http://news.yahoo.com/s/ap/20091013/ap_on_go_co/us_health_care_overhaul
QuoteWASHINGTON – With support from a lone Republican, a key Senate committee Tuesday approved a middle-of-the-road health care plan that moves President Barack Obama's goal of wider and affordable coverage a giant step closer to becoming law.
Maine Republican Olympia Snowe said she was laying aside misgivings for now and voting to advance the bill, a sweeping $829-billon, 10-year health care remake that would help most Americans get coverage without creating a new government insurance plan. "When history calls, history calls," said Snowe.
Finance Committee Chairman Max Baucus, D-Mont., called his bill "a commonsense, balanced solution." A distance runner, Baucus has endured months of marathon meetings to get this far. It's not the finish line.
Health care legislation is expected to be on the Senate floor the week after next, said a spokesman for Majority Leader Harry Reid of Nevada. But it won't be the Baucus bill. Reid will combine the Finance version with a more liberal proposal from the health committee — with unpredictable results.
The vote in the Finance Committee was 14-9, with Snowe joining all 13 Democrats in support. In a sign of long political battles ahead, every other Republican voted against it.
The ultimate fate of the legislation hinges on how lawmakers decide dozens of unresolved issues, from letting government sell insurance to abortion coverage. Even some senators who voted for the Baucus bill said they have concerns it will deliver on providing access to affordable coverage for all.
As Snowe made clear, "My vote today is my vote today. It doesn't forecast what my vote will be tomorrow."
The Baucus plan would, for the first time, require most Americans to purchase insurance and it also aims to hold down spiraling medical costs over the long term. Questions persist about whether it would truly provide access to affordable coverage, particularly for self employed people with solid middle class incomes.
The Finance Committee's top Republican, Chuck Grassley of Iowa, gave voice to the GOP's concerns about the bill, saying it was "moving on a slippery slope to more and more government control of health care."
"There's a lot in this bill that's just a consensus that needs to be done, but there are other provisions of this bill that raise a lot of questions," Grassley said, contending the legislation would mean higher costs for Americans.
The committee approval marked a personal victory for Baucus. Four other congressional committees finished their work before August, and for months all eyes had been on the Finance panel, whose moderate makeup most closely resembles the Senate as a whole.
Snowe kept Washington guessing about how she would vote until she announced it late in the debate Tuesday. Democrats, aware that Snowe could be the only Republican in Congress to vote for their health care overhaul, have spent months addressing her concerns about making coverage affordable and how to pay for it.
The committee's centrist legislation is also seen as the best building block for a compromise plan that could find favor on the Senate floor.
One of the biggest unanswered questions is whether the legislation would slow punishing increases in the nation's health care costs, particularly for the majority who now have coverage through employers. The insurance industry insists it would shift new costs onto those who have coverage.
Congressional Budget Office Director Douglas Elmendorf, under questioning by Republican senators, acknowledged that the bill's total impact on the nation's health care costs is still unknown. The CBO has been able to establish that the legislation would reduce federal government deficits, but Elmendorf said his staff has not had time to evaluate its effects on privately insured people. Government programs pay about half the nation's annual $2.5 trillion health care tab.
Once the Finance Committee has acted, the dealmaking can begin in earnest with Senate Majority Leader Harry Reid, D-Nev., working with White House staff, Baucus and others to blend the Finance bill with a more liberal version passed by the Health, Education, Labor and Pensions Committee.
Baucus' bill includes consumer protections such as limits on copays and deductibles and relies on federal subsidies to help lower-income families purchase coverage. Insurance companies would have to take all comers, and people could shop for insurance within new state marketplaces called exchanges.
Medicaid would be expanded, and though employers wouldn't be required to cover their workers, they'd have to pay a penalty for each employee who sought insurance with government subsidies. The bill is paid for by cuts to Medicare providers and new taxes on insurance companies and others.
Unlike the other health care bills in Congress, Baucus' would not allow the government to sell insurance in competition with private companies, a divisive element sought by liberals.
Last-minute changes made subsidies more generous and softened the penalties for those who don't comply with a proposed new mandate for everyone to buy insurance. 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.
A major question mark for Reid's negotiations is whether he will include some version of a so-called public plan in the merged bill. Across the Capitol, House Democratic leaders are working to finalize their bill, which does contain a public plan, and floor action is expected in both chambers in coming weeks. If passed, the legislation would then go to a conference committee to reconcile differences.
And I had thought Ms. Snowe was a reasonable person.
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?
I hope that at some point the mandate to buy insurance will get stronger. Lack of screening coupled with lack of effective mandate is a recipe for financial disaster. Half-measures will only discredit the concept of insurance mandate.
Quote from: DGuller on October 13, 2009, 02:42:44 PM
I hope that at some point the mandate to buy insurance will get stronger. Lack of screening coupled with lack of effective mandate is a recipe for financial disaster. Half-measures will only discredit the concept of insurance mandate.
That was the article I read yesterday about the PWC study that showed the negative effects of this bill as it doesn't force people to buy insurance but also doesn't allow insurance companies to refuse to cover people with pre-existing conditions.
Quote from: garbon on October 13, 2009, 02:33:47 PM
And I had thought Ms. Snowe was a reasonable person.
I can live with the GOP being a big tent party if the 'moderates' at least follow the fiscal conservatism that supposedly binds us all together. I've not been impressed with her lately.
Quote from: garbon on October 13, 2009, 02:33:47 PM
And I had thought Ms. Snowe was a reasonable person.
RINO. -_-
Agree, since the DINOs are basically extinct. :)
Quote from: Caliga on October 13, 2009, 02:59:26 PM
Agree, since the DINOs are basically extinct. :)
I'm special! :w00t:
Quote from: garbon on October 13, 2009, 02:47:11 PM
That was the article I read yesterday about the PWC study that showed the negative effects of this bill as it doesn't force people to buy insurance but also doesn't allow insurance companies to refuse to cover people with pre-existing conditions.
Yeah, I read about it as well, although to actuaries it's a very obvious conclusion anyway. Of course, the all-knowing politicians immediately brushed such nonsense away. The worst part is that can be self-reinforcing.
If the new system encourages adverse selection and the premiums rise sharply as a result, more people would decide to just take the fine. Then you'll have lots of bitter people unable to afford insurance due to skyrocketing premiums, and having to pay the fine on top of that. Not quite the result we want, I would think.
Quote from: Caliga on October 13, 2009, 02:59:26 PM
Agree, since the DINOs are basically extinct. :)
Yep, they're now called Blue Dogs.
Is there any real reform here or just a bunch of money being put into the pockets of insurers?
QuoteThe 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.
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
Is there any real reform here or just a bunch of money being put into the pockets of insurers?
Some key insurance company lobbyist came out against this yesterday. If you look at what dGuller said, this is a lose situation for insurance companies as most people will end up avoiding health insurance...excepting those who have expensive medical conditions.
