Leave aside the lack of a public option and the fact that the weak exchanges are probably unworkable. And, for now, let’s ignore the poorly designed regulator framework and the huge give away to PhRMA. (I know, big stuff to leave aside). Let’s just look at Baucus’s bill from 10,000 feet.
For starters, being “covered” under Baucus’s reform really is no guaranty of financial security. The yearly cap on out-of-pocket expenses for a family is $11,900 (and that is not counting the cost of premiums, which could be double that). How many middle income families have the financial reserves to take that kind of hit if a spouse needs serious medical treatments over the course of a few years? This bill would reduce–but will not end–one of the greatest shames in our nation. That of “under-insured” Americans forced into medical bankruptcy.
The other major problem is that there is no major reduction in the number of uninsured until 2014. It will be roughly 44 months after the bill is signed before we start seeing a noticeable reduction in the number of uninsured. There is not one but two elections before anything really gets started. Looking closely at the new CBO report, it won’t be until 2014 or 2015 that we start seeing a serious reduction in the number of uninsured.
Even after the bill is in full swing, around 2015, the number of uninsured who will be “covered” is only 27-29 million. Even after reform is fully implemented their will still be 24-25 million people in this country without health insurance, a full 9% of our population. Ignoring undocumented immigrants you are still talking about 17 million Americans without health insurance. This bill will not produce universal health care. It will not even produce near universal health care. After this bill goes into effect we will need another almost equally massive reform effort if we want to get to universal health coverage.
Just to give you a comparison, let’s look at Switzerland (the second to last major industrialized nation to adopt universal health care). In 1994, the Swiss decided to reform their health care system partly because roughly 4% of the country was without health insurance. This number of 4% was considered to be unacceptable by the Swiss. I hope that sinks in. Baucus’s bill would hopefully get us to a place five years from now where we have 9% of people in our country without health insurance. That is still dramatically worse than where Switzerland was before it decided to undertake serious health care reform.
Even if Baucus’s bill works as hoped, we would still have the dramatically more of our people uninsured than any industrialized nation. We will still have the cruelest, least fair, most wasteful, and most expensive health care system of any rich nation. It will only get us to a place that any European nation would consider shockingly unacceptable.
Would Baucus’s bill be an improvement on the currently awful state our health care system? Yes, but starting from a terrible place is no excuse for aiming incredibly low. The nicest thing I could say about it, is that Baucus’s bill will improve the grade of our nation’s health care coverage from a F to a D-. We will still be the absolute bottom of the class compared to all other rich nations. Let’s not try to pretend that this is anything short of an awful bill that would still leave us with a terrible health insurance system. This is not change we can believe, this is the change than I might have expected from a President Mitt Romney.




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I have to agree with your sentiment on change. Frankly, I don’t think there is enough good in the Baucus bill to warranty passing it. I’m hopeful that it won’t pass out of committee. The ’solution’ is unacceptable and it is time that Washington understand that we, the People, want and expect real reform. The kind of reform that President Obama campaigned on but has been dismal in actually delivering.
What I don’t understand is that the Dem’s in power don’t understand that anything vaugly resembling this bill is a poison pill for the party. What was the main lesson from the Medicare catastrophic coverage debacle. Have they forgotten that if you postpone all the benifits while upfronting the cost there will be a revolt? This is where they are headed. We need a bill that will visibly show the everyday person real benifits in the short term or we loose. The dems are selling out to big (Insurance, Pharma, Hospital…) and thinking the money they get will keep them in the game. What a bunch of fools.
