… if they set such a high MLR they would would declare all private insurance effectively part of the federal budget

I heard that the other day. What’s the logic? Why that figure?

What’s the logic? Why that figure?

Like the Bush WH, the CBO makes its own reality.

…The CBO somehow concluded that if the MLR was only 85% for the small group market and 80% for the individual market that would be just low enough to make private insurance magically not part of the government:

I’m distressed that the insurance industry is somehow more important than the Health of Americans…?

It’s hard to tell who is the more powerful unelected bureaucrat nowadays: the Fed chair, the head of the CBO, or the Senate parliamentarian. It’s very clear, though, that our electeds have abrogated their constitutional responsibilities by investing such power in these faceless entities.

CBO score does not have to account for the $250 billion to keep doc pay up with inflation (which will happen).

CBO score includes $73 billion in CLASS (disability) premiums with almost no payouts, which will go very negative within next several years…

the score is a sham

the bill is worse

Can someone explain why? Heavy regulations = ownership? Doesn’t that make all local gas/electric utilities government subsidiaries?

Jon, thanks for another great post: once again, you learned me.

I wish for the day when legislation is written by our legislators and not by some unelected accountant. Because Reid wanted to make the CBO score look prettier, he will allow insurance companies to waste an extra 10% of your premiums on not providing health care. All hail the almighty CBO.

I’m wishing for the same day.

Until then, as we raise our glass to the almighty CBO, we’re toasting the Hamilton Project the CBO’s director Elmendorf hatched out from, Robert Rubin (who spawned the Project)….and Barry Obama: the only Senator who genuflected at the bedpan when proud daddy Rubin introduced his larva to the world.

In 2007, Elmendorf began working for the well-known think-tank the Brookings Institution, co-editing the yearly publication “Brookings Papers on Economic Activity.”[3] In 2008, Jason Furman, the director of the Brookings’ group known as the Hamilton Project left to join the Obama campaign. Elmendorf replaced him as director of the Hamilton Project, a forum for economic policy discussion that was created by Clinton Treasury Secretary Robert Rubin — an advocate of free trade and a small deficit.[4]

BREAKING NEWS:

NATIONAL ORGANIZATION OF WOMEN OPPOSES SENATE BILL

as if we needed more reasons to oppose this:

NOW President Condems Compromised Health Care Bill;
Women’s Access to Abortion Care Traded Away

Statement of Terry O’Neill, NOW President

December 19, 2009

The so-called health care reform bill now before the Senate, with the addition of Majority Leader Harry Reid’s Manager’s Amendment, amounts to a health insurance bill for half the population and a sweeping anti-abortion law for the rest of us. And by the way, it’s the rest of us who voted the current leadership into both houses of Congress.

The National Organization for Women is outraged that Senate leadership would cave in to Sen. Ben Nelson, offering a compromise that amounts to a Stupak-like ban on insurance coverage for abortion care. Right-wing ideologues like Nelson and the Catholic Bishops may not understand this, but abortion is health care. And health care reform is not true reform if it denies women coverage for the full range of reproductive health services.

We call on all senators who consider themselves friends of women’s rights to reject the Manager’s Amendment, and if it remains, to defeat this cruelly over-compromised legislation.

If the NOW is against this along with all of the unions, Dean democrats and a good portion of Indy’s, I’d say that this bill is DOA.

Again, it cannot be emphasized enough that a bad bill will be hung around the necks of the Democrats in 2010 and 2012 like a lead noose!

So, CBO, would rather allow a private business get 10% or higher of our tax dollars with no accountability; however, the tax payer has 100% accountability with taxation on health care as well as a mandate?

I think I actually would take 100% MLR and kill the loophole.

How in the world can CBO/Congress demand 100% of our money and then not demand 100% accountability from the “contractor. This screams for a lawsuit.

If corporations are going to argue that they are “an individual” then they need to be held to the same demands the individual tax payer is being held to.

100% accountability for all.

