Reform: Obama Plan Beginning to Gasp for Air

[JMO Fan]

My MD son did his residency at Mayo -Scottsdale. Now an internist in San Diego, I suspect some locals there are grateful for his expert training. So am I.

 

[ins.dave]

In my view, that is not where we are headed. We are talking about the government approving a set of creditable plans, as I call them, that will be eligible for the govenment seal of approval which will include subsidy, tax credit, whatever. All plans that recieve this status will be guaranteed issue- all of them. If they do not have it they are not in the exchange and if the exchange concept collapses then they will simply be plans that do not receive the government kickers. In other words, you will have choice but unless you want to forego government subsidy or tax credit you will choose one of the "creditable" plans.

You are presenting the idea that only the public option will be GI. Not so, in my view. Also, I believe that the public option will not fly anyway but the government will extract so many demands and controls over private carriers that they will all seem like public options. Refer to the pharmaceutical companies that are now running a doughnut hole program as a cost of doing business and keeping the red guard off their backs.

As Barry et al learn how to be better socialists they are learning that you can play the game of making things look like private sector to appease your opponents all while having the government run everything. Tis the socialist way.


----------------------------

Wow.
What public speech or literature are you basing your presumptions upon?
Opinions are great but they should be based on something that was said or read or presented to the public in some way?
This bit that you wrote here –

"We are talking about the government approving a set of creditable plans, as I call them, that will be eligible for the govenment seal of approval which will include subsidy, tax credit, whatever."

You admit this is speculation only and not something that is based on documented statement(s) in any form from the present administration?
My observations have been based on what has been discussed on the news and the internet and also recently in an article in Time by Michael Grunwald. His sources for said article were: Ezekiel Emanuel (white health advisor) and his brother Rahm (his chief of staff).

Also what do you base the following on?

"If they do not have it (the govt. seal of approval) they are not in the exchange and if the exchange concept collapses then they will simply be plans that do not receive the government kickers."

What government kickers? That notion was brought up by the senate health committee (hardly makers of any final determinations) on 06.16.09 and was buried in a sea of roadblocks.
The finance panels chairman Senator Max Baucus (Dem. – Montana) was expected to release a final draft by 06.19.09 and had failed to do so to date.

I've got to call you on this one also.

"You are presenting the idea that only the public option will be GI."

No sir. I don't believe that I am. As Barry stated yesterday (06.23.09), "people who want to keep their own insurance can do that." Private plans will stay the same if they want to. With both underwritten and hippa options.

Your point on the "subsidy, tax credit, whatever " is a valid one. Certainly if the govt. makes it more appealing for people to use the exchange over a private plan that is not in the exchange by offering "kickers" to only those who utilize said exchange, then we could have a problem even when we take into account that unless the subsidies are substantial that these GI subsidized plans would only be attractive to the medically ineligible.

This suggestion was made only in a preliminary discussion and is by no means in the final draft. There is no final draft. There is a great deal of opposition to this proposal because of the Congressional Budget Office review findings. The Congressional Budget Office has stated that the exchange / subsidy proposal would only insure 16 out of the 51 million currently uninsured and this many people would not be covered until 2015. Also note that these subsidies would have income limitations attached to them. Therefore it is unrealistic to think that it would solve the problem of 51 million uninsured Americans. The goal of the administration is to reduce cost and provide everyone with quality health care. Hardly a threat considering that course of action would not address the problem? Barry clearly stated yesterday that any legislation that does not reduce costs and produce quality healthcare to every American will not be signed.

"the government will extract so many demands and controls over private carriers that they will all seem like public options"

Again, we don't know this. This is complete speculation. We have to keep focused on Barry and the admin's. statements / actions only.

Also, like Somarco keeps saying. The big difference is in the medical underwriting with GI plans. They will always cost a lot whole. Barry also stated yesterday that they will NOT sign legislation that adds to the deficit. That means no subsidies does it not? Again he stated that the public offering would be paid for by public premium only.
Taking all this into account, it seems like the only thing that might happen, if they can arrange it so that there is no deficit gain, is that people who are MI may get some govt. assistance on those public exchange plans and that operating costs may be lowered bringing down the cost of health insurance for all. If not, I still can't see this as a threat at this time all things considered.

 

[motoxxx]

Whichever way this goes, none of it seems good to me. They are trying to sell this plan to the public so that they will have choices. There are already over 1300 different plans available. How much more choice does any one need?

 

[Charpress]

Celiac?