Hi Jon, Thanks for a very good analysis of what the bill would do. I think, however, that you’re too easy on the bill. In closing you say:
I think I disagree on whether this is an improvement or not. It certainly does result in more people being covered, but that doesn’t mean it’s an improvement. Whether or not one thinks it is, depends on how the bill affects you. If you’re one of those forced into paying for an insurance policy from one of the companies, you may not think it’s an improvement. If you’re one of the businesses mandated to have insurance you won’t think it’s an improvement. If you’re one of those who has to wait 44 months for coverage and meanwhile the cost of insurance is increasing by double digits each year, so that by the time you get it’s nearly 50% more expensive than it is now, you won’t view it as an improvement. If the insurance companies find new ways to game the system in the 44 months before it will take effect, so that they can make coverage prohibitively expensive for you and you have to pay a fine as a result, you won’t think this bill is an improvement. Finally, if you believe that Government can produce solutions that help Main Street rather than Wall Street, you won’t think this bill is an improvement, because it will certainly disillusion you about the effectiveness of government and elections in producing solutions to the problems of ordinary people.
In short, I think that when we take into account the effects of this bill on the political system, as well as its short-term effect in reducing the number of uninsured, we have to include that it makes the situation worse and that it is better to defeat it, if it can’t be substantially changed during the sausage-making process.
If the false spin is that Maine R Snowe wants it to cover more then there is trouble. My “hope” is there is 200B reserved for upgrades (from .9T to 1.1T+) and that the score is good. Beyond that, or Obama doing anything, I think it will all unfold as predicted in the majority here (its nice to see good policy positions, and knowing how the game will play out a the same site – only way to get in there and try to make a change).
Price and quality controls for private insurers before you even think about a mandate.
Public health insurance as a national option with national bargaining power that no one is required to have or penalized for not having.
A word about the lobbyists
Lobbyists for health insurance companies, or any private company for that matter, do not represent either the customers or the employees. They reserve the right to raise prices or deny service at will or fire all of their employees if it suits their needs. So there is no doubt their lobbyists represent only the Directors and major shareholders of these corporations and should be treated like thousands of people running around influencing law to benefit a relative handful of people –like a clown show.
Or a threat to the Republic.
Congressional Budget Office (CBO) score’s the baucus plan at $829 Billion over a 10 year period, that is paid for. The CBO also states that it will lower the deficit by $80 Billion and it would be much lower if there was a public option.
Criminally corrupt politicians are the reason the U.S. is ranked near the bottom of every catagory when ranked next to other modern, industrialized nations. Time for publically funded elections.
lieberman $12.6M, mcconnell $7.8M, baucus $7.7M, cornyn $6.7M,
kyl $5.6M, grassley $5.4M, ensign $5.2M, conrad $5.1M, cantor $4.9M,
nelson $4.9M, burr $4.8M, boehner $4.4M, hatch $4.4M, lincoln $4.1M,
vitter $3.9M, carper $3.6M were paid by the Medical Industrial Complex to kill Health Care Reform. (Source: OpenSecrets.org, Aug. 09)
Follow the Money: Link
Call Congress and demand, Single-Payer Health Care for All!
(Toll Free # House and Senate)
1-866-338-1015 _____ 1-866-220-0044
1-800-473-6711 _____ 1-866-311-3405
Sign Single-Payer Petitions: Link Link
Don’t let the Medical Industrial Complex steal your Health Care from you and your family by donating huge sums of money to Crooked Politicians in order to maintain the Status Quo. Keep up the good fight.
SEMPER FI!
The Baucus bill is crap , let’s hope it sees some major revisions before it’s presented for a final vote
“Other than that, Mrs. Lincoln, how was the play?”
I think you are being overly generous, Jon.
Maybe he’s just leaving a little room for grace.
So Reid, Baucus and Dodd are going to be responsible for merging the two senate bills. Good gawd.
Wealthy politicians and their corporate masters are so out of touch with the finances of average Americans that it would be comical if it wasn’t so infuriating.
The Democrats are REDEFINING THE DONUT HOLE!!!!