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
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.
Its better than nothing, good news.
Quote from: DGuller on October 13, 2009, 03:12:51 PM
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
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.
Quote from: alfred russel on October 13, 2009, 03:10:43 PM
QuoteThe 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.
Quote from: crazy canuck on October 13, 2009, 03:24:13 PM
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.
Quote from: DGuller on October 13, 2009, 03:28:40 PM
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.
Quote from: DGuller on October 13, 2009, 03:25:15 PM
Quote from: alfred russel on October 13, 2009, 03:10:43 PM
QuoteThe 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.
Quote from: crazy canuck on October 13, 2009, 03:45:26 PM
Destroy is probably too strong a word.
How about "become totally non-functional"?
Quote
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.
Quote from: DGuller on October 13, 2009, 04:08:58 PM
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.
Quote from: garbon on October 13, 2009, 02:33:47 PMBtw, 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.
Quote from: Hansmeister on October 13, 2009, 06:38:02 PM
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?
Quote from: crazy canuck on October 13, 2009, 05:14:19 PM
Quote from: DGuller on October 13, 2009, 04:08:58 PM
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).
Quote from: Admiral Yi on October 13, 2009, 08:01:00 PM
Quote from: Hansmeister on October 13, 2009, 06:38:02 PM
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. :contract:
Quote from: alfred russel on October 13, 2009, 08:08:33 PM
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.
Quote from: DGuller on October 13, 2009, 03:12:51 PM
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
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.
Quote from: BuddhaRhubarb on October 13, 2009, 09:47:50 PM
Quote from: DGuller on October 13, 2009, 03:12:51 PM
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
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.
Yes, those fatcats are rolling in the dough with their whopping 3.3% profit margins. :rolleyes:
UnitedHealth Group had a 6.5% margin last year, down from roughly 10% in the prior years.
I didn't check the others, but they should be illustrative.
For the most part, health insurers are acting the way they because that's how the system is set up. You're not going to stay in business if you don't aggressively screen for pre-existing conditions, and things like that. If you're going to have a system set up based on competition and profit-seeking, you're going to see aggressive cost-cutting and profit-seeking actions that are incompatible with the social goals. That said, obviously there is never an excuse for reneging on a contract, whether in letter or in spirit, and insurers that do that as a matter of policy are scum.
Quote from: The Minsky Moment on October 13, 2009, 10:28:44 PM
UnitedHealth Group had a 6.5% margin last year, down from roughly 10% in the prior years.
I didn't check the others, but they should be illustrative.
What would be even more illustrative is a list of industry profitability by sector from last quarter.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fi74.photobucket.com%2Falbums%2Fi263%2FBlackMamba_01%2F1_profits.jpg&hash=bd8d6808cdb21eab1cae7f079220ca116df836b3)
Kinda weird that your first instinct would be to look up the profit margin of a single company.
What would be even more illustrative is having an image that is readable.
Quote from: DGuller on October 13, 2009, 11:04:03 PM
What would be even more illustrative is having an image that is readable.
Get some glasses. Or google for a better image/chart.
Quote from: Hansmeister on October 13, 2009, 11:06:00 PM
Quote from: DGuller on October 13, 2009, 11:04:03 PM
What would be even more illustrative is having an image that is readable.
Get some glasses. Or google for a better image/chart.
I already have glasses. Unfortunately, they don't magically increase the pixel count of the image.
Quote from: crazy canuck on October 13, 2009, 09:42:51 PM
Quote from: alfred russel on October 13, 2009, 08:08:33 PM
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.
Mandating tax payers buy coverage that they can afford is reform that doesn't add to deficits.
Supplying subsidies to get health insurance to those that can't afford it may marginally add to government debt as more people get access to primary care, but won't blow up deficits because those people are already being treated for illnesses in emergency rooms with bills being footed largely by state and local governments.
Quote from: DGuller on October 13, 2009, 11:07:40 PM
I already have glasses. Unfortunately, they don't magically increase the pixel count of the image.
Stop having old people eyes then. I can read his chart.
What is with the republican fetish for using profit margins to evaluate industries (here, or with oil and gas)? Metrics such as return on invested capital are far more relevent. 90% profit margins may not be very attractive if it takes a lot of capital to generate revenue, and 3% margins may be attractive if it doesn't.
So when do we get our death panels?
Or is that another Obama promise he won't deliver on? <_<
Quote from: HisMajestyBOB on October 13, 2009, 11:37:24 PM
So when do we get our death panels?
Or is that another Obama promise he won't deliver on? <_<
Wanna join my death roundtable? Our first topic is Marty.
QuoteHistoric legislation to expand U.S. health care and control costs won its first Republican supporter Tuesday and cleared a key Senate hurdle, a double-barreled triumph that propelled President Barack Obama's signature issue toward votes this fall in both houses of Congress.
Getting one Republican supporter is a triumph? :lol:
Quote from: garbon on October 13, 2009, 11:41:07 PM
QuoteHistoric legislation to expand U.S. health care and control costs won its first Republican supporter Tuesday and cleared a key Senate hurdle, a double-barreled triumph that propelled President Barack Obama's signature issue toward votes this fall in both houses of Congress.
Getting one Republican supporter is a triumph? :lol:
And even she said that she didn't like the bill but wanted to keep the process moving in the (futile) hope of being able to fix it on the floor.
Quote from: alfred russel on October 13, 2009, 11:27:09 PM
because those people are already being treated for illnesses in emergency rooms with bills being footed largely by state and local governments.
:) That's one of my favorite liberal myths these days.
Also, I like that everything is historic now. Such heady days, indeed.
Quote from: alfred russel on October 13, 2009, 11:27:09 PM
won't blow up deficits because those people are already being treated for illnesses in emergency rooms with bills being footed largely by state and local governments.
Sounds like they already have healthcare then. Problem solved. :)
Quote from: Hansmeister on October 13, 2009, 10:16:45 PM
Quote from: BuddhaRhubarb on October 13, 2009, 09:47:50 PM
Quote from: DGuller on October 13, 2009, 03:12:51 PM
Quote from: crazy canuck on October 13, 2009, 03:08:46 PM
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.
Yes, those fatcats are rolling in the dough with their whopping 3.3% profit margins. :rolleyes:
:rolleyes. Yeah they're hurting.
3.3% this year when no one can afford to make premiums. wow go figure. but a company's history means nothing right? it's only value is this quarter and maybe next. sure. gotcha.
Quote from: garbon on October 14, 2009, 12:53:37 AM
Quote from: alfred russel on October 13, 2009, 11:27:09 PM
won't blow up deficits because those people are already being treated for illnesses in emergency rooms with bills being footed largely by state and local governments.
Sounds like they already have healthcare then. Problem solved. :)
Or not, because they don't have access to all parts of the system. Plus people that don't get health insurance through their employer are in a real bind--they have to pay a lot for coverage if they can get it at all.