Looking that way. We suspected it but the local doctors said no. Turns out they were not even running the proper tests for Celiac.

For crying out loud, our pharmacist had this pegged a year ago. One doctor got really pissed that a "pill counter" was suggesting a diagnosis.

I have found that pharmacists know more about the practical side of medicine than the M.D.s.

 

[Winter_123]

In my view, that is not where we are headed. We are talking about the government approving a set of creditable plans, as I call them, that will be eligible for the govenment seal of approval which will include subsidy, tax credit, whatever. All plans that recieve this status will be guaranteed issue- all of them. If they do not have it they are not in the exchange and if the exchange concept collapses then they will simply be plans that do not receive the government kickers. In other words, you will have choice but unless you want to forego government subsidy or tax credit you will choose one of the "creditable" plans.

You are presenting the idea that only the public option will be GI. Not so, in my view. Also, I believe that the public option will not fly anyway but the government will extract so many demands and controls over private carriers that they will all seem like public options. Refer to the pharmaceutical companies that are now running a doughnut hole program as a cost of doing business and keeping the red guard off their backs.

As Barry et al learn how to be better socialists they are learning that you can play the game of making things look like private sector to appease your opponents all while having the government run everything. Tis the socialist way.


----------------------------

Wow.
What public speech or literature are you basing your presumptions upon?
Opinions are great but they should be based on something that was said or read or presented to the public in some way?
This bit that you wrote here –

"We are talking about the government approving a set of creditable plans, as I call them, that will be eligible for the govenment seal of approval which will include subsidy, tax credit, whatever."

You admit this is speculation only and not something that is based on documented statement(s) in any form from the present administration?
My observations have been based on what has been discussed on the news and the internet and also recently in an article in Time by Michael Grunwald. His sources for said article were: Ezekiel Emanuel (white health advisor) and his brother Rahm (his chief of staff).

Also what do you base the following on?

"If they do not have it (the govt. seal of approval) they are not in the exchange and if the exchange concept collapses then they will simply be plans that do not receive the government kickers."

What government kickers? That notion was brought up by the senate health committee (hardly makers of any final determinations) on 06.16.09 and was buried in a sea of roadblocks.
The finance panels chairman Senator Max Baucus (Dem. – Montana) was expected to release a final draft by 06.19.09 and had failed to do so to date.

I've got to call you on this one also.

"You are presenting the idea that only the public option will be GI."

No sir. I don't believe that I am. As Barry stated yesterday (06.23.09), "people who want to keep their own insurance can do that." Private plans will stay the same if they want to. With both underwritten and hippa options.

Your point on the "subsidy, tax credit, whatever " is a valid one. Certainly if the govt. makes it more appealing for people to use the exchange over a private plan that is not in the exchange by offering "kickers" to only those who utilize said exchange, then we could have a problem even when we take into account that unless the subsidies are substantial that these GI subsidized plans would only be attractive to the medically ineligible.

This suggestion was made only in a preliminary discussion and is by no means in the final draft. There is no final draft. There is a great deal of opposition to this proposal because of the Congressional Budget Office review findings. The Congressional Budget Office has stated that the exchange / subsidy proposal would only insure 16 out of the 51 million currently uninsured and this many people would not be covered until 2015. Also note that these subsidies would have income limitations attached to them. Therefore it is unrealistic to think that it would solve the problem of 51 million uninsured Americans. The goal of the administration is to reduce cost and provide everyone with quality health care. Hardly a threat considering that course of action would not address the problem? Barry clearly stated yesterday that any legislation that does not reduce costs and produce quality healthcare to every American will not be signed.

"the government will extract so many demands and controls over private carriers that they will all seem like public options"

Again, we don't know this. This is complete speculation. We have to keep focused on Barry and the admin's. statements / actions only.

Also, like Somarco keeps saying. The big difference is in the medical underwriting with GI plans. They will always cost a lot whole. Barry also stated yesterday that they will NOT sign legislation that adds to the deficit. That means no subsidies does it not? Again he stated that the public offering would be paid for by public premium only.
Taking all this into account, it seems like the only thing that might happen, if they can arrange it so that there is no deficit gain, is that people who are MI may get some govt. assistance on those public exchange plans and that operating costs may be lowered bringing down the cost of health insurance for all. If not, I still can't see this as a threat at this time all things considered.

Just count the number of times, including yesterday, that Barry said that carriers are "not going to be able to cherry pick" who they accept and then reflect upon what all that means in the real world.

