Lets save all the other threads, Health Reform Passed. Go!

[cmcner]

Go.

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[pogue]

Go.

I'm not celebrating, and I'll tell you why.

I was told the purpose of the bill was to insure all Americans. This was supposed to be deficit neutral. Taxes would not go up. This would be paid for by reducing waste in medicare. No rationing of care, and everyone can keep their plan and their primary care physician if they liked them. But...

They are cutting medicare payments by more than 20% to get this bill into the black, then passing the "doc fix" to essentially roll the cuts back, putting this deficit neutral plan back in the red. So we're starting off knowing that we're going to take a bath on this... but it still passes the vote.

Those of you who have worked for large corporations know how much a 90/10 or 85/15 low deductible plan costs your employer. It's a lot. Especially if you have a family. You can kiss that coverage goodbye when your employer tells you they would rather pay the 7% "penalty" to push you onto a government program instead of paying the typical 12-20% that is costs them to subsidize insurance for their employees. When your employer takes the savings gained by kicking you to the government program they will probably not turn around and just give you the money, so the feds are expecting to maintain the same level of payroll tax collection and they aren't going to be getting it. I'm not kidding. One of my good friends just got a strange email from his employer reminding him of how expensive it is to subsidize his family's health insurance. Guess what they're thinking?

I would guess doctors will be working extra hard seeking out privately insured patients as more and more Americans are pushed onto the public plan. When they are no longer able to do so, they will start to feel the economics of this bill. A branch of the Mayo Clinic in Arizona is already doing this out of necessity. Keep your doctor? Well, only if he is willing to treat people on the government plan. But if the government can compel you to have insurance, they can compel your doctor to treat you too, right? So who exactly is running the show again?

This is an economic disaster for the American taxpayer. The only way I see a way to raise the money to pay for this is to institute a national sales tax, or even worse- a value added tax. A value added tax would be a hoot, especially since we are staring at a reduction in our credit rating from "AAA". That would mean serious inflation like back when your parents were buying their first house at 20% back in the late 70s and early 80s. When credit freezes up for real it will make this recession look like a catered picnic. Forget about any business that relies on credit to operate/buy inventory.

I can only assume that as our government creeps further toward insolvency the money available for research grants will be reduced to nothing and the private sector will be unable to keep up with places like China that are coming on strong. "Big Pharma" and all the little biotechs feeding them will wither on the vine. Eventually we'll be like the europeans, but with a significantly larger military that we can't equip. Maybe our navy will look like the Russian navy post 1990. Rusting in port... very sad sight.

Of course, I could be wrong! That's what I'm praying for!!! If I am right, I'm not sticking around too long. I'll be banking what I make and heading for the next best thing. I have a buddy who is an economist who likes New Zealand for some reason. I'm not ready for Christmas in July or heatwaves in January quite yet, but I guess the world is slowly turning upside down so what's the difference.

 

[SeattleRDH]

Such a complicated issue.....

I recommend everyone read The Brave New World of Health Care by Richard D. Lamm.

There's something to be said about the status quo being unsustainable.

 

[Shasan546]

I'm not celebrating, and I'll tell you why.

I was told the purpose of the bill was to insure all Americans. This was supposed to be deficit neutral. Taxes would not go up. This would be paid for by reducing waste in medicare. No rationing of care, and everyone can keep their plan and their primary care physician if they liked them. But...

They are cutting medicare payments by more than 20% to get this bill into the black, then passing the "doc fix" to essentially roll the cuts back, putting this deficit neutral plan back in the red. So we're starting off knowing that we're going to take a bath on this... but it still passes the vote.

Those of you who have worked for large corporations know how much a 90/10 or 85/15 low deductible plan costs your employer. It's a lot. Especially if you have a family. You can kiss that coverage goodbye when your employer tells you they would rather pay the 7% "penalty" to push you onto a government program instead of paying the typical 12-20% that is costs them to subsidize insurance for their employees. When your employer takes the savings gained by kicking you to the government program they will probably not turn around and just give you the money, so the feds are expecting to maintain the same level of payroll tax collection and they aren't going to be getting it. I'm not kidding. One of my good friends just got a strange email from his employer reminding him of how expensive it is to subsidize his family's health insurance. Guess what they're thinking?

I would guess doctors will be working extra hard seeking out privately insured patients as more and more Americans are pushed onto the public plan. When they are no longer able to do so, they will start to feel the economics of this bill. A branch of the Mayo Clinic in Arizona is already doing this out of necessity. Keep your doctor? Well, only if he is willing to treat people on the government plan. But if the government can compel you to have insurance, they can compel your doctor to treat you too, right? So who exactly is running the show again?