Quote from: alfred russel on October 14, 2009, 01:30:47 AM
Or not, because they don't have access to all parts of the system.
Everyone can't have access to everything.
Quote
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.
Not so. We have social insurance and a competitive private insurance industry. IMHO what you certainly can't have is private firms providing social insurance. There is a basic incompatibility in the objectives.
Quote from: garbon on October 14, 2009, 01:35:56 AM
Quote from: alfred russel on October 14, 2009, 01:30:47 AM
Or not, because they don't have access to all parts of the system.
Everyone can't have access to everything.
But everyone can have access to a primary care physician.
Quote from: Alatriste on October 14, 2009, 02:32:34 AM
Quote
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.
Not so. We have social insurance and a competitive private insurance industry. IMHO what you certainly can't have is private firms providing social insurance. There is a basic incompatibility in the objectives.
Obviously our private health insurance companies are either devilishly cunning or have made a pact with Satan, because it is very well known that public health systems annihilate every other possible actor in the health sector. [/sarcasm]
So this plan went as written for the Congressional Budget Office to do the math. Came out with some savings. But that's with cutting lots of waste from Medicare, which has never been done and won't happen now. The bill may just cut Medicare funds which will exacerbate that program, which is already broke, and only pays a portion of costs to doctors. As a result many docs don't take Medicare patients, and/or pass costs on to other patients where they can. If the govt could actually fix/reform Medicare that would actually, maybe, save money. But the last time reform was tried, or any time, the other political party cries foul! I think the Repubs tried last time and got slammed by the Dems for tossing old people out on the street. And I think that was just to slow the rise in costs, not to actually cut anything. Now we're being made to believe that some kind of real reform is going to happen, out of this mass of a mess of a bill, and that will cover some of the costs of the new bill? That's a sham and we all know it.
The new bill will cost at least double what the projection is, as usual with these bills.
The CBO did an analysis on what they were given but it's not what is going to be the case in reality.
What about changes in Pharmaceutical costs? Nothing said about that. In fact, it appears that the drug companies have been given a pass and so have pretty much been quiet about these reform attempts.
Nothing to address tort reform, which is outrageous. Doctors pay huge insurance amounts which adds to costs.
Then in any event, this current bill will be so changed, added to, taken from and taken apart, that we'll wind up with a mess trying to please everyone, if we do get a final bill passed. In fact, I feel that a thousand page bill will have enough vagueness and flexibility in it to allow for all sorts of new committees, spending, laws, and more to be made up as we go on.
I've been supportive of reform of health care but the direction this has all been going is too much, too expensive, and too messy. Most of all it still doesn't seem to curb costs, which is one of the biggest factors after insuring those who have no insurance. As for covering those without insurance, the proposed bill apparently only covers some of those? I also wonder what's going to be added on to buy the votes of reluctant legislators.
Quote from: Alatriste on October 14, 2009, 02:32:34 AM
Quote
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.
Not so. We have social insurance and a competitive private insurance industry. IMHO what you certainly can't have is private firms providing social insurance. There is a basic incompatibility in the objectives.
That's what I meant, you can't have private insurance industry in a social insurance business. Obviously I didn't mean that private car insurance should go as well.
Quote from: alfred russel on October 14, 2009, 04:43:18 AM
But everyone can have access to a primary care physician.
Clearly not.
Quote from: The Larch on October 14, 2009, 05:34:57 AM
because it is very well known that public health systems annihilate every other possible actor in the health sector.
It would certainly happen here, for the most part. There might still be some luxury-type insurance companies that survive, of course, but most of us would end up on de gubmint plan. If a government-run plan can (and undoubtedly will) operate at a loss indefinitely *and* has the power to set all the rules, what other outcome could there be?
Quote from: derspiess on October 14, 2009, 11:49:55 AM
Quote from: The Larch on October 14, 2009, 05:34:57 AM
because it is very well known that public health systems annihilate every other possible actor in the health sector.
It would certainly happen here, for the most part. There might still be some luxury-type insurance companies that survive, of course, but most of us would end up on de gubmint plan. If a government-run plan can (and undoubtedly will) operate at a loss indefinitely *and* has the power to set all the rules, what other outcome could there be?
Why? In Canada we have Gov. healthcare (which I pay the exact same rate as anyone else in my province (I have to pay or pay US prices for shit) making far more than me. I could have all the Private Insurance I wanted to. (I don't because I'm poor) Big Insurance does just fine not competing with gov. healthcare but complimenting it in Canada. But I gues that could never work in the US because...?
Quote from: BuddhaRhubarb on October 14, 2009, 12:40:31 PM
Why? In Canada we have Gov. healthcare (which I pay the exact same rate as anyone else in my province (I have to pay or pay US prices for shit) making far more than me. I could have all the Private Insurance I wanted to. (I don't because I'm poor) Big Insurance does just fine not competing with gov. healthcare but complimenting it in Canada. But I gues that could never work in the US because...?
You both are saying the same thing. Niche market private health insurance.
Quick poll: do you say "neesh" or "nitch?"
Just learned that the Senate Finance version does *not* include an employer mandate, which is pretty huge.
Quote from: alfred russel on October 13, 2009, 11:27:09 PM
Quote from: crazy canuck on October 13, 2009, 09:42:51 PM
Quote from: alfred russel on October 13, 2009, 08:08:33 PM
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.
Mandating tax payers buy coverage that they can afford is reform that doesn't add to deficits.
Supplying subsidies to get health insurance to those that can't afford it may marginally add to government debt as more people get access to primary care, but won't blow up deficits because those people are already being treated for illnesses in emergency rooms with bills being footed largely by state and local governments.
In the short run you might be right, although given the cost of this program you may have some rose coloured glasses on. But assuming you are right in the short term, what happens when the insurance companies start racheting up rates to keep their profit margins? Is the government going to sit back and let even more people become uninsured because they cant afford the higher premiums or is the government going to start paying even more toward the bottom line of the insurance companies?
Quote from: garbon on October 14, 2009, 12:52:29 AM
Also, I like that everything is historic now. Such heady days, indeed.
:lol:
I had the same reaction when I read the rationale for switching her vote.
Quote from: Admiral Yi on October 14, 2009, 12:46:12 PM
Quote from: BuddhaRhubarb on October 14, 2009, 12:40:31 PM
Why? In Canada we have Gov. healthcare (which I pay the exact same rate as anyone else in my province (I have to pay or pay US prices for shit) making far more than me. I could have all the Private Insurance I wanted to. (I don't because I'm poor) Big Insurance does just fine not competing with gov. healthcare but complimenting it in Canada. But I gues that could never work in the US because...?
You both are saying the same thing. Niche market private health insurance.
Quick poll: do you say "neesh" or "nitch?"
Nitch.
Other: nish.
