Obama's health plan takes shape

Nurses Activism

Published

Barack Obama's health plan takes shape

Source

If Congress were to take a vote on a health reform bill today, Democrats and Republicans would find a surprising level of agreement-so much so that the broad outlines of a consensus plan already are taking shape.

Sick or healthy, rich or poor, all Americans would be guaranteed access to health insurance.

In fact, they'd probably be required to purchase it-perhaps through mandates in the law that would include stiff tax penalties for anyone who tried to opt out.

Newly created insurance marketplaces would make finding a plan as easy as shopping for cheap airfare. People could keep their coverage, even if they switched jobs. And they might be able to choose between private insurers and a government-backed plan.

But here's the catch-none of this would come free, with the wealthiest Americans likely to face higher taxes to help pay for coverage for all.

It's hard to believe that only three months ago, health care advocates worried that President Barack Obama would drop the health reform issue from his first-year agenda. Now, with an August deadline to pass a bill, a compromise that once seemed unimaginable is considered quite possible, both sides say.

Specializes in Psych, LTC, M/S, Supervisor, MRDD,.

i think what president obama wants to do is make healthcare accessible to all americans. this means: everyone! rich, poor, middle-class, etc. most of the poverty stricken americans have better access to healthcare then us hard workin middle class folks. most of the people living below the poverty level in the usa can access healthcare and their are programs to help them like medicaid. larger citied have non-profit organizations that help them get meds, free clinic visits, etc. these people your so afraid of supporting are already being supported by you, me, and all other tax payers....that will not change! what the prez is trying to do is cover the rest of us. the healthy wealthy person is already set up, the poor medicaid recipient is already set up....what he's trying to do is fill in the gaps!!!

newsflash:

you can live a healthy lifestyle, work hard everyday for your family and their health insurance, and still be left without insurance if you were unable to work due to disability from accident of disease!!

example: you can be the epitome of physical health...get in an accident and boom!!!---your unable to work due to a fx pelvis, head injury, c-spine fx with paralysis...whatever, you get the point...lets say you exhaust all your fmla, short-term disability, etc and you have to cobra out on your insurance through your former employer at about... 1,000/month(much cheaper now since obama agreed to pay 60%, but still expensive!). you have to do this because all your injuries are "pre-existing" so u dare not lose the insurance you have!!! your short-term disability is running out, your depleting your savings account, etc.

due to the loss of your job and $175,000/yr salary, you get behind on mortgage, car, blah, blah, blah. you've exhausted savings and are now faced with losing your cobra because it'll only cover you for 1-2 years and you still need 2 more operations and extensive pt before your able to return to work, if you ever do return to work. :crying2:so there you are!!! unable to work, unable to get better, losing your assets, exhausting all options!!! wouldn't it have been nice to have a health insurance plan that wouldn't have demanded all your savings and covered you with your big salary or without????? now, after all this you will probably qualify for medicaid.....does this make you a "leech on society" or another victim of our flawed healthcare system???

Here's a random question: Instead of trying to jam everyone into the current healthcare system, why not create an alternate system like the VA system at least temporarily?

Have hospitals specifically designed to take gov't health insurance. Pretty much every academic center is already set up like that but why not make more use of it? We can increase the number so that we can train more doctors and nurses, meet the up coming shortage, provide health care to those who need it.

Dont get me wrong, I would still be opposed to this system but it makes more sense at least until obamacare gets off the ground and the recession has passed.

Specializes in Psych, LTC, M/S, Supervisor, MRDD,.

#1. Have u tried to get into a specialist now???? Takes a couple months....It will not change! Canada has the same wait time that we have overall.

#2. No, the drug companies depend on development...If costs are contained and governed plus they take away the CEO's private jet and quit paying a drug rep $80,000/yr to pimp their products they will be just FINE!!

#3. This will not change. We have an excellent education system and most of these things are developed with aid of grants, at University Hospitals throughout the US---and fyi: Drs and researchers will still study, research, and invent...enough private and public institutions pay for that stuff.

#4. UUHHHHH......anyone ever heard of a PPO or a HMO???? What the heck could get worse then that??

