Senate committee approves health care plan

[crazy canuck]

Is there any real reform here or just a bunch of money being put into the pockets of insurers?

It's definitely real.  Elimination of screening is a huge deal, and so is introduction of mandates.  I also wouldn't assume that money would flow into the pockets of insurers, they could take it in the ass big time if this goes wrong.

The government is subsidizing the payment of premiums to the insurance companies who will be raising premiums to account for the people that they are being forced to insure.

Not sure where the downside is for the insurance companies.  I do see a downside for the tax payer and the employers who will have to ensure that private insurance comanies continue to meet their profit margin targets.

[DGuller]

The latter change drew the ire of the health insurance industry, which said that without a strong and enforceable requirement, not enough people would get insured and premiums would jump for everyone else.

DGuller, the problem is general public doesn't believe the insurance industry in the quote above.

The problem is that the general public, and even not-so-general public, has poor grasp of how for-profit non-social insurance works in general.  Just a couple of days ago, I was watching Larry King show with 10 women senators talking about health insurance.  They all were saying what an absurdity it was for insurance companies to regard pregnancy as a pre-existing condition, and Dr. Sanjay Gupta agreed.  There you have 11 highly educated and influential people saying that insurance companies are evil for, in effect, not insuring houses that are on fire.

[DGuller]

The government is subsidizing the payment of premiums to the insurance companies who will be raising premiums to account for the people that they are being forced to insure.

Not sure where the downside is for the insurance companies.  I do see a downside for the tax payer and the employers who will have to ensure that private insurance comanies continue to meet their profit margin targets.

The downside is that adverse selection destroys the health insurance market by making it unaffordable to healthy people, even with subsidies and fines.

[garbon]

Its better than nothing, good news.

[crazy canuck]

The downside is that adverse selection destroys the health insurance market by making it unaffordable to healthy people, even with subsidies and fines.

Destroy is probably too strong a word.

My prediction is that so long as the US keeps feeding the private insurance industry with tax payors money, you will never get the kind of health care reform you really need. 

[alfred russel]

The latter change drew the ire of the health insurance industry, which said that without a strong and enforceable requirement, not enough people would get insured and premiums would jump for everyone else.

DGuller, the problem is general public doesn't believe the insurance industry in the quote above.

The problem is that the general public, and even not-so-general public, has poor grasp of how for-profit non-social insurance works in general.  Just a couple of days ago, I was watching Larry King show with 10 women senators talking about health insurance.  They all were saying what an absurdity it was for insurance companies to regard pregnancy as a pre-existing condition, and Dr. Sanjay Gupta agreed.  There you have 11 highly educated and influential people saying that insurance companies are evil for, in effect, not insuring houses that are on fire.

To be fair, in their spot I would say the same thing. To say insurance companies shouldn't cover expectant mothers is a great way to lose your next election.

[DGuller]

Destroy is probably too strong a word.

How about "become totally non-functional"?

My prediction is that so long as the US keeps feeding the private insurance industry with tax payors money, you will never get the kind of health care reform you really need.

The disconnect is more basic than that.  Many people think that health insurance should be treated as social insurance, sort of like Social Security or Medicare.  Basically, it shouldn't be a financial risk-mitigation instrument that's priced according to risk, it should be something that protects everyone in society from a shitty outcome.  I personally share that belief. 

The problem is that social insurance is incompatible with a competetive private insurance industry.  Pregnant women need to be covered, but what insurance company in their right mind would offer to do it when it would obviously be a huge money loser?  It's very hard to reconcile the social insurance goal with the need to earn profits and not be out-competed, and IMO it's a fool's errand to try.  Unfortunately, that's all that we can in this political climate.  The best we can hope for is to get there one half-assed attempt at a time.