Quote from: crazy canuck on October 14, 2009, 01:55:57 PM
In the short run you might be right, although given the cost of this program you may have some rose coloured glasses on. But assuming you are right in the short term, what happens when the insurance companies start racheting up rates to keep their profit margins? Is the government going to sit back and let even more people become uninsured because they cant afford the higher premiums or is the government going to start paying even more toward the bottom line of the insurance companies?
There is the problem of soaring health care costs--that isn't solved by the types of reform we are discussing and is a big problem--but it is also a problem somewhat independent of insurance companies.
I think there are two reasons that what you are worried about won't happen:
a) insurance companies are regulated, so they can't set prices as they please even if they could get away with it competitively, and
b) insurance regulations are state matters in the US, which as you can imagine makes it incredibly byzantine. Each state not only has its own regulators, but also its own reporting requirements, reserve requirements, asset requirements, and often their own twists on accounting standards (and often the same state will have different twists for accounting rules depending on the type of insurance). This is a significant barrier to entry, and many insurance companies are not in all states reducing competition and logically increasing premiums. The proposed bill apparently takes a step toward reducing this situation.
Quote from: Hansmeister on October 13, 2009, 11:03:10 PM
What would be even more illustrative is a list of industry profitability by sector from last quarter.
Kinda weird that your first instinct would be to look up the profit margin of a single company.
My first instinct is to look at facts that can easily be verified, instead of a chart with no citation or explanation of what it is measuring and how it is measured.
My second instinct would be to look for something reporting multi-year or at least one years data rather than a single quarter.
Quote from: The Minsky Moment on October 14, 2009, 05:48:48 PM
Quote from: Hansmeister on October 13, 2009, 11:03:10 PM
What would be even more illustrative is a list of industry profitability by sector from last quarter.
Kinda weird that your first instinct would be to look up the profit margin of a single company.
My first instinct is to look at facts that can easily be verified, instead of a chart with no citation or explanation of what it is measuring and how it is measured.
My second instinct would be to look for something reporting multi-year or at least one years data rather than a single quarter.
Your instincts would make you a poor Republican.
The Obama admin is going after the insurance companies with threats of legislation because they had the temerity to put out their own studies that disagreed with the govt estimates on the health care bills. Is this Chicago politics at its worst? That is actually kind of scary power to be wielding by the admin? Punitive legislation, if it comes to that, or at least threats of it. Seems no one can criticize this admin without becoming a public enemy. What a bunch of whiners this admin is. Apparently, even The Nation, a very left magazine, has been critical of Obama's handlers for allowing him to become a whiner in chief.
Quote from: Admiral Yi on October 14, 2009, 12:46:12 PM
Quote from: BuddhaRhubarb on October 14, 2009, 12:40:31 PM
Why? In Canada we have Gov. healthcare (which I pay the exact same rate as anyone else in my province (I have to pay or pay US prices for shit) making far more than me. I could have all the Private Insurance I wanted to. (I don't because I'm poor) Big Insurance does just fine not competing with gov. healthcare but complimenting it in Canada. But I gues that could never work in the US because...?
You both are saying the same thing. Niche market private health insurance.
Quick poll: do you say "neesh" or "nitch?"
Neesh. most Canadians I believe say neesh, or the other mentioned "nish". :frog: influence.
Quote from: KRonn on October 14, 2009, 08:51:48 PM
The Obama admin is going after the insurance companies with threats of legislation because they had the temerity to put out their own studies that disagreed with the govt estimates on the health care bills. Is this Chicago politics at its worst? That is actually kind of scary power to be wielding by the admin? Punitive legislation, if it comes to that, or at least threats of it. Seems no one can criticize this admin without becoming a public enemy. What a bunch of whiners this admin is. Apparently, even The Nation, a very left magazine, has been critical of Obama's handlers for allowing him to become a whiner in chief.
Link?
Quote from: jimmy olsen on October 14, 2009, 10:01:50 PM
Quote from: KRonn on October 14, 2009, 08:51:48 PM
The Obama admin is going after the insurance companies with threats of legislation because they had the temerity to put out their own studies that disagreed with the govt estimates on the health care bills. Is this Chicago politics at its worst? That is actually kind of scary power to be wielding by the admin? Punitive legislation, if it comes to that, or at least threats of it. Seems no one can criticize this admin without becoming a public enemy. What a bunch of whiners this admin is. Apparently, even The Nation, a very left magazine, has been critical of Obama's handlers for allowing him to become a whiner in chief.
Link?
http://www.nydailynews.com/blogs/dc/2009/10/senate-takes-aim-at-insurance.html (http://www.nydailynews.com/blogs/dc/2009/10/senate-takes-aim-at-insurance.html)
QuoteSenate Takes Aim At Insurance 'Monopoly'
By Michael McAuliff
Democrats declared war on the health insurance industry this morning, opening hearings on a bill that would strip its anti-trust exemption.
"It's something that should have been done a long time ago," said Majority Leader Harry Reid, who argued that insurance companies have gotten so large, "they dominate entire regions of the country."
"They make more money than any business in America today," he said. "What a sweet deal they have."
The entire insurance industry got the exemption in 1945's McCarran-Ferguson Act on the grounds that it was not engaged in interstate commerce, and, federal anti-trust probes would interfere with state rules.
Unlike other industries, insurance companies are allowed to discuss pricing, territories and other practices that would be considered collusion if not for the exemption.
The hearing comes just three days after a health insurance industry trade group warned its members would raise rates even higher than the 6% a year they are expected to go up already if the Senate Finance committee bill passed yesterday becomes law.
Many lawmakers and the White House saw that as a threat.
Although today's hearing had been scheduled before, lawmakers used it as a chance to fire back, arguing that ending the exemption would immediately open up competition, and curb rate-setting collusion.
New York Sen. Chuck Schumer cited Justice Department statistics that found 94% of the nation's insurance markets are "highly concentrated" and that in nearly 40 states, two firms control over half the market.
"That's not acceptable," Schumer said, adding that the anti-trust bill should be added to health care legislation. "We need more competition."
A representative of the insurance industry argued competitors need to be able to share data because they are pricing things that have not happened, and it's extremely difficult to predict costs and losses.
The senators were skeptical, however, and pointed to testimony by Assistant Attorney General Christine Varney, who argued insurers could still share such "pro-competitive" data.
She suggested strongly the Obama administration favors yanking the anti-trust exemption.
"Repealing the McCarran-Ferguson Act would allow competition to have a greater role in reforming health and medical malpractice insurance markets than would otherwise be the case," she said.
The insurance industry is taking none of this lying down, and today is firing back with a tough ad in several swing states, charging that the bill passed by the Senate Finance Committee yesterday will hurt seniors.
"Most people agree we need to reform health care, but is it right to ask 10 million seniors on Medicare Advantage for more than their fair share?" the spot says. "Congress has proposed more than $100 billion in cuts to Medicare Advantage."