Donut Hole for the middle class:
1. increase taxes on middle class
2. leaves 25 million uninsured, almost all of whom will be middle class
3. bad subsidies for the middle class
4. more taxes on small business, reducing job prospects at a time of 16% un/underemployment
leave it to the Senate Dems to find a way to make it all worse — along with a big give away to the health insurers and phrma… at the expense of doctors…
Let me add that if you are one of the 180,000 Americans who will die while waiting for health insurance reform, you do not see this bill as an improvement.
Whatever happened to the plan to tax the rich?
Let’s cut the bullshit, we want Medicare 4 All. A member of the UK government stated today that they need to reduce their Defense budget by 25%. We can pay for Medicare 4 All if we cut our defense budget by 10%. We are fighting two unnecessary wars.
Let’s stop this bullshit and say exactly want we want and when we want it. We want healthcare reform now, not in 2013. It’s our tax dollars not the congress.
Remember, they work for us.
Not Dodd — Harkin.
(Dodd decided to keep the Banking Committee chair when Kennedy died, leaving the Health, Education, Labor, and Pensions Committee chair to Harkin.)
But yesterday it was announced that Dodd would be the one involved since he was the one in charge of the committee when their plan was developed and due to his relationship to Kennedy
I missed that. Got a link?
I think it was on MSNBC
If the Democrats choose to screw the people who elected them by enacting health insurance corporate welfare that does not meet the desires of 2/3 of the electorate, much less the policy goals espoused by the Democratic Party, its platform and candidates, then that will go a long way towards proving that the Democrat and Republican duopoly is a rigged simulacra of politics, similar to Roman bread and circuses.
Yes, Bauchus has given us the worst of both worlds.
After allthe hooplah, regualr citizens are expecting to see a transformation, when nothing appears to change, they will punish Dems in the 2010 cycle and maybe punish Obama in 2012.
Baucus should be stripped of his leadership position if he sides with Republicans to block REAL health care reform!
PETITION TO SENATE MAJORITY LEADER HARRY REID:
“Any Democratic senators who support a Republican attempt to block a vote on health care reform should be stripped of their leadership titles. Americans deserve a clean up-or-down vote on health care.”
According to Rachel Maddow, “two major powerbrokers on the left…are encouraging a Senate strategy in which the leadership would revoke chairmanships and other leadership positions from any Democrat who sides with a Republican filibuster to block a vote on health reform.”
See the clip of Rachel breaking the news and SIGN THE PETITION!
Thanks to the PCCC for sending out emails with a link to this petition.
Do I read your screen name correctly? Navy Doctor 3rd Marines?
And you support single payer, Dr? That is welcome news indeed.
Wow, somebaody took their word of the day calledar very seriously. Such eloquence has come to the blogosphere. Thanks for bring some class to the joint.
If we do not define what we want, congress will declare whatever they pass as a public option and call the left of left sore losers. Public Option, robust public option, co-opts, triggers, caps, turtlenecks, whatever, is meaningless. This congress is interested in passing the bare minimum for the insurance industry and no more.
Or maybe went on a Holliday Inn cruise on MAr. 2nd?
Jane has a new post up…
But Harry decided to use Dodd, who was stand-in chair at the time the HELP Committee bill was developed.
So what would happen if Baucus’s Committee *cannot* get a bill voted out? Could there be reconciliation with the House version and ONE bill which has been produced on the Senate side?
iow, is it absolutely necessary to even have the second bill? Can’t the Senate just vote on the HELP version?
Navy Corpsmen are assigned to Marine units. They’re part of what is called the FMF, Fleet Marine Force. Only large ships have MDs, smaller ships have E-6 or E-7 corpsmen and are referred to as “Doc.” From his screen name I’d say he was a corpsman assigned to the Marine 3rd Division, 3rd MARDIV.
NAVDOC3rdMAR, please correct me if I’ve got it wrong.
I keep harping on the cost of health insurance for private purchasers because I’m a contract employee and can’t get coverage through my employer.
