Washington Post article on National Universal Health Plan

Jan 20, 2007

  1. furlover
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    furlover Expert

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    Wondered what members thought.



    A New Consensus on Universal Health Care

    By Steven Pearlstein - Washington Post
    Wednesday, January 17, 2007; D01


    On the surface, it looked to be just another Washington news conference, part of the white noise of the political and policy process.

    But this one was different. There, at the National Press Club, stood the president of the Business Roundtable, representing the country's largest corporations; the president of the Service Employees International Union, the country's most vibrant union and one of its fastest-growing; and the president of AARP, the formidable seniors lobby. They put aside their usual differences to deliver a clear, simple message to President Bush and congressional leaders of both parties:

    We stand ready to give you the political cover you need for a centrist, bipartisan fix for a broken health-care system.

    Or, if you refuse, we stand ready to embarrass you and run you out of office.

    "Washington is behind where the rest of the country is," said Andy Stern, a labor leader. "Democratic leaders in Congress say this is not the time. The White House has said now is not the time. And we are saying, 'Now is the time.' "

    Stern and his new friends are right about one thing: Something's going on.

    A Republican governor of Massachusetts, working with Sen. Ted Kennedy and a Democratic legislature, hammered out a comprehensive reform plan last year. And last week, another Republican governor proposed a similarly bold plan for California.

    Not coincidentally, both state plans conform roughly to a consensus that has been taking shape in Washington over the past two years, in behind-the-scenes negotiations among health insurers, hospitals, physicians, business and labor groups, drug companies and consumer groups such as Families USA. The first draft of their effort will be unveiled tomorrow. And while the "consensus" will fudge some of the most difficult issues in an effort to keep the coalition together, the outlines of a genuinely comprehensive reform plan are coming into focus.

    What does that consensus look like?

    It starts with universal coverage, accomplished either through a mandate on everyone to purchase basic health insurance or a mandate on all employers to offer it.

    It includes subsidies for families with incomes up to 300 percent of the poverty level to help defray the cost of that insurance and the deductibles and co-payments that go with it.

    It involves changes in tax law so that individuals who purchase health insurance enjoy the same tax benefits as those who get it as a fringe benefit at work.

    It sets up a pooling arrangement in every state to allow individuals and small businesses to buy health insurance at the same price as large corporations.

    Finally, it sets a deadline for physicians and hospitals to switch to computerized health records, along with a program to provide no-interest loans to buy the necessary hardware and software.

    Of course, in health care, the details are always tricky. To get a plan that hangs together, all of the major interest groups would have to make important concessions.

    Doctors would have to agree to have their compensation from insurers tied, in part, to how well they conform to treatment protocols established by the various medical specialties.

    Hospitals and insurers would have to agree that 85 percent of their revenue would go to providing direct care, capping profit and administrative expenses at 15 percent.

    Health insurers would have to accept the obligation to sell insurance to everyone, with only modest variation in rates for age and health status.

    And to raise some money and hold down the growth in insurance premiums, union members and high-income workers would have to accept a cap on the amount of health benefits they receive tax-free.

    To avoid government "negotiated" prices, drug companies would have to submit new drugs to a rigorous cost-benefit test by an independent agency, such as the Institute of Medicine, as a condition for being included on the Medicare and Medicaid formularies.

    Conservatives and their small-business allies would have to swallow some form of "pay or play" -- either providing employer-paid health insurance or paying a tax to the state subsidy pool.

    And liberals would have to accept a "basic" insurance package that provides full coverage for preventive care and catastrophic illness but requires patient cost-sharing for routine care.

    These concessions won't come easy, which is why there has been no significant progress on health-care reform in the decade since the Clinton debacle. But the current system has become such a problem for so many providers and consumers that many are now willing to compromise on long-held positions.

    Unfortunately, pulling it all together will require the active engagement of Congress and the White House, who, so far, have been missing in action.

    It remains unclear whether Democrats would prefer to make progress now or have an issue to run on in the 2008 presidential election. If they're interested in a deal, the go-to guys will be Kennedy, who played a crucial role in negotiating the Massachusetts plan, and Rep. George Miller, a Californian and confidant of Speaker Nancy Pelosi who chairs the House Education and Labor Committee.

    It is also unclear whether the Bush administration is prepared to move beyond its narrow ideological fixation on "consumer-driven health care" and become an honest broker. As head of Medicare and Medicaid, economist-physician Mark McClellan might have played that role, but he has resigned. And the obvious candidate to replace him -- Mike Leavitt, the secretary of Health and Human Services and former governor of Utah -- has yet to be given the same broad mandate and authority from the White House that Treasury Secretary Hank Paulson got to tackle budget balancing and entitlement reform.

    All of which explains why the SEIU's Andy Stern, the Roundtable's John Castellani and AARP's Bill Novelli decided to put aside their differences and put it to the politicians. As Stern said yesterday, "The answer to the health-care problem is not one of policy but one of politics."
     
    furlover, Jan 20, 2007
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  2. somarco
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    somarco That Medicare Guy

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    Mostly bravado and chest thumping.