It advises people to call their senators and complain.
One witness in the hearing, Robert Hunter, the Consumer Federation of America's insurance director, noted that since the industry can collude on prices, it could simply pass along the cost of that ad to consumers.
http://www.mainjustice.com/2009/10/14/antitrust-division-wades-into-health-care-battle/ (http://www.mainjustice.com/2009/10/14/antitrust-division-wades-into-health-care-battle/)
QuoteAntitrust Division Wades Into Health Care Battle
Posted By Steve Bagley On October 14, 2009
Democrats have opened a new front on the health care reform battle: antitrust exemptions for insurance companies.
The Senate Judiciary Committee on Wednesday held a hearing on a measure to repeal the 1946 McCarran-Ferguson Act, which put regulation of the health insurance industry in the hands of individual states.
Democrats complain that lax oversight has allowed the insurers to concentrate their market power. They argue that more competition in the health-insurance market would lower prices for consumers.
Now, the Department of Justice has thrown its support behind a bill sponsored by the Sen. Patrick Leahy (D-Vt.) to repeal the 1945 antitrust exemptions.
Assistant Attorney General for the Antitrust Division Christine Varney at the hearing called the McCarran-Ferguson act a product of a different age in American business. The 1945 legislation reversed a 1944 Supreme Court decision that said health insurance should be regulated on the federal level.
McCarran-Ferguson created a broad antitrust exemption for insurance companies regulated by state law, rendering them immune from challenge as long as they're not engaged in an activity deemed "boycott, coercion, or intimidation," Varney said.
The justifications that led to McCarran-Ferguson's passage "are no longer valid today," she said. "It's no longer necessary."
She added: "The antitrust laws reflect our society's belief that competition enhances consumer welfare and promotes our economic and political freedoms," Varney said.
"Nobody's above the law," Leahy said. "I don't know anyone who can say with a straight face that they shouldn't be subject to the same antitrust laws."
Sen. Orrin Hatch (R-Utah) argued against making insurance agencies subject to antitrust laws, saying he saw "little evidence to justify a complete repeal."
Democrats, by contrast, saw much evidence to repeal McCarran-Ferguson.
Sen. Dick Durbin (D-Ill.) said, Monday's threats by insurance companies that if health reform passed, insurance rates would go up, was evidence that health insurance companies could do just that. "When insurance agencies said on Monday night 'we're raising rates, they're going up," Durbin said, "they could get together, and fix prices; they wouldn't be able to do that if they were subject to prosecution, would they?"
"They would not," Varney responded.
"The health insurance agencies have thrown down the gauntlet," Durbin replied.
Democrats say the the health insurance markets are generally dominated by one or two providers, sometimes with a single insurance provider controlling up to 90 percent of the market. With these kinds of monopolies or duopolies, the Democrats said, the insurance companies have been free to charge whatever they could.
Sen. Dianne Feinstein (D-Calif.) said: "Healthcare and medical insurance should be nonprofits." She said insurers' profits rose 428 percent from 2000 to 2007, while "premiums have escalated dramatically."She called Leahy's bill "one small step to a very loud signal" to the insurance companies.
Sens. Sheldon Whitehouse (D-R.I.) and Al Franken (D-Minn.) painted a picture of the kind of market domination insurance agencies have. Whitehouse noted that in 39 states, two health insurers cover 50 percent of the market, and in nine states, only one company covers 75 percent of the market.
In Maine, Franken noted, an insurance company took the unprecedented move of suing a state to guarantee they make enough money. Anthem Blue Cross/Blue Shield sued the state, in what Franken called a "brazen" move, to guarantee a 3 percent profit margin that would raise insurance costs on subscribers 18.5 percent.
Hatch was not the only one to argue for keeping McCarran-Ferguson in place. Panelist Lawrence Powell, who represented the Physician Insurers of Association of America, said repealing the law would make little difference, leading to at best, the "status quo."
"Market concentration is not always indicative of competition," Powell said. "Another company controls 10 percent."
I can't wait until they fuck up my healthcare!
Wait, wait, wait. Repealing the antitrust exemption makes sense; why didn't they start with this in the first place? Not enough glitz, glamor, and HOPE?
Ugh, Robert Hunter. There is a name I could go without seeing. The guy should really have his actuarial designation stripped for professional malpractice.
Quote from: DontSayBanana on October 15, 2009, 06:53:37 AM
Wait, wait, wait. Repealing the antitrust exemption makes sense; why didn't they start with this in the first place? Not enough glitz, glamor, and HOPE?
It makes sense if you don't know much about the business of insurance. With some knowledge it becomes far less clear on what should be done about it.
Quote from: DontSayBanana on October 15, 2009, 06:53:37 AM
Wait, wait, wait. Repealing the antitrust exemption makes sense; why didn't they start with this in the first place? Not enough glitz, glamor, and HOPE?
It would seem to have made sense, actually. Probably didn't want to go there before since the insurance companies, big lobbies and all, would have been more troublesome in the health care debate. But it now appears more like it's being used as punitive and retribution instead, even though that may not be the case. But coincidental? That seems a bit dubious now. The insurance companies are easy to vilify anyway, rightly or wrongly.
Interesting. No surprise really and to be expected, as those who stand to make/lose out or new players in the new scheme of things jockey for position and influence.
Quote[size]
http://www.cnn.com/2009/POLITICS/10/15/health.care.lobbying/index.html
Millions spent to sway health care opinions
CNN) -- The amount of money lobbyists are spending on health care reform could break records, and now that the five bills before Congress have cleared committee, that spending is expected to go into overdrive.
Lobbyists are hitting the Capitol to schmooze lawmakers.
Lobbyists are hitting the Capitol to schmooze lawmakers.
"It is sort of a Super Bowl of lobbying for health care reform. The lobbyists are winning so far. But the game's not over yet," said Rep. Jim Cooper, D-Tennessee.
As lawmakers work to come up with a plan that can make it to President Obama's desk, industries and interests close to the issue are digging deeper into their pockets to sway public opinion and those in office.
The insurance industry launched its first air attack with an ad aimed at seniors.
"Most people agree we need to reform health care, but is it right to ask 10 million seniors on Medicare Advantage for more than their fair share? Congress is proposing more than $100 billion in cuts to Medicare Advantage," the ad says, referring to the private insurance plan Medicare offers to some recipients.
The industry's trade group America's Health Insurance Plans put out the ad. Video Watch more on the big bucks spent on health care lobbying »
In addition to the battle with the insurance industry, liberal reform supporters and armies of special interest groups are entering the fray.
And there's also a ground offensive: Lobbyists hitting the Capitol to schmooze lawmakers. Members of Congress feel they're getting slimed.
"I rise just days before Halloween to unmask the insurance industry," said Rep. Donna Edwards, D-Maryland. "Now, we see the industry and their lobbyists for what they are, a little shop of horrors."