[crazy canuck]

The problem is that social insurance is incompatible with a competetive private insurance industry.  Pregnant women need to be covered, but what insurance company in their right mind would offer to do it when it would obviously be a huge money loser?  It's very hard to reconcile the social insurance goal with the need to earn profits and not be out-competed, and IMO it's a fool's errand to try.  Unfortunately, that's all that we can in this political climate.  The best we can hope for is to get there one half-assed attempt at a time.

I agree.

Thats why I pointed out that there is no real reform here.  This is really just a crap shoot to see if private insurers can be made to look like a single payor public insurer.  Somewhere, someone is going to figure out how to milk this.

[Hansmeister]

Btw, I saw a news article that said that this bill was going to raise coverage to 94% of Americans...and that 83% have coverage now.  Is that actually the case?

This is based on the flawed claim that 47 million Americans lack health insurance - the real number is about 30 million (10 million illegals and 7 million who falsely answer on surveys that they don't have health insurance make up the difference).

Under this plan the number of uninsured would drop to 25 million -  a 5 million drop for a measly $839 billion - gov't efficiency at its best.

In return health insurance cost would skyrocket, partially through the tax on medical device makers to fund this expansion, partly through costly new federal mandates, and mostly through a 40% tax on "cadillac health" plans, which thanks to the aforementioned elements and because the cost definition of a "cadillac" plan is tied to overall inflation, not medical inflation,  will be over 50% of insurance plans within 6 years.  It would probably be higher but Chuck Shumer already secured an exemption for NY (it's good to be the king).  It's another bad plan that will go nowhere.

[Caliga]

Its better than nothing, good news.

[Admiral Yi]

This is based on the flawed claim that 47 million Americans lack health insurance - the real number is about 30 million (10 million illegals and 7 million who falsely answer on surveys that they don't have health insurance make up the difference).

Under this plan the number of uninsured would drop to 25 million -  a 5 million drop for a measly $839 billion - gov't efficiency at its best.

Since cost is a function of the number of people subsidized presumably if there are fewer of them it will cost less.

Have you got a cite for that number of uninsured?

[alfred russel]

The problem is that social insurance is incompatible with a competetive private insurance industry.  Pregnant women need to be covered, but what insurance company in their right mind would offer to do it when it would obviously be a huge money loser?  It's very hard to reconcile the social insurance goal with the need to earn profits and not be out-competed, and IMO it's a fool's errand to try.  Unfortunately, that's all that we can in this political climate.  The best we can hope for is to get there one half-assed attempt at a time.

I agree.

Thats why I pointed out that there is no real reform here.  This is really just a crap shoot to see if private insurers can be made to look like a single payor public insurer.  Somewhere, someone is going to figure out how to milk this.

But if you mandate coverage, you can have real reform. This bill seems to have that, only it also seems to have watered down the penalties to the point they aren't effective (or so says the insurance lobby).

[Hansmeister]

This is based on the flawed claim that 47 million Americans lack health insurance - the real number is about 30 million (10 million illegals and 7 million who falsely answer on surveys that they don't have health insurance make up the difference).

Under this plan the number of uninsured would drop to 25 million -  a 5 million drop for a measly $839 billion - gov't efficiency at its best.

Since cost is a function of the number of people subsidized presumably if there are fewer of them it will cost less.

Have you got a cite for that number of uninsured?

Barack Obama in his speech to the Senate. 

[crazy canuck]

But if you mandate coverage, you can have real reform. This bill seems to have that, only it also seems to have watered down the penalties to the point they aren't effective (or so says the insurance lobby).

Mandating tax payor subsidized coverage without doing anything to control cost is a recipe for huge dificits - even by American standards.

[BuddhaRhubarb]

Is there any real reform here or just a bunch of money being put into the pockets of insurers?

It's definitely real.  Elimination of screening is a huge deal, and so is introduction of mandates.  I also wouldn't assume that money would flow into the pockets of insurers, they could take it in the ass big time if this goes wrong.

that would be terrible. Not. If anyone deserves an ass-raping or three it's Insurance companies.