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On “Meet the Press,” Chris Van Hollen, the chairman of the Democratic Congressional Campaign Committee, inadvertently admitted how mediocre the new health care law is when he attacked Republican Paul Ryan’s (R-WI) proposal for Medicare. The new health care law creates a system of expanding coverage by forcing people to buy poorly regulated private health insurance and providing subsidies or vouchers to make it more affordable.
Rep. Ryan’s “Roadmap for America’s Future” would completely eliminate Medicare and replace it with a system similar to the new health care law’s exchanges for individuals and small businesses. Seniors would no longer just directly receive government health insurance from the popular Medicare program. Instead, just like those who buy from new exchanges, they would receive government subsidies and be required to buy their own individual coverage from the private insurance companies.
Van Hollen rightly made it clear that eliminating the popular and cost-effective public Medicare program and replacing it with subsidized, badly regulated private insurance companies would be a terrible idea. He calls giving vouchers to seniors and making them buy private health insurance “throwing you over to the insurance industry.”
Van Hollen correctly argues that government-run, single-payer Medicare is a much better way to provide health insurance than subsidized individual private insurance plans. Yet, during the health care fight, he never advocated for the simple solution of expanding Medicare to the uninsured. He promoted a law that used an idea—from the Republicans—to make vouchers for private insurance.
If Ryan’s plan is “throwing seniors over to the insurance industry,” then, by default, the new health care law Van Hollen supported is throwing the uninsured and individuals under 65 over to the insurance industry. It is too bad that it’s only after passage that Van Hollen finally, accidentally, admits the new law’s way to expand coverage is absurd compared with implementing single-payer public health insurance.
Just to recap: Making senior citizens buy subsidized individual private health insurance is dangerously throwing them to the insurance industry. But a new law making people under 65 buy subsidized individual insurance coverage from private companies is a progressive victory.
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Exactly.
Ryan’s plan would be like changing from the metric system back to English units. Why would anyone want to do that? As we all know, once you’re on the crappy English system switching to metric is even harder than starting from scratch.
The difference between this a mandate is that nearly all older folks need the insurance coverage of Medicare whereas the mandate will be a cash cow for those that are healthy or can’t afford the high copays. Gruber should be singing his bend the cost curve song any minute now. Once Team Obama pays his cheerleading fees that is.
Another problem with Ryan’s plan is how it shifts the risks of cost escalation from the government to individuals. Under Ryan, you get a voucher, but he wants to control rising costs by telling Medicare/seniors that if costs go up and premiums rise, it’s their problem, not the problem of Medicare/government. But individuals have zero market power to leverage against rising costs imposed by those with market power, like insurers or providers. Only the feds, via a single buyer of care and services, can use their market power against rising costs imposed by providers.
So what Ryan is doing is not just shifting the risks of cost escalation to individuals, but he’s also making sure that there is no entity to challenge the market power of either insurers or providers — in other words, he’s shielding private insurers and providers from any competition or counter-veiling market power that could hold down their prices — and then telling consumers they’re stuck with the price rises.
Just another form of protect corporate power and wealth and screw the individual — but it’s sold to the clueless T-party conservatives as keeping government out of your life and protecting freedom.
Hey, I thought this was the “first step” toward single payer? That’s what the horde of “new” posters on various political forums said repeatedly.
There’s bound to be more steps, so it could be a first step.
Here’s my problem with this post summarized in a question: What happens if no law is passed whatsoever?
The reality is there was no magic progressive legislation that Ben Nelson and Lieberman would have approved. I would have loved single payer, but there is no doubt that a bill that bans pre-existing conditions, allows children to stay on their parents health care till they are 26, and gives subsidies to a segment of the population that otherwise would have NO health care whatsoever is still a good, solid bill.
There’s no doubt that Medicare is going to be much better than private insurance, but to live in a world where you ignore real progress that this administration has done in favor of some idealistic fantasy is foolish.
http://gregthecollegestudent.wordpress.com/
LOL
Medicare is one of two gov’t programs that actually works beautifully – the other is Social Security. I have both and am constantly stunned at how great they are. The Rs just can’t stand it when something works for the citizens. In the last few months my medical bills would have been in the thousands of dollars – I have probably paid less than $200.00.