Don't Miss
* Pushback grows against insurance industry report
The health care sector has spent $263 million this year lobbying Congress for changes to reform plans, a government watchdog group estimates.
"This is one of the biggest lobbying pushes that we've seen on a single issue in U.S. history," said Dave Levinthal, communications director for the nonpartisan Center for Responsive Politics.
There are more than 3,000 people registered to lobby about health care, almost six lobbyists for every member of Congress.
Many of the lobbyists are former members of Congress and staffers from both sides of the aisle.
"It's like a sports team. If you want to put together a good team, then you're going to have to hire some pretty big-dollar players," Levinthal said.
Cooper, who opposed President Clinton's health care plan in the 1990s, says President Obama put himself in a tough position when he invited the health care sector to help craft reform.
"There are a number of groups that are threatening to revolt on the White House deals and Congressional deals," Cooper said.
Earlier this week, AHIP released a controversial study it commissioned claiming the Senate Finance Committee bill would result in premium increases of up to $4,000 for a family. However, the study conducted by the consulting firm PricewaterhouseCoopers did not take into account some of the proposed subsidies that would be offered to low-income families to help them pay for insurance, and the firm has said such provisions would offset some of the impact it estimated.
Republican leaders in Congress are quoting the study, predicting higher premiums for consumers. But Congressional Democrats and the White House say the analysis is flawed.
Finance Committee spokesman Scott Mulhauser called the analysis "a health insurance company hatchet job -- plain and simple."
Some top Democrats including Senate Majority Leader Harry Reid are swinging back at the insurance industry. Reid testified before the Senate Judiciary Committee, asking them to repeal an antitrust law that has given certain protections to the insurance industry and lets them reap in huge profits.
Reid's office says the law allows insurance companies to huddle in a room and come up with rates. They say that other than Major League Baseball, no other industry has this exemption.
If lawmakers were to repeal this law, the McCarran-Ferguson Act, it could cut into the health insurance industry's profits.
Reid's office says the timing of the attempts to appeal the law -- shortly after the health care industry's report -- is just a coincidence.
advertisement
The industry, however, says the McCarran Ferguson law has nothing to do with competition in the market.
"The focus on this issue is a political ploy designed to distract attention away from the real issue of rising health care costs," the industry said in a statement.
Watching or reading CNN's take on insurance industry makes my brain go dead.
Quote from: DGuller on October 15, 2009, 10:33:21 AM
Watching or reading CNN's take on insurance industry makes my brain go dead.
:yes: :bleeding:
Just to provide a counter-point to the "repealing McCarran Ferguson obviously makes sense" arguments, let me describe what it is. It is a limited exemption from anti-trust laws that allows insurers to co-operate when it is necessary for the well-being of the insurance market. One example of when that is needed is sharing the data. Most insurers do not have enough data on their own to calculate required premium with any sort of precision. Pooling the data makes it easier, but obviously it can be seen as collusion, since a lot of companies determine their premiums from the same data.
What McCarran Ferguson doesn't allow is price fixing or collusion. When you hear some Senator spouting off that insurance is expensive because insurers are legally allowed to collude, and you'll hear that A LOT, you should know that he has no idea what he's talking about. Obviously some kind of price agreement can form implicitly due to data and model sharing, but that's a far cry from accusing the industry of having formed a cartel. The fact that these accusations fly unchallenged is a sad indictment on both the politicians, and the media that repeats falsehoods uncritically.
The problem is that laws like that, even if they do not intend to create that situation (price collusion) often provide cover for it anyway. If you let them, they will certainly collude, since it is in their interests to do so - and the law seems to give them the cover they need for that.
Quote from: Berkut on October 15, 2009, 12:04:34 PM
The problem is that laws like that, even if they do not intend to create that situation (price collusion) often provide cover for it anyway. If you let them, they will certainly collude, since it is in their interests to do so - and the law seems to give them the cover they need for that.
Insurers are still subject to federal anti-trust laws when it comes to price fixing and collusion, which is why the exemption is called limited.
Quote from: DGuller on October 15, 2009, 12:06:41 PM
Quote from: Berkut on October 15, 2009, 12:04:34 PM
The problem is that laws like that, even if they do not intend to create that situation (price collusion) often provide cover for it anyway. If you let them, they will certainly collude, since it is in their interests to do so - and the law seems to give them the cover they need for that.
Insurers are still subject to federal anti-trust laws when it comes to price fixing and collusion, which is why the exemption is called limited.
Of course - but are those law enforced? Are they enforceable, given that the insurers can just claim that their prices are not "fixed", they just happen to look that way because of the exemption that allows data sharing?
There is certainly *something* going on, with insurance companies posting incredible profits while expanding at an incredible rate. I don't know if it is price fixing and collusion, but it would not at all surprise me if that was the case.
Quote from: Berkut on October 15, 2009, 12:11:08 PM
Of course - but are those law enforced? Are they enforceable, given that the insurers can just claim that their prices are not "fixed", they just happen to look that way because of the exemption that allows data sharing?
There is certainly *something* going on, with insurance companies posting incredible profits while expanding at an incredible rate. I don't know if it is price fixing and collusion, but it would not at all surprise me if that was the case.
Are they posting incredible profits?
Quote from: Berkut on October 15, 2009, 12:11:08 PM
Of course - but are those law enforced? Are they enforceable, given that the insurers can just claim that their prices are not "fixed", they just happen to look that way because of the exemption that allows data sharing?
There is certainly *something* going on, with insurance companies posting incredible profits while expanding at an incredible rate. I don't know if it is price fixing and collusion, but it would not at all surprise me if that was the case.
I wouldn't assume that "something" is going on, nor would I just take at face value the statement of politicians that insurers are posting incredible profits. Historically, insurers have produced lousy returns on capital. The industry's financial performance did improve in the recent years, but attributing it to a 65 year old exemption is a stretch.
As for enforcing the anti-trust law, I don't know, I'm not a lawyer. Obvioulsy data sharing makes it easier to get away with price fixing if you set out to do it. However, that would still be illegal, despite what some senators think.
Quote from: Admiral Yi on October 15, 2009, 12:38:10 PM
Quote from: Berkut on October 15, 2009, 12:11:08 PM
Of course - but are those law enforced? Are they enforceable, given that the insurers can just claim that their prices are not "fixed", they just happen to look that way because of the exemption that allows data sharing?
There is certainly *something* going on, with insurance companies posting incredible profits while expanding at an incredible rate. I don't know if it is price fixing and collusion, but it would not at all surprise me if that was the case.
Are they posting incredible profits?
I thought they were, but admit that was based on just what I have heard from talking heads. I imagine the real answer depends on who you ask.
The problem with M-F is that is balkanizes supervision and makes the quality of regulation ultimately depend on the least competent, honest and dilligent of the 50 state insurance departments.