    Fat Teddy has been trying to get this going for years in hopes of having a legacy that will overshadow Chappaquiddick.

    The Democrats are back in power . . . albeit a slim margin . . . because the Republicans gave away the election with their stupidity.

    MA has mandated health insurance but they are already admitting they have no idea how much it will cost.

    http://www.capecodonline.com/cctimes/healthagencies16.htm

    The Governator is sounding more like a Democrat by wanting to cover everyone including illegal aliens.

    MN wants to limit premium increases while expanding toward universal coverage. Only one problem. They dont know how much it will cost or how the plan will work.

    http://www.winonadailynews.com/articles/2007/01/11/mn/04minhealthbill11.txt

    The problem in taking this national is this.

    Medicare doesn't work and is underfunded.

    Medicaid which is a combination of state & federal funds is on the rocks in most states.

    Everyone is wanting a change without really knowing what they want, how it will work, or how much it will cost. All of that adds up to a train wreck.

    Eventually you have to ask yourself . . . what are these folks smoking?
     
    somarco, Jan 20, 2007
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  3. salpro22
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    Re: Washington Post article on National Universal Health Pla

    What exactly is broken about the health-care system. Affordability, access, lack of properly trained doctors and hospitals...... A bit more clarification is needed.

    Sounds very similar to car insurance, except once your car is paid off you are not legally required to carry full coverage, except where noted. Will the mandate affect only companies that have W-2 employees or will that include independent contractors (i.e., more policy changes to require insuring indies)? Additionally, who sets the "minimum" health insurance requirements that individuals have to buy. How about a few MEGA policies or plans with "Right" in the name as financial roulette guidelines.

    Why not just let the market determine how much to pay for a service? It amazes me how angry some people become when they have to spend money, but if they accumulate money (i.e., last 2-3 years of fairly consistent real estate appreciation), everything is great and acceptable.

    Again, the market will automatically dictate how high profits become as long as one company does not have a monopoly. Last time I checked, quite a few companies are competiting for business.

    Let's apply this to loans. In other words, regardless of prior credit history or verification of employment, everybody should get the same loan. Yeah, there is a smart idea to ensure that the 100 year loan is around the corner.

    This system is already in place. It is called, "I either pay my bill or the hospital takes my assets."

    Good luck getting that passed.

    Again, what "precisely" are the problems?


    Making consumers "responsible" for their own bills is not narrow-minded, it is prudent planning to ensure that people accept responsibility for their actions, or more importantly, "lack of responsibility."

    Now let's debate :)
     
    salpro22, Jan 20, 2007
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  4. Crabcake Johnny
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    Crabcake Johnny Guru

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    Most likely the states will take care of health insurance instead of the federal government. Trying to implement a national healthcare system is in my opinion un-achievable.

    Things that must be fixed:

    1) Affordable access to insurance for hourly workers who don't have access through their job.

    2) Forcing people to pay outrageous money for Cobra coverage while looking for another job.

    3) Solving the fact that workers don't own their policy - the employer does. That plan can be changed at will or dropped at will without employee consent.

    4) The concept that everything's supposed to be a copay and Americans aren't supposed to absorb smaller bills.

    I don't see anyone whining that car insurance doesn't cover oil changes, brakes, tune-ups, transmissions or engines. Your tranny goes out and it's $1,500 to fix it? Guess what. Get it fixed.
     
  5. furlover
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    John,

    If we did see state covered health insurance, what is the future for health insurance sales?
     
    furlover, Jan 20, 2007
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  6. Crabcake Johnny
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    The same future car insurance agents have - lucrative. I do believe Mass. agents will be doing very well come July of this year. Health will be mandatory yet people have to buy it through private companies.

    The only thing that would kill health agents would be national socialistic universal healthcare. Won't ever happen.
     
  7. furlover
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    Requiring car insurance is easy to enforce, if someone owns one they must be licensed annually. Even then for the very poor this doesn't work.

    So, ... how can they force people to have health insurance?
     
    furlover, Jan 21, 2007
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  8. somarco
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    somarco That Medicare Guy

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    Have you ever noticed the number of drivers involved in accidents that were driving without a license?

    People will continue to evade & break the law as long as they do not get caught. It is the same philosophy used by those who do not have health insurance but are looking for coverage. The longer they go without cover without a serious financial repurcussion the more invincible they become.

    Then when something does happen they want the rest of us to bail them out.
     
    somarco, Jan 21, 2007
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  9. Crabcake Johnny
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    Car insurance is extremely difficult to enforce which is why there's so many uninsured drivers. Look at some of these figures:

    http://www.insurancejournal.com/news/national/2006/06/28/69919.htm

    The problem is and will always be that you cannot force people to have anything they can't afford. Then you're just taking honest people and turning them into criminals.
     
  10. James
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    It is without a doubt Big Business would be all behind this! Outside of having the cost already what it would to is to raise that bar for any competition starting today to ever be viable. In other words increase the cost of business to eliminate competition.
     
    James, Jan 21, 2007
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