I hope no one breaks this news to Kos and other veal pen inhabitants.
Heads may explode.
Wealthy Republics just believe that if you didn’t work hard enough to be born wealthy, you shouldn’t expect the government to make up for that.
it is a great system; If you live long enough, you graduate to real healthcare reform–Medicare.
And Social Security.
At least we have that to look forward to while we struggle to make it across the finish line by hanging on to our jobs, getting lower paying ones or stretch our savings.
Unless the catfood commission decides to change the American way of life and turn us into a Third World economy for seniors.
Personally, I think your definition of ‘real progress’ is an “idealistic fantasy” ; the concept that failure to use ALL methods needed to take advantage of a historical opportunity to truly change the way the U.S. is governed and provides for it’s citizens as ‘real progress’ is tragicomic.
You’re exactly right. I’ve not ignored the progress.
W and The Dick brought us a health “reform” bill for seniors that was written by the industry to ensure their profits over the well being of seniors. It was called Medicare Part D.
This administration took that further by letting the health insurance industry write it’s own bill for the whole population that guarantees new customers and new profits for ever and ever, while not providing a single person with any actual health care. (Providing a person health insurance is not providing health care. Lots of folks have insurance that they can’t afford to use due to high copays and deductibles.)
W and The Dick brought us arresting American citizens on American soil and throwing them in the brig without a right to a lawyer, being charged with a crime, or any habeas corpus rights.
This administration has progressed by arguing (and winning) before the Supreme Court that this Prez can sign a piece of paper and a person becomes a non-person with no rights whatsoever. And, oh yeah, they further progressed to claim they can assassinate American citizens.
Pfffft, that last administration was a bunch of pussies.
EDIT: AND once AGAIN I forgot to hit the Reply to gregyoung @ 6 button.
I think I’m gonna give it up now.
At least in most places, you don’t have to worry that gays might be marrying while you are looking for that finish line. Republics really do care about you.
Yes that was the srgument they used.BUT that was just to get any piece of crap passed,so the Prez could get a WIN.It was not about what is good for Americans ,it was about the Prez getting a WIN.This was how fucking insideous their argument was,This is not about you & I or about Americans,this is about what is good for the Prez.
Now remember the principals who were gung ho for this crap on TV……Sen Tom Harkin & Ed Shultz were the 2 who you could see on TV championing this shit…..remember Harkin with his “down payment on a starter home” bullshit.
Nice blog.
These politicians spend so much time selling Americans their laughable disingenuous ‘reform’ policies, they can’t even keep it all straight anymore. Just a matter of time before they step into their own shit, and admit it.
Great post!
Obamacare cut hundreds of billion from Medicare in order to subsidize people in private insurance companies. By Van Hollen’s own logic, he shouldn’t have voted for Obamacare.
First step to single payer perhaps with the public option
As is it is a lot of minor (major to those affected) changes to the way of doing business of the health industry -
plus it sets aside funds – $ 600 Billion currently used for the welfare check to the ins companies in the form of “subsidies” – - but which could be “re-purposed” for real reform.
SS 2008 Income was 696 OASI 110 DI 230 HI and 250 SMI
The $600 plus the current 230 HI and $250 SMI could provide a good single payer national health plan – it would require agreement on heath priorities (that death panel nonsense where the common sense that you do not give heart transplants to 95 year olds becomes a death sentence – and we make these decisions already). Current level of Medicare would need to be agreed to be maintained if it is to pass. A National Budget would be done annually, affecting the priority list, and possibly affecting the price control list for common procedures, if we had such a list. But the point is that the money would be there for a single payer national health plan – with no increase in payroll taxes – just call the $600 billion a General Funds contribution to the National Health ins. plan.
Post Obama’s sellout, I realize I’ll be long dead before we another chance for this – but the money is there – waiting to be “re-purposed”.
And because of the lack of cost control in Obama HCR, we are heading toward more than 20% of GDP going toward health – double other nations, making our goods non-competitive in their countries, destroying out economy, and forcing another look at health care in the US.
“The reality is there was no magic progressive legislation that Ben Nelson and Lieberman would have approved”
That’s why you have the Senate actual work based on democracy by getting rid of the filibuster. However, Nelson and Lieberman delivered what Obama actually wanted and Obama likes to use the undemocratic Senate process as an excuse to pass crappy legislation.