Quote from: The Minsky Moment on October 15, 2009, 12:47:29 PM
The problem with M-F is that is balkanizes supervision and makes the quality of regulation ultimately depend on the least competent, honest and dilligent of the 50 state insurance departments.
Does it really do that? The problem with state regulation is that passing the mustard with North Dakota regulators will not make it any easier for you to enter New Jersey market, for example. It's a huge problem in itself, as you have to deal with 50 regulators instead of one, but at least it prevents the race to the bottom that you mention.
Quote from: The Minsky Moment on October 15, 2009, 12:47:29 PM
The problem with M-F is that is balkanizes supervision and makes the quality of regulation ultimately depend on the least competent, honest and dilligent of the 50 state insurance departments.
Can you explain--the applicable insurance regulator is going to be where the business is done, so there can't be a race to the bottom (except for niche markets like captives--where there definitely is a race to the bottom).
Quote from: Berkut on October 15, 2009, 12:04:34 PM
The problem is that laws like that, even if they do not intend to create that situation (price collusion) often provide cover for it anyway. If you let them, they will certainly collude, since it is in their interests to do so - and the law seems to give them the cover they need for that.
An insurance company without loss information can not write insurance. If you don't have much loss information, you are not going to be able to write competitive policies due to your inability to narrow the reasonable range of future losses. Loss information doesn't grow on trees: it is generated by insurance companies. In 1945 it made sense to allow for the sharing of information because small insurers wouldn't be able to generate much loss data on their own--but collectively they could do so.
Today there aren't as many small insurers, though there are still some. Even big insurers are small in certain lines of business and in certain markets. Maybe it makes sense to revisit this as a part of insurance reform (which is definitely needed). But this seems to be a temper tantrum move by people who have been fired up by the health care rhetoric and want to lash out at insurance companies--not a thoughtful step toward reform.
Nancy Pelosi on insurance companies:
It's almost immoral what they are doing. Of course they've been immoral all along in how they have treated the people that they insure. They are the villains. They have been part of the problem in a major way.
Quote from: alfred russel on October 15, 2009, 01:40:24 PM
It's almost immoral what they are doing. Of course they've been immoral all along in how they have treated the people that they insure. They are the villains. They have been part of the problem in a major way.
Hardly shocking considering the district she represents.
Quote from: Caliga on October 15, 2009, 01:42:07 PM
Quote from: alfred russel on October 15, 2009, 01:40:24 PM
It's almost immoral what they are doing. Of course they've been immoral all along in how they have treated the people that they insure. They are the villains. They have been part of the problem in a major way.
Hardly shocking considering the district she represents.
She is the speaker of the house and supposedly overseeing insurance reform.
Quote from: alfred russel on October 15, 2009, 01:46:23 PM
She is the speaker of the house and supposedly overseeing insurance reform.
She may be the speaker of the house, but that doesn't change the fact that she represents, and is voted in or out, by a whacko liberal district in San Francisco. :)
You know, for all the outrage over the death panel stuff, I have not heard any Dems bitching about whathisface from Georgia claiming that Republicans want everyone to die as quickly as possible when they get sick.
Quote from: Berkut on October 15, 2009, 02:03:00 PM
I have not heard any Dems bitching about whathisface from Georgia claiming that Republicans want everyone to die as quickly as possible when they get sick.
Alan Grayson is from Florida.
Quote from: DGuller on October 15, 2009, 12:53:09 PM
The problem with state regulation is that passing the mustard with North Dakota regulators will not make it any easier for you to enter New Jersey market, for example. It's a huge problem in itself, as you have to deal with 50 regulators instead of one, but at least it prevents the race to the bottom that you mention.
That will be of little solace to the citizens of North Dakota though.
Quote from: The Minsky Moment on October 15, 2009, 02:41:14 PM
Quote from: DGuller on October 15, 2009, 12:53:09 PM
The problem with state regulation is that passing the mustard with North Dakota regulators will not make it any easier for you to enter New Jersey market, for example. It's a huge problem in itself, as you have to deal with 50 regulators instead of one, but at least it prevents the race to the bottom that you mention.
That will be of little solace to the citizens of North Dakota though.
Yes, idiot regulators will screw the residents of the state they're regulating. However, that's not the point you were making.
You were implying that insurers could shop around among 50 regulators, and pick the one most pliable to regulate you in the whole of US, which is very much untrue. Yes, you can pick the least stringent of the 50 regulators if you're an insurance company, as long as you want to write insurance only in their state.
Quote from: DGuller on October 15, 2009, 02:57:09 PM
You were implying that insurers could shop around among 50 regulators, and pick the one most pliable to regulate you in the whole of US, which is very much untrue. Yes, you can pick the least stringent of the 50 regulators if you're an insurance company, as long as you want to write insurance only in their state.
I am implying that under M-F some states will become regulatory dumping grounds. that may not directly impact people living in other states, as long as they don't move, but it is still not a good outcome.
Quote from: The Minsky Moment on October 15, 2009, 03:12:26 PM
I am implying that under M-F some states will become regulatory dumping grounds. that may not directly impact people living in other states, as long as they don't move, but it is still not a good outcome.
What is a regulatory dumping ground?
Quote from: Caliga on October 15, 2009, 01:51:48 PM
She may be the speaker of the house, but that doesn't change the fact that she represents, and is voted in or out, by a whacko liberal district in San Francisco. :)
Her district covers most of SF. :(
Quote from: alfred russel on October 15, 2009, 01:40:24 PM
Nancy Pelosi on insurance companies:
It's almost immoral what they are doing. Of course they've been immoral all along in how they have treated the people that they insure. They are the villains. They have been part of the problem in a major way.
I heard a commercial (for some debt consolidation or something company) on the radio today that home mortgages should be illegal because they force you to pay so much more when you add in interest than if you had bought the house outright on day 1. :bleeding:
Quote from: garbon on October 15, 2009, 04:09:04 PM
Quote from: alfred russel on October 15, 2009, 01:40:24 PM
Nancy Pelosi on insurance companies:
It's almost immoral what they are doing. Of course they've been immoral all along in how they have treated the people that they insure. They are the villains. They have been part of the problem in a major way.
I heard a commercial (for some debt consolidation or something company) on the radio today that home mortgages should be illegal because they force you to pay so much more when you add in interest than if you had bought the house outright on day 1. :bleeding:
I hear similar ones saying that debtors shouldn't have to pay back what the greedy credit card companies made them spend.
I liked the debt relief program that you can only enter if you have over $10,000 in credit card debt. <_<
Quote from: DGuller on October 15, 2009, 12:53:09 PM
...passing the mustard
FYI: I think the phrase is passing muster. ;)
Quote from: DGuller on October 15, 2009, 03:14:08 PM
What is a regulatory dumping ground?
States where due to lack of resources or agency capture, the regulator provides limited meaningful supervision.