This could be an angle for progressives. Demand 100% MLR and kill the loop hole. Would love to see the health care industry balk at that stance.

Now it’s time to take action and press the House for all that is objectionable to americans in this bill. We’ve watched Ben Nelson and Joe Lieberman play POTUS and VPOTUS; now it’s time to let them know that their little “gig is up” and the american people will now decide what we want.

It’s time to go over their heads since they’re so compromised by payoffs from Big Insurance that they can no longer represent us.

The people’s “real – not astroturfed” revolt will be right around the corner if this horrendous bill is passed. People are angry and will accept another screwjob.

Then it will be time to check all of their refrigerators and freezers – where the payoff money is stashed. No damn wonder they still haven’t released the crooks with the offshore accounts.

IT WOULD DECIMATE THE ENTIRE CONGRESS OF THE UNITED STATES. They’re all crooks, liars, and hypocrites – except for a few….very few.

Health care reform died long ago, when it become first and foremost about enhancing and cementing the power, wealth, and prerogatives of the health insurance and pharmaceutical cartels. Talking “CBO scores”, “exchanges”, etc. is simply playing out the end game in a chess match that was already badly lost.

My letter to Boxer and Feinstein today:

I write today to ask that you oppose the current Manager’s Amendment, as announced this morning, for health care ‘reform.’ As you may know, the National Organization for Women just announced their opposition to this bill, calling it health care ‘reform’ for half the population and an anti-abortion bill for the other half.

I never thought I would live to see the day when a Democratic Congress would approve such sweeping restrictions on women’s health. It is shameful. Please vote against this bill, and start again in the New Year with a bill that is fair to women, provides real cost controls, and doesn’t make all of us serfs to the insurance monopoly.

There’s no excuse for approving this bill, despite whatever protestations you’d like to make about the enmity of the perfect for the good. This bill is NEITHER perfect nor good. Defeat this bill, please.

Thank you for your service to California and the United States of America.

Sincerely,

teddy– great, great letter… forward it to everyone you know… Jane should put it firmly on the front page

So isn’t putting it on the federal budget a good thing – wouldn’t that mean that there would be more transparency? I’m not seeing how there is any substantive difference in what is paid (other than by shinning a light on how much is being paid and where it is going) whether it is on the budget or not. Certainly Reid can come up with a much better excuse than this for making us pay more other than saying he wants us to pay more in order to discourage transparency. Shouldn’t Mr Transparency be a fierce advocate for transparency (as well as real HCR) and say put that back in?

I would almost – almost – rather be ruled by a GOP majority because at least we’d know we were going to be ruthlessly exploited, pillaged, and left at the mercy of the corporatocracy.

Of course, the GOP will always eventually overreach, and make things so effing bad that even republican voters hate them. And then, we democrats kid ourselves that things will be fixed when our party is back in power. And every time, it’s a sickening ritual of caving in, selling out, rolling over, crying and apologizing after initially (against all odds) summoning the nerve to tell the truth – looking at you Dick Durbin (and by the way, eat an effing lozenge, your voice makes me want to stomp bunnies; maybe it’s so raspy from all the crying). Can you tell I’m in a big ass snit right now?

Never again, NEVER again will I donate to the Democratic party for fear a single penny end up in the hands of anyone in the craven, weak, and uninspiring majority. I will selectively donate to individuals who show integrity, courage, honor, compassion, and determination to do the right thing. In other words, my discretionary income won’t be overtaxed by political donations.

To whom does the CBO report? Don’t they report to Congress? Isn’t Congress currently controlled by Democrats? Specifically, don’t Reid and Pelosi have control over the CBO? If not, WTF?

The CBO reasoning seems to be gibberish. Whether the MLR is 90% or 85% doesn’t change the amount of revenues flowing through the treasury by a single $1. This is just an accounting myth. The government outlays wouldn’t change a dime.