This is an economic disaster for the American taxpayer. The only way I see a way to raise the money to pay for this is to institute a national sales tax, or even worse- a value added tax. A value added tax would be a hoot, especially since we are staring at a reduction in our credit rating from "AAA". That would mean serious inflation like back when your parents were buying their first house at 20% back in the late 70s and early 80s. When credit freezes up for real it will make this recession look like a catered picnic. Forget about any business that relies on credit to operate/buy inventory.

I can only assume that as our government creeps further toward insolvency the money available for research grants will be reduced to nothing and the private sector will be unable to keep up with places like China that are coming on strong. "Big Pharma" and all the little biotechs feeding them will wither on the vine. Eventually we'll be like the europeans, but with a significantly larger military that we can't equip. Maybe our navy will look like the Russian navy post 1990. Rusting in port... very sad sight.

Of course, I could be wrong! That's what I'm praying for!!! If I am right, I'm not sticking around too long. I'll be banking what I make and heading for the next best thing. I have a buddy who is an economist who likes New Zealand for some reason. I'm not ready for Christmas in July or heatwaves in January quite yet, but I guess the world is slowly turning upside down so what's the difference.

So whats your genius plan that will make everything work? How would you fix our healthcare system? And please don't say the status quo because obviously it IS NOT SUSTAINABLE. Yes ideally taxes would not go up; etc. But it has to be paid for somehow right? Its not like were rolling in $$$ right now.

 

[NOsaintsfan]

I don't understand why supporters of the health care bill think that this legislation is the only way to inact reform. There was another way. How? We could have done it for free. Allowing interstate competition between insurance companies, addressing malpractice lawsuits through medical tort reform would cost nothing. Also additional regulation could have been placed on insurance companies could have been done that would making it illegal for insurance to drop you once you develop disease.

These few things would have made a big difference in the current health care system and they would have cost taxpayers nothing. They could have been implimented and we could have watched the situation for a few years and made additional changes as needed.

We didn't have to go the western european route. Western Europe is a nice place to visit and turning America into that type of government isn't going to spell the end of the world for everyone, however, a Western European government is DRAMATICALLY different from the U.S. and this health care bill puts us on that path. But what do I know?

 

[pogue]

So whats your genius plan that will make everything work? How would you fix our healthcare system? And please don't say the status quo because obviously it IS NOT SUSTAINABLE. Yes ideally taxes would not go up; etc. But it has to be paid for somehow right? Its not like were rolling in $$$ right now.

There is not a plan that would "make everything work". There are only plans that will make things work as much as possible without ultimately destroying the foundation of our healthcare system as we know it and/or destroying our economy.

I agree that our healthcare insurance system is not sustainable as costs continue to escalate. The problem is this bill does little to reduce premiums, but it will eventually lead to insolvency for our country.

The best ideas I have heard start with the no-brainers as outlined in the previous post. Those cost nothing and are a positive first step. I would also like to see tax credits where people can purchase insurance on state exchanges. It would be nice to see the government encourage insurers to include 100% coverage of preventative care on basic "catastrophic" policies- policies that are pretty cheap (just go to ehealthinsurance.com).

The solutions have to include choice and competition between private insurers with governmental oversight to eliminate insurers that cherry pick patients.

Instead, we will have a system where young healthy people who may not have health insurance will wait until they become sick to get insurance. Older people with more health problems (and younger people who feel they can afford their premiums) will see their premiums skyrocket. These younger people will drop coverage, and the death spiral continues. Cost goes up and money in goes down... uh oh.

Ask yourself who will pay for this. Those of us paying taxes will pay for this. Premiums will have to go up.

I'm not trying to make you mad, I'm just telling you that these sweeping legislative events do not play out in a vacuum. People will continue to do what is best for themselves and their families. It's human nature. It's a force of basic economics. Instead of harnessing this tendency our politicians are trying to snuff it out.

 

[eliot81]

Correct me if i am wrong, but I don't think socialized medicine is working in Western Europe or Canada. Don't rich people just come to America when they want good medical care? Didn't the Canadian Prime Minister recently come to the US for surgery?

Anyway, does anyone think Obamacare is going to affect dentistry?

Also was anyone else weirded out that Pelosi was allowed to be in charge of the appropriations committee when her state is a financial disaster? Clearly she and her people like to spend tons of money without thinking of where it will be coming from. I think someone dropped the ball on that one.