In regard to people having current plans that may be group or underwritten that will be grandfathered in, I dont doubt that he needs to do that to make it palatable. In regard to any movement though, the new plans will be guaranteed issue if they want favorable treatment from the govenment and the government has many, many ways of accomplishing that. What you call speculation on my part, is actually listening to the sum total of what is being said by his administration. Barry will get beaten on the public option and on the mandate and on the universal payer aspects, but he will win on the guaranteed issue piece, or a set of incentives to provide more favorable treatment of guaranteed issue. You dont see this or accept this and that is fine. Barry will be repeating his position often enough in the coming days to help us get clear as we go forward. If it becomes apparent that I am wrong, I will adjust my views.

 

[ins.dave]

Whichever way this goes, none of it seems good to me. They are trying to sell * this plan to the public so that they will have choices. There are already over 1300 different plans available. How much more choice does any one need?

---------------------
* what plan Bro.

I think you might be missing it.
If any good comes out of this it will be in getting all of the parties involved to take less in order to get operating and therefore premium costs down. All this wrangling is an end to that means. The very idea of a govt. based exchange could very well be a clever bit of stratagey on the part of the present Admin. in order to "stimulate" a more "conjenial tone" from the AMA, and the ins. companies, etc. I'll say it, a possible bluff. It's a poker game folks.
Your right, there are plenty of choices. Possibly some of the money saved in operating costs could be used to assist people who are MI while simultaneously lowering costs for the medically eligible also.
I think it may be that or next to nothing. I'm as paranoid as Winter on this when it comes to losing our gig. Dat gum it, I figured Ehealth was going to bury all of us. It didn't happen.
Again, this is speculation on all our parts, but there is no possible way that they can provide competitive "exchange" or govt. or "exchange compliant" or whatever the hell you want to call it plans for everyone; sick and not sick, with or without subsidies without increasing the deficit. Clearly stated publicly on 06.23.09 that this was not acceptable.
The numbers are not there so there is no threat. The more I think about it; I think maybe Barry and freinds are just trying to scare these greedy "so and so's" straight. There is no other way he can get what he wants done numerically, again, without increasing the deficit.

 

[somarco]

carriers are "not going to be able to cherry pick" who they accept

If it happens, that doesn't bother me a bit at all, especially if coverage is mandated.

Folks will (somehow) have to find the money to pay the premium at 2x - 3x current rates. Even if my commission is cut by 80% I can still make good money.

What is odd is the same folks who want it all think the price will go down. Doesn't anyone study basic economics in school?

 

[Winter_123]

I'm as paranoid as Winter on this when it comes to losing our gig. Dat gum it, I figured Ehealth .

Without dampening your spirit, I might suggest that you listen in a bit longer before characterizing my position. I have stated many times that I am in a State where the action is totally dead so I am not paranoid about losing any gig. There is no gig to be lost in my state. We can only go up. When the reform comes about, I am in for whatever action there is. This may not make immediate sense to you based on your recent arrival and that is fine.

 

[ins.dave]

Originally Posted by motoxxx

If all of this BS goes through, do you think they have factored in the 100,000 or so agents around the country that will be out of work into their jobless numbers?​

Oh, I think they most definitely have, and have calculated how much it will help to reduce the cost of premiums. I am not agreeing or disagreeing, just laying out their rationale.

Originally Posted by ins.dave

I'm as paranoid as Winter on this when it comes to losing our gig. Dat gum it, I figured Ehealth would bury all of us. It didn't happen.
​

Without dampening your spirit, I might suggest that you listen in a bit longer before characterizing my position. I have stated many times that I am in a State where the action is totally dead so I am not paranoid about losing any gig. There is no gig to be lost in my state. We can only go up. When the reform comes about, I am in for whatever action there is. This may not make immediate sense to you based on your recent arrival and that is fine.


"Dampen my spirit?" I truly doubt that. If you can help it, please spare us all this kind of
condescending remark? Pardon me, but, If that's (underlined above) not someone paranoid about losing their job, or should I say agents in general losing their jobs, than I don't know what is. Forgive me for not only thinking about you and your state? We were speaking in general terms for all agents nationwide and their concern that we all may be getting phased out and your reply to Motxxx in that regard. Let's try for once to keep things in context?
As Motoox stated - 100,000 or so agents around the country...
We were commenting in reference to your comment to Motoxx's post.

 

[AgentOrange]

its gonna be like Medicare; you can get treatment from over 97% of Drs and hospitals and no pre existing exclusions ... thats all Obama has stated ... you guys need to stop listening to talk radio, its rotting your brains.