The argument for a high (90%) MLR is that since the uinsurance companies cannot exclude for prior conditions and must take everyone and must offer standardized policies, it’s costs for usual insurance underwriting — i.e., hiring staff to exclude people and deny claims — should be much lower.

I guess this means that if Pelosi insisted on upping the ratio to 90% in the conference committee conservadems would be falling all over themselves to see who could get to a press gaggle and threaten a filibuster first.

Not only that, but as near as I can tell, Senators are absolutely terrible negotiators. They couldn’t negotiate their way out of a brown paper bag! Since most are lawyers, what I want to know is, don’t they teach the art of negotiation in law school? Don’t they tell these people you don’t give away stuff without getting some concession in exchange? And you certainly don’t start negotiations by already discounting your highest and best position, like Medicare for all. That is, you don’t if you’re representing the American people. From what we can see, the Senators truly are wholly owned and operated subsidiaries of special interests. Sadly, we don’t have representatives anymore and we don’t live in a democracy anymore. Call it a plutocracy or a corporatocracy, but no longer do the rules of democracy apply, as we see on a daily basis. Disgusting!

Jon,

I wish for the day when legislation is written by our legislators and not by some unelected accountant. Because Reid wanted to make the CBO score look prettier he will allow insurance companies to waste an extra 10% of your premiums on not providing health care. All hail the almighty CBO.

No need to wish for that day. It’s already here. Reid bears the responsibility for writing this legislation. He is the one choosing to comply with Elemndorf’s opinion. He is the one choosing to comply with Obama’s deficit hawkism. He is the one choosing to turn an extra 10% of our mandated premiums over to the corporates. Let’s make sure he’s not there in 2011 to screw us anymore.

wiki:

Loss ratio in insurance is the ratio of total losses paid out in claims plus adjustment expenses divided by the total earned premiums.[1] If an insurance company, for example, pays out $60 in claims for every $100 in collected premiums, then its loss ratio is 60%.

medical loss ratio

The money insurance companies pay out on health claims is the loss here. You know, from the perspective of the almighty bottom line.

That in and of itself speaks volumes. You know, from the perspective of a civilized approach to health care.

“Distressed?” How about hopping mad and I won’t take it anymore?

Time for a new party. All in favor of the purple party? Out of all those that appear to be commenting from my state of AZ here, are there any progressives that I can get behind to oppose McCain and eventually Kyl? We got to get this state out of the hands of the corporate shills that we have now.

Will now threaten to work in primaries against Barbara Boxer, Maria Cantwell, Patty Murray, Barbara Mikulski, and the other Democratic women Senators who normally benefit from NOW support, if they vote for cloture on this Reid’s bill. If not, their opposition is worth nothing.

If it were equal to ownership, then why would the private stockholders still be getting the profits.

My only concern anymore is the penalty for not buying their junk insurance.
I am sure the first “fix” down the road is to jack it up to the same cost as the actual insurance.

They have control. They’re to blame. They can replace Elmendorf, tomorrow. They should do so.

Just out of curiosity, did everyone get one of these from Anthony Weiner?

Dear Ann,

This has been a frustrating week for all of us who have fought so hard for the public option and for real reform that will bring down health care costs. As I wrote earlier in the week on http://www.CountDownToHealthCare.com, some of us have begun to feel as though we’ve compromised our compromised compromise.

I’m not ready to leave the table yet. I believe it’s too important and there’s still time to help improve the result.

But I want you to guide this effort. I want to hear your concerns and get your guidance. That’s why, on TUESDAY December 22nd, at 7:00 PM EST, I’LL BE HOSTING A LIVE ONLINE CHAT AT CountDownToHealthCare.com/chat/.

There’s a lot to discuss. Some have said that progressives shouldn’t support the current Senate proposal. Without the public option, they say, there’s not enough to provide genuine competition to insurers.

Others have said that we should focus our energies on how to improve whatever emerges from the Senate. Once the Senate passes a bill, it will go to a conference committee to be reconciled with the House bill. That process could be a real opportunity to move the Senate bill closer to the one we passed in the House.