#5. We will still be provided with supplemental plans to cover certain items...but if we have "universal" healthcare it will be the SAME for everyone and cover anywhere or any provider (like in CANADA).....so ya that one is probably true....AND A GOOD THING

#6. Unless we **** off another country it probably won't change. lol. We will still get access to the research and development of Japan, Sweden, UK, ETC>>>BELIEVE IT OR NOT AMERICA...WE DON'T DEVELOP ALL THE TECHNOLOGY OR MEDICAL ADVANCEMENTS OR BREAKTHROUGHS

call me arrogant all you want but it doesnt change the facts. redistribution of wealth, by definition, (let me highlight that again by definition) is when money or goods are taken from one group and given to another. this is often used for taking goods/taxes/income from the more wealthy of society to pay for programs for the poor. uhc fits both of these definitions, plain and simple.

other examples of redistribution include: graduated income tax used for social programs, welfare, inheritance tax among others.

you agree with redistribution of wealth- it goes hand-in-hand with much of your political ideology. you just dont like the connotation that comes with the term redistribution of wealth because it can (and has been in the past) used as leverage in media bytes and has closely been linked to socialism in mass media.

no, i do not see your narrow definition as the be-all and end-all of uhc. and while i have no problems with the term "redistribution of wealth," i'll thank you to not presume to know what i like, don't like or think.

Specializes in Critical care, tele, Medical-Surgical.

how health insurance companies redistribute wealth

they take our premiums and spend it in ways that do not provide any healthcare.

this is because they have a fiduciary duty to their shareholders.

* the major health interests have spent an average of $1.4 million per day to lobby congress so far this year and are on track to spend more than half a billion dollars by the end 2009. that comes out to about $2,600 per day per member of the house and senate. the pharmaceutical lobby alone spent $733,000 per day in the first quarter of 2009.

* health insurance companies donated $20,319,441.00 to congressional campaigns in 2008. http://www.opensecrets.org/

* 2008 compensation from the u.s. security and exchange commission.

1. ron williams, aetna - $24.3 million

2. h. edward hanway, cigna - $12.2 million

3. angela braly, wellpoint - $9.8 million

4. dale wolf, coventry health care - $9 million

5. michael neidorff, centene - $8.8 million

6. james carlson, amerigroup - $5.3 million

7. michael mccallister, humana - $4.8 million

8. jay gellert, health net - $4.4 million

9. richard barasch, universal american - $3.5 million

10. stephen hemsley, unitedhealth group - $3.2 million

* denial management distribues wealth too.

http://www.medicalnewstoday.com/articles/63092.php

http://www.sec.gov/edgar/searchedgar/webusers.htm

http://www.publicampaign.org/node/41456

http://www.opensecrets.org/politicians/summary.php?cycle=career&cid=n00009869&type=i

http://www.deseretnews.com/article/1,5143,705288521,00.html

http://soprweb.senate.gov/index.cfm?event=lobbyistselectfields

http://thomas.loc.gov/cgi-bin/bdquery/z?d111:hr00002:@@@s

http://online.wsj.com/article/sb124338375682356635.html#mod=todays_us_nonsub_marketplace

http://www.nchc.org/facts/cost.shtml

http://www.familiesusa.org/resources/publications/reports/americans-at-risk.html

economics professor uwe reinhardt asks, "is health care reform worth $1.6 trillion?" and puts the numbers into perspective:

a price tag of $1.6 trillion seems immense if one contemplates the figure in the abstract. it is, however, only about 4 percent of the total cumulative health spending of $40 trillion, the amount government actuaries now project for the decade from 2010 to 2020. that is also less than the 6 to 7 percent that total national health spending has increased each year in the past decade.

and $1.6 trillion is only about 1 percent of the amount of g.d.p. that america can reasonably be expected to produce in the next decade (about $150 trillion to $170 trillion).

that 1 percent would not be lost to g.d.p., of course, because health spending is part of g.d.p. rather, it would be a diversion of g.d.p.-away from other uses, and toward providing the otherwise uninsured with the peace of mind that comes with health insurance and access to timely health care. it would represent merely a change in the composition of g.d.p.

a change in the composition of g.d.p. should be distinguished from an actual loss of g.d.p.

indeed, to give a sense of perspective: whatever waste there might be in any new spending on health care, the loss of welfare it implies is dwarfed many times over by the actual loss of g.d.p. and human welfare over the coming decade caused by the reckless mismanagement of our financial sector. not to mention the diversion of additional g.d.p. to wall street bailouts and away from uses that taxpayers probably would have preferred.

to be sure, congress may have a political problem of financing an estimated $1.6 trillion price tag for health reform without raising taxes of some sort, a subject to be explored in a future post to this blog.

but that price tag is not much of a real burden, if any, on our economy over all.

as congress is hemming and hawing over this price tag, america's middle class might take a moment to contemplate its future fate in health care without any government subsidies toward health insurance.

let's start with the graph below.