I’ve been mis-diagnosed in the past with rheumatoid arthritis (it wasn’t, it was Lyme’s Disease) and can’t get into anything resembling actual insurance coverage for myself. All I can get is catastrophic care at $900/month for myself, plus I pay 35% of the total costs. My family can get reasonable coverage with a $1,000 deductible and a $35 copay for $800/month.
To meet the Baucus Bill’s coverage requirements, I’m out a total of $1,700/month IF NO ONE GETS SICK OR HURT. That means my total annual costs could be “limited” to $32,300 under the Baucus Bill. Is it any wonder that I’ll be opting to pay the penalty instead of getting coverage if this bill is passed as it currently stands, and that I view it as not only NOT reform, but a TAX INCREASE, because Bad Max & his buddies in the Health Insurance Coalition can’t pass actual reform or provide a public option.
MEDICARE FOR ALL or NO MANDATE!
I was fortunate enough to enjoy a superlative PUBLIC OPTION education, both at my PUBLIC OPTION high school and PUBLIC OPTION state university back in the 1970s and 1980s when there was money for such trivialities, back before the Finance, Insurance and Real Estate machine began to digest the fabric of American society.
D-
Wonderful.
Fired up? Ready to go?
Come to think of it, when I was enjoying a ‘public option’ university education in the early sixties, the time or two that I got sick — Strep, usually, in one or another manifestation — when I went to the University infirmary for treatment, I received ’single payer’ healthcare at no charge to me: the antibiotics, the nights in the infirmary, the care, the diagnosis — no charge.
But then, that was in the early sixties, well-before anyone knew Reagan as anything other than a crappy actor, well before greed overtook and overwhelmed the consciousness of a nation which once offered hope ahead of profit.
Please correct me if I’m wrong, but I believe that more than 50% of the 47 to 50 million people without health insurance make more than 300% of the poverty level, which is a little over $14,100 per year. This means no federal subsidy for anyone making more than $42,300 per year.
I don’t know what the cheapest insurance plans will cover, but I’ve got a sneaking suspicion that most people are so saddled with debt that they will not be able to afford the insurance they will be mandated to buy.
The penalty for not buying insurance in the Baucus bill is $1,500. Is that assessed on a monthly or yearly basis? If monthly, the yearly penalty would be $18,000. The higher number looks like a one-way ticket to bankruptcy for millions of people.
Next question: Can the penalty for violating the mandate be discharged in bankruptcy?
Do any of the bills criminalize a failure to pay the penalty, or is a plan to do so in the works to amend the statute after Obama signs it into law?
Although people can’t be excluded for preexisting conditions or terminated for expensive treatments, are there any limitations in the bills that would prevent insurance companies from charging higher and unaffordable rates for preexisting conditions and increasing rates for expensive treatments so they become unaffordable? If not, the “reform” of these two malevolent practices will be illusory without a much cheaper public option which the Baucus bill is designed to prevent.
What about long-term nursing care? My dad needed it for six years (Alzheimers) and my mother needed it for seven years (stroke). Their care cost a little over $1 million in a privately owned nursing home (the state facility was a disgrace) and, although I paid it, I was unable to recover financially and a traumatic injury my wife suffered in a 30-foot fall that cost her her job and our health insurance took us down forcing us to declare bankruptcy. I don’t believe any of these bills covers LT nursing home care.
How, if at all, are the moribund economy and continuing job losses considered in these bills?
Finally, it seems to me that the slow motion train wreck we’re watching is doomed because it’s focused on protecting insurance company and Big PhRMA profits instead of improving health care and making it accessible to all. A fundamental question is at the crux of the reform issue; namely, which is more important — health or corporate profits? We can’t have both and Baucus has been proving that for the past six months. His piece-of-crap bill is the icing on the cake.
This is why single payer is the only way to go and, depending on the answers to my questions I would rather Congress start over with a single payer proposal and put it to a vote without all the political graft and gamesmanship dedicated to concealing and protecting corporate agendas.
And, we need to get out of Afghanistan and Iraq NOW!
We can only hope that Montana’s understand who they have elected!