I want to hear what you think and where you come down. There’s a lot of noise out there–much of it heated. Now is a time for all of us to have a conversation about what we need to achieve and how we’re going to get there. Please join me on TUESDAY, December 22nd at 7:00 PM EST at CountDownToHealthCare.com/chat/.

Thanks,
Anthony

I got one of those too. I clicked the link and it said it was under construction. I sure wish we could get to single-payer.

The world accepts that it is the US responsibility to police the world. Most of the Us accepts that as a given as well. We do so presumably because it’s to our benefit in the US. As I see our rights, our liberties, our social order disintegrate, I seethe benefit diminishing. Many of the Europeans, and a whole bunch of Asians, are glad to see us play policeman. They get free health care, free or affordable education, monitored infrastructure. We get bloated bankers, falling bridges, potholes, auto dependency, killer insurance rates, and the finest military a deficit can buy. We also get a Congress totally unable to do something beneficial for the public and clearly favored by the public. We have the money, but we spend it to police the world to our benefit? Really? I’m beginning to see a different outcome. The priorities need to change, and it may take some civil action to make that happen. It ain’t gonna happen without some persuasion.

Can someone, anyone, explain to me what the logic of this CBO position is? I’m not asking you to agree with it, I’m just trying to understand the mind-set under which a statement like that is not nonsense. I find myself unable to do so. And that’s bad. If you want to defeat an argument, you first have to understand it, and I don’t.

Anyone?

Some investigative journalists need to seriously look into this Elmendorf guy and this obscene seizure of government power needs to be publicized as a front page story every where. Even the private insurance industry said that would abide by and 85% loss ratio, at one point a while ago in this debate, so pushing it down to 80% is OUTRAGEOUS!!!

UNBELIEVABLE!!!

CBO report reads, “….at its root, the key consideration is whether the proposal would be making health insurance an essentially governmental program, tightly controlled by the federal government with little choice available to those who offer and buy health insurance—or whether the system would provide significant flexibility in terms of the types, prices, and number of private-sector sellers of insurance available to people.”

I read this in the CBO introduction several times, each time gasping (OK screaming bloody epithets that interrupted my wife watching Doctor Who) at the implications.

1) The FALSE assumption that for profit insurance can not survive on 10% margin ON TOP OF paying for their costs and setting aside reserves which they can use for profit-making investment purposes (talk with a tort attorney and actuary about how that scam is played) is complete and utter BS.

2) The fallacy the CBO is asserting is that insurers must be GUARANTEED A PROFIT regardless of their lack of added economic value.

It is a bit beyond my area of expertise, but what other industries does the US government subsidize with guaranteed profits in spite of providing not economic value?

3) As cofounder of a medical device firm, the US govt does not guarantee us a profit, even should we extend the lives of tens of thousands of cancer patients. I will chat with my congressman in the next month after one of his town halls and ask how we, too, can get a guaranteed profit.

4) This raises the question of for whom is the CBO working? The American people or insurance companies?

5) I really do not want to know the answer to 4) because the question begs the answer.

sTiVo
see my comment in 35 as my best guess at the logic. Let me go a bit further. There seems to be several assumptions, that most of us have missed with the removal of the public option, that
a) by mandating purchases by citizens we must purchase for-profit insurance, and
b) for profit insurers have a constitutionally given right to make a profit if
c) they are in competition with the US government.

I work with patent law, not the commerce clause.

roand at 32 brings up a potential parallel with US military spending. The US government must have made some pact with military contractors that requires cost plus profit contracts. (apologies, this is not my area of expertise, I’m merely an inventor and entrepreneur). I do know that the US gov’t contracts with for-profit firms for manufacture of billion dollar B-2s down to bullets.

However, we have the National Institutes of Health which conduct key research for drugs, medical procedures and devices. But NIH doesn’t commercialize products, at least to my knowledge.