000001221a576272c0e9c54400c000a80001001b.picture%201.png

the data in the chart come from the milliman medical index published annually by the benefit consulting firm milliman inc.

based on a sample of several million american families with employment-based health insurance, the index represents the average annual cost of health care for a typical american family of four.

the "cost" figures in the graph are all inclusive. they are the sum of employer- and employee-paid health insurance premiums plus the family's out-of-pocket spending on health care.

at the trend over the last decade, which is likely to continue, this cost index will stand at $18,000 by 2010. it will have more than doubled its level since 2001. and if that trend continues for another decade-and there is a good chance it will-then 10 years hence america's health system will be able to extract from the rest of society the sum of $36,000 per typical nonelderly family of four.

consider now an average american family that is sustained economically by a gross wage base of $60,000 today. by "gross wage base" economists mean the wages earned by the household's breadwinners before deduction of fringe benefits and taxes, whether paid by employer or employee. businesspeople would think of it as all the debits they make for an employee to the account "payroll expense." economists call it the "price of labor."

all of the health care costs included in the milliman index are financed by this gross wage base, which must also finance all of the family's taxes and living expenses.

in the past decade, average wages in the united states have grown at about 3 percent a year. with the economy likely to be in the doldrums for years to come, it would be highly optimistic to expect an average growth rate in wages any higher than 3 percent. most probably it will be lower.

but even at an optimistic 3 percent growth rate in the average gross wage base, a base of $60,000 now will have grown to only about $80,000 a decade hence. the $36,000 of projected health spending would have to come out of that wage base of $80,000. in other words, health care alone would chew up 44 percent of the wage base that must support such a family.

one can change the assumed growth rates for such a calculation to get slightly different forecasts. but the conclusion for any realistic set of assumptions remains the same: in the coming decade, an ever larger number of middle-class american families will have their household budgets chewed up inexorably and mercilessly by the cost of health care.

millions upon millions of middle-class families will see themselves pushed into the ranks of the uninsured-and possibly into bankruptcy-unless someone helps them financially. but it is doubtful that it can be done if the 10-year budget cost of the proposed health reform bill is constrained to $1 trillion or less.

Specializes in Psych, LTC, M/S, Supervisor, MRDD,.

i am a product of welfare! i hate sharing this stuff, but.....

a. i was pregnant at 15. my first son was born under medicaid- my entire pregnancy was covered as was his birth and subsequent operations he needed after his birth. i got pregnant not because i didn't know better, but because that seemed like the only way out at the time. :heartbeatif you know anything about about human development you know that "magical thinking" rules the thought processes of teens. their cerebral cortex and higher level of thinking do not come full circle until late teens early 20's. so... even if they "are held responsible" they really don't have the good sense to understand the impact of their actions. they only understand the romantic ideation and delusional thought processes that lead them to the wrong decisions. this is where parental guidance comes in and some kids just don't have it!

b. i was an iv cocaine user, homeless, lived in a car, and did not take care of any of my resposibilities! not that i didn't know better---i started out "just trying it" then boom- there i was!! if it wasn't for all this reallocation of wealth, i believe i would be dead! its because of state funded programs that i was able to get treatment at 21, get counseling, medical services, and move out of my car into a home with my child----not to mention go to school!

for every 100 addicts only 3 recover! is it worth it? i think so, others say let us all die "we made our beds...."

i'm a productive member of society now. i pay taxes. i donate money to help others, i worked in addictions and mental health for years to just help those 3 that will hear what i have to say.

i have found the people that usually are against supporting or helping the "ingrates" are rich, have good upbringing, good support systems, and have never been in my situation. after doing 12 years in addictions/ mental health i was frustrated to tears with em, but i would never deny them medical care or treatment.

it would be nice if everyone came from a loving home, had great insurance and money, and just "knew better"---but some of us are dense and need a little help. thank god its there....

my straight "a" children are reaping the benefits of a society that helped their mom get better and be a mom! thank you

Specializes in LTC.

Do you think we will see a public option? I suppose this is the best thread to ask the question. Apparently, the Prez. wants it, but is flexible on the idea and I think it's the most important part of any reform, a public option.

He has committed to these thing...

1) It has to be paid for.

2) It has to reduce costs.

3) It has to "make sure, that all Americans have quality, affordable health care".

But, he hasn't insisted on a public option. What do you think?

Specializes in Critical care, tele, Medical-Surgical.

I'm concerned.

