters have very little time to analyze the info and call their Rep or Senator to tell them to vote against it.
     
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