And the reality is they never needed approval from Ben Nelson and Lieberman.
You have a lot to learn young man. I suggest you look back thru the archives of FDL and get more familiar with all the ways that the Health insurance industry will subvert and sneak around ALL the provisions of this law. Read about em and watch them come true.
Sad and brutal as it may sound, I believe it would have been better to do nothing and let the HealthCartel go into massive FAIL via a dieing business model (based on predation) than to bail them out with this Rube Goldberg contraption dubbed Health Care Reform. It will ultimately fail also, but it will take many more years (and tears) of suffering for us to finally rid ourselves of these criminals.
They’re already chipping away at the things that were passed – not being able to choose your own doctor, etc.
I should note that the $600 b is over 10 years, unlike the Medicare 230 and drugs and doctors for Medicare of 250 – so there is $60 B ready to be re-purposed.
We actually need about $600 extra per year for a Medicare quality system for everyone, so the $60 B is short by over 500 – which equates to a doubling of the current Medicare taxes and their expansion to include investment income.
Still doable – but a much heavier lift than I was indicating.
Right, I forgot about that. Once the Senate went to reconciliation there was absolutely NO NEED for Nelson or Lieberman and the PO could have passed easily. The Senate and Obama stood naked in their duplicity and America just swallowed it.
Mr. Greg Young you are simply uninformed. For starters, google “rotating villains” for course #1 in understanding the modern political system of Kabuki and treachery.
Roger.
Vote no was also my position – and Reich’s position until the last minute change of heart.
No public option meant there was no point, and the power of the companies was is increased for the next go round.
Nixon’s 73 proposal was better – and I did not like it!
reconciliation of the basic senate bill did not happen – it was simply agreed to as that was not the point the rules changed to 51 votes from 60.
It was when they went to BUDGET reconciliation for fixes to the Senate bill that we were in the 51 vote rule world – and Obama ordered no public option add on at that point.
I don’t see how the administration didn’t use all possible avenues in making this bill as good as possible. The reality is that the Senate has a moronic 60 vote requirement, thus giving Ben Nelson and Joe Lieberman a veto over all legislation. Considering the system we have in place, I think that this is the best possible legislation that could have been produced.
http://gregthecollegestudent.wordpress.com/
Yikes! First off, I resent you calling me a “young man,” as if I am somehow less informed then you are about the issues at hand. It is one thing to disagree with people, its an entirely different thing to insult someone, then think that passes for an argument.
Secondly, I agree that the health care industry is a mess and that single payer would be the best solution! What I’m arguing is that this bill was better than the status quo. You can’t argue that this bill doesn’t ban pre-existing conditions, or that opening up these companies and forcing them to compete on exchanges won’t help reduce some of the insurance companies worst practices.
Undoubtedly, this bill falls short in some areas, but emphasizing those in comparison to the areas where the bill improves people’s lives doesn’t result in an reasonable opinion of the legislation.
FWIW, you ARE a young man in comparison to many of the commenters here, since many of us have been following these issues since we were college students.
If you do not wish to be called young man by folks in their fifties and sixties, don’t name your blog “gregthecollegestudent”
When you do so, don’t be offended if others notice and say something.
But where and how did that health insurance reform bill set up something forcing insurance companies to compete? They managed to kill the public option that would have done that explicitly so where do you find the forced competition in the existing bill?
And what about the unemployed who are going to be mandated to buy insurance? The gov’t might not find them, of course, since there is no address for living under a bridge.
Sure you can. They intentionally left in the “fraud loophole” that gives insurance companies a way to wiggle out of pre-existing conditions. And the fact is you can’t force companies to compete when they have an anti-trust exemption. You can ask, beg, urge, but you can’t force them to. The anti-trust exemption was also intentionally left in.
The fact is this bill was worse than doing nothing as it gives the health insurance industry millions of new customers and billions of new dollars making it even harder to fight for real reform next time. And by locking them into the system like that, they’ve basically killed any and all hopes of single payer in the future.
And I didn’t even mention the fact that there were NO cost controls in there. None. Nada. Zip.