Specializes in He who hesitates is probably right....
i am a product of welfare! i hate sharing this stuff, but.....

a. i was pregnant at 15. my first son was born under medicaid- my entire pregnancy was covered as was his birth and subsequent operations he needed after his birth. i got pregnant not because i didn't know better, but because that seemed like the only way out at the time. :heartbeatif you know anything about about human development you know that "magical thinking" rules the thought processes of teens. their cerebral cortex and higher level of thinking do not come full circle until late teens early 20's. so... even if they "are held responsible" they really don't have the good sense to understand the impact of their actions. they only understand the romantic ideation and delusional thought processes that lead them to the wrong decisions. this is where parental guidance comes in and some kids just don't have it!

b. i was an iv cocaine user, homeless, lived in a car, and did not take care of any of my resposibilities! not that i didn't know better---i started out "just trying it" then boom- there i was!! if it wasn't for all this reallocation of wealth, i believe i would be dead! its because of state funded programs that i was able to get treatment at 21, get counseling, medical services, and move out of my car into a home with my child----not to mention go to school!

for every 100 addicts only 3 recover! is it worth it? i think so, others say let us all die "we made our beds...."

i'm a productive member of society now. i pay taxes. i donate money to help others, i worked in addictions and mental health for years to just help those 3 that will hear what i have to say.

i have found the people that usually are against supporting or helping the "ingrates" are rich, have good upbringing, good support systems, and have never been in my situation. after doing 12 years in addictions/ mental health i was frustrated to tears with em, but i would never deny them medical care or treatment.

it would be nice if everyone came from a loving home, had great insurance and money, and just "knew better"---but some of us are dense and need a little help. thank god its there....

my straight "a" children are reaping the benefits of a society that helped their mom get better and be a mom! thank you

i am not rich. i worked for 25 years as a maintenance employee for a public transit system, and took an early retirement. i then returned to college and became an rn. my wife and i (both rns) work hard and already pay way too much in taxes. i congratulate you for your success, but the rest of us need not pay for your mistakes/lack of judgement. i take care of mine, you take care of yours. having worked for the government, i recognize the fact that they have no place in healthcare.

Specializes in My son...for now..
i am a product of welfare! i hate sharing this stuff, but.....

a. i was pregnant at 15. my first son was born under medicaid- my entire pregnancy was covered as was his birth and subsequent operations he needed after his birth. i got pregnant not because i didn't know better, but because that seemed like the only way out at the time. :heartbeatif you know anything about about human development you know that "magical thinking" rules the thought processes of teens. their cerebral cortex and higher level of thinking do not come full circle until late teens early 20's. so... even if they "are held responsible" they really don't have the good sense to understand the impact of their actions. they only understand the romantic ideation and delusional thought processes that lead them to the wrong decisions. this is where parental guidance comes in and some kids just don't have it!

b. i was an iv cocaine user, homeless, lived in a car, and did not take care of any of my resposibilities! not that i didn't know better---i started out "just trying it" then boom- there i was!! if it wasn't for all this reallocation of wealth, i believe i would be dead! its because of state funded programs that i was able to get treatment at 21, get counseling, medical services, and move out of my car into a home with my child----not to mention go to school!

for every 100 addicts only 3 recover! is it worth it? i think so, others say let us all die "we made our beds...."

i'm a productive member of society now. i pay taxes. i donate money to help others, i worked in addictions and mental health for years to just help those 3 that will hear what i have to say.

i have found the people that usually are against supporting or helping the "ingrates" are rich, have good upbringing, good support systems, and have never been in my situation. after doing 12 years in addictions/ mental health i was frustrated to tears with em, but i would never deny them medical care or treatment.

it would be nice if everyone came from a loving home, had great insurance and money, and just "knew better"---but some of us are dense and need a little help. thank god its there....

my straight "a" children are reaping the benefits of a society that helped their mom get better and be a mom! thank you

thank you for sharing your story. these kind of triumphs and getting a helping hand when one gets kicked down is what makes me love this country. who are we if we can't take care of our people? even if you hadn't had as many dire circumstances, life happens, people can end up unemployed and very ill. my dad, who has had his income significantly reduced because of economic issues and can barely pay his house note just had a quintuple bypass last week. thankfully he is insured, but there are many many out there who are not. my heart just breaks for them.... again, your story is triumphant ! thanks

Anti-public plan Sen. DeMint inadvertently concedes that public plan won't take over the market

(source)

On Bill Bennett's radio show, DeMint called blocking health care reform the top Republican priority, arguing that of all the items on President Obama's legislative agenda, it would be the hardest to reverse. To support his point, he offered "government schools"-public education-as an example. "You can never, with another piece of legislation, change it," DeMint said:

DEMINT: I think the biggest issue is health care. I think if they succeed in a government take over of health care the situation may be irreversible.
It will be like government schools. I mean you can never just, with another piece of legislation, change it.

DeMint's example of education is instructive, not because it is hard to repeal, but because it's a prime example of successful public-private competition. Indeed, while state and local governments own and run the public education system-to a much greater extent than either Obama or members of Congress are suggesting with a public health insurance option-private schools are competing against the government and thriving in this country. Further, such competition actually improves outcomes. As the conservative Hoover Institution found, competition between public and private schools "improves achievement for both public and private school students and decreases the amount spent per pupil."

+ Add a Comment