Quote from: garbon on October 15, 2009, 04:18:11 PM
I liked the debt relief program that you can only enter if you have over $10,000 in credit card debt. <_<
I listen to satellite radio all the time, and every third commercial (on the talk channels that have commercials) is for some kind of debt consolidation. I wonder what the scam or gimmick is on those kinds of companies... :unsure:
Quote from: The Minsky Moment on October 15, 2009, 06:07:49 PM
States where due to lack of resources or agency capture, the regulator provides limited meaningful supervision.
Ok. In my experience, however, it's the regulators with resources that are the biggest danger. Florida's regulators can't be said to lack resources, and with the help of Florida's politicians they've managed to wreak greater havoc on the homeowners insurance market than even hurricane Andrew.
Quote from: MadImmortalMan on October 15, 2009, 06:11:27 PM
Quote from: citizen k on October 15, 2009, 06:01:47 PM
Quote from: DGuller on October 15, 2009, 12:53:09 PM
...passing the mustard
FYI: I think the phrase is passing muster. ;)
The guy's not a native speaker. :P
Screw you all. ^_^ For all intensive purposes, you knew what I was talking about.
Quote from: Barrister on October 15, 2009, 06:11:20 PM
I listen to satellite radio all the time, and every third commercial (on the talk channels that have commercials) is for some kind of debt consolidation. I wonder what the scam or gimmick is on those kinds of companies... :unsure:
Massive upfront fees. Like the kind where they want people with $10K debt so that the $2K fee seems like a drop in the bucket.
:lol:
Just saw an article in the NYT on the latest development in reform plans:
Pelosi Retreats on Having US Set Rates for a Public Option
The key quote for me:
QuoteThe new House bill would also impose annual fees on manufacturers of medical devices like heart pacemakers and artificial hips. The fees — in effect, excise taxes — would total $20 billion over 10 years.
House Democrats borrowed this idea from the Senate. Under a bill approved this month by the Senate Finance Committee, the government would try to collect $40 billion in fees over 10 years from makers of medical devices.
Won't these costs eventually be passed onto consumers? So the solution to the problem of high cost of health care is to... make consumers pay more? Unless I'm missing something here, this seems backwards.
The whole article:
Quote
Pelosi Backs Off Having Set Rates for Public Option
By ROBERT PEAR
WASHINGTON — Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government, aides said Wednesday.
Ms. Pelosi said the public plan, which she prefers to call a "consumer option," would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the "robust" liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.
Members of the House Democratic leadership team offered these details of their bill, to be unveiled on Thursday. It would provide coverage to 35 million or 36 million people. The 10-year cost of expanding coverage would be less than the $900 billion ceiling suggested by President Obama. The cost would be offset by new taxes and by cutbacks in Medicare, so the bill would not increase the federal budget deficit in the next 10 years or in the decade after that.
The new bill, like an earlier version, retains a surtax on high-income people, but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500,000 — just three-tenths of 1 percent of all households, Democrats said.
Ms. Pelosi can describe the proposal as a "millionaires' tax." The original thresholds were $280,000 for individuals and $350,000 for couples.
The government insurance plan would negotiate rates with doctors and hospitals, as private insurers do. Payments would not be based on Medicare rates, as Ms. Pelosi had wanted. Democrats from rural areas balked at the use of Medicare rates, saying they were so low that hospitals could not survive on them.
House Democratic leaders will hold a rally at the Capitol on Thursday to promote the legislation. They hope to take it to the House floor next week, with a final vote before Veterans Day, Nov. 11.
Scores of lobbyists were "cordially invited" to attend the rally in e-mail messages sent Wednesday by Ms. Pelosi. The Senate majority leader, Harry Reid, Democrat of Nevada, announced Monday that he too had decided to include a government plan, with negotiated rates, in the bill he intends to take to the Senate floor for weeks of debate.
House Democrats do not have firm commitments from enough lawmakers to guarantee passage of their bill at the moment. But their aggressive schedule suggests they are confident they can round up the votes they need.
Speaker Pelosi evidently fell well short of the votes needed for the "robust" public option.
A whip count, prepared Tuesday, shows that 47 House Democrats opposed that approach while 8 more were "leaning no." That suggests that Ms. Pelosi had lined up, at most, 201 votes of the 218 she would probably need. Ms. Pelosi's difficulties in securing votes for the most liberal version of a government insurance plan were illustrated by four members of her caucus.
Representative Ike Skelton, Democrat of Missouri, who faces a serious re-election challenge next year, said: "Health insurance reform must not include a public option. While access to health insurance ought to be expanded to reduce costs for everyone, the public option could have the unintended consequence of forcing private health insurance providers out of business."
Another moderate Democrat, Representative Jim Matheson of Utah, said there were better ways to foster competition. He prefers nonprofit member-run cooperatives, rather than a government plan.
Representatives Kathy Dahlkemper, of western Pennsylvania, and Steve Kagen, from the Green Bay area of Wisconsin, support a public option, but believe the government plan should negotiate rates with health care providers. Aides to the two Democratic lawmakers said Medicare rates in their districts were inadequate.
The new House bill would also impose annual fees on manufacturers of medical devices like heart pacemakers and artificial hips. The fees — in effect, excise taxes — would total $20 billion over 10 years.
House Democrats borrowed this idea from the Senate. Under a bill approved this month by the Senate Finance Committee, the government would try to collect $40 billion in fees over 10 years from makers of medical devices.
The new House bill would expand Medicaid to cover childless adults, parents and others with incomes less than 150 percent of the poverty level, or $33,075 for a family of four. This goes beyond the earlier House bill and a companion measure in the Senate, which would extend Medicaid to people with incomes less than 133 percent of the poverty level ($29,327 for a family of four).
This change saves money. It is less expensive for the federal government to cover low-income people under Medicaid than to provide them with subsidies to buy private insurance.
Earlier on in this whole thing I was for reform, hoped that Congress and Pres Obama could get some change made. I was never for a government take over, but wanted first for issues and problems addressed with the health care system. However, given the fiasco this has become, too much to mention, I'm now hoping that nothing is passed. I've had it with the joke this has become. Health Care reform isn't reform, but a push for massive spending, disguised with plays on words to hide that fact, or devious spending schemes to blur costs, all wrapped up in an opaque shroud containing many hundreds of pages that no one has much idea of. I'm now hoping earnestly that this massive mess never passes. The one thing I will continue to hope for, against all odds now, is for some change as I said, to address problems and costs in health care. But even that isn't going to happen I fear.
Quote from: stjaba on October 28, 2009, 10:43:16 PM
Won't these costs eventually be passed onto consumers? So the solution to the problem of high cost of health care is to... make consumers pay more? Unless I'm missing something here, this seems backwards.
The cost saving aspect of health care reform has been grossly oversold.
Wow. Glad I sold my shares in Medtronics a while back.