Bad legislation, passed with bad intentions, designed to fool us “lesser people” into believing it was something it wasn’t. Apparently it’s worked on you. But I’m betting once you get a little more “experienced” you’ll learn to see through this type of bullshit.
Kindly explain how expecting our “representatives” to pass the best possible HIR(Single Payer)is “some idealistic fantasy.” When did doing things half-assed become a victory, or something to be enamored with?
Given the noise comming out of Obama’s catfood commision about cutting Social Security benefits, does anyone seriously believe they will actually take any steps to improve the Heathcare Reform bill?
Competition is enforced through the exchanges – in order to have access to all those millions of new customers, the insurance companies will have to provide pre-defined, comparable plans that will be sold on an open exchange. Meaning anyone who gets their insurance through the exchange will be able to compare benefits & pricing and choose the plan that gives them the most value for their money. A well-designed exchange is a great competitive mechanism.
That doesn’t mean all states will create well-designed or well-run exchanges, but in theory there will be plenty of competitive pressure on the insurance carriers.
For GODS sake…Buy your own health insurance.
A lot of things happen in theory and I doubt seriously that ANY state will create a “well-designed or well-run exchange” of any sort.
And what exact mechanism will force the insurance companies to actually offer usable health plans? By usable, I mean plans that have both affordable premiums, affordable deductibles and affordable co-pays?
The exchanges won’t as many states won’t be able to offer a volume of potential insured that will force the insurance companies to lower their rates, even if by some odd chance a state actually develops something that can be described as well-designed or well-run.
I’m 50, and I’ve been AMAZED since I was 18 in ’78 how the Prop 13 crowd, then the Christo-Fascists of Raygun … stole, Stole and STOLE.
F’k it. Let’s do EVERYTHING with “private” insurance, EXCEPT, we gotta make sure each company has exclusive rights in certain geographic areas, so there is even LESS of their phony ass competition.
Maybe once the drooling pathetic f’king IDIOTS have to get 7 different insurance policies to get their toenail fungus kind of looked at –
1 policy for your feet,
1 policy for fungus below the knees,
1 policy for the nurse,
1 plicy for the receptionist,
1 policy for the doctor,
1 policy for the drugs,
1 re-insurance policy to cover what the first 6 don’t (well, except for what they don’t want to do)
I’m SOOOOOOOOOO done with these stupid m’ther f’king mouth breathers who line up to call Dancing with the Lost American Surviving Idol, and don’t even know who their congress-THIEF is…
MAYBE when the dumb pieces of crap have 7 insurance policies for foot fungus, each policy with different payment schedules and co-pays and deductibles …
MAYBE then they’ll get off their asses?
Bring it on Rand! Yippee Kai-Yah!
rmm.
Sorry – but the exchanges are just the broker down the street that you already have access to
They have been in effect in Mass for several years and have nothing as to competition or cost – companies compete by doing confusion – “we cover more” without saying how little of the cost of what they do cover is actually paid by them. Then the “affordable policy” that is the minimum to satisfy the Mass mandate covers so little that many are choosing to pay the penalty tax.
The pre-existing elimination was done in the 70′s by the unions – and copied into every major group policy in the 80′s. Hard to see it in mandated individual policies as much of an achievement.
The only real possibility of change by regulation is the 80% of the premiums must be paid out as claims rule – Medicare pays out 97% – and there the accounting types in FASB are showing folks how to add to the dollars paid the sick the dollars paid the CEO – because you see the CEO is needed to get the claim paid – a cost of paying the claim which Obama is saying can be included in the regulated “loss ratio” calculation as if it was paid to the insured – so the paid out claims ration must include the 30% overhead the insurance companies run for CEO and friends in management plus the over charges paid their personal re-insurance companies plus the investment of reserves losses from funding their friends companies.
The next step will have to be a million man march on DC at this rate.
For one thing, the Obama administration did not have to exclude Single Payer healthcare from the debate. See http://www.singlepayeraction.org/blog/?p=2064.
So a program that helps less than 1% and screws the rest while making the evil insurance companies even richer is progress? Only to Democrats who are desperate for a victory. A few more victories like this and we will all be staying at home in November.
Sounds like another free market system. We can see how well that works out with monopolies in control.