Healthcare Plans Explained

Healthcare Plans Explained

Debates

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U

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01 Mar 10

Here's the no BS nuts and bolts of the Democratic and Republican plans.

The Democratic Plan
http://www.politifact.com/truth-o-meter/article/2010/feb/26/health-care-reform-simple-explanation-updated/

Politifact.com expresses skepticism about a public option ending up in the final bill, which is understandable. However, support for a public option is growing momentum and I do think it's a real possibility.

Also of note:
• Will the promised cost savings materialize? The Congressional Budget Office has concluded that the Senate plan would reduce the deficit over the next 10 years, and over the 10 years after that. But even the CBO warns that it's very difficult to put dollar figures on many of these things, because of the size of the health care industry and the inherent unpredictability of major policy changes over many years. It's good to keep in mind that when it comes to health care reform, no one has a crystal ball.s

And the GOP Plan
http://www.politifact.com/truth-o-meter/article/2010/feb/26/gop-health-care-reform-simple-explanation-updated/

M

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looking at the Democrats' plan - according to the politifact article.
The following things should have been mentioned in the "What's controversial" section

Requirements for comprehensive coverage. Under the Democratic plan, people won't be able to buy high-deductible, catastrophic plans that only kick in for major medical expenses.

This is a MAJOR problem. The insurance companies LOVE this idea. The rest of America should hate it. We should be encouraging people to buy high-deductible, catastrophic plans, not banning them. People (unless they are poor) should be able to pay out-of-pocket for the non-catastrophic stuff. If I was in Congress, I would insist on this as a condition for my vote.

an individual mandate. This requires people to buy insurance, unless they qualify for a hardship exemption.

This is perhaps the BIGGEST point of controversy. I understand the reasoning behind it, but I also understand that it's almost impossible to sell this to the American people right now. It would seem that the public option approach would be a much easier way to allow high-risks to get affordable coverage.

The only way an individual mandate MIGHT work is if you only require people to buy catastrophic coverage. The premium wouldn't be very high and I think almost everyone would accept that it makes sense to get this kind of coverage

M

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2 edits

looking at the GOP plan.

It seems that the main thing that it does is to enact some measures to stimulate competition in the insurance industry. I would go further and eliminate the anti-trust exemption that the insurance currently enjoys, and enact whatever else is needed to create maximum competition in all insurance markets. Time for the nanny-state to remove the umbilical cord.

Their main approach for covering the really sick people is to put them into "high risk pools". But as the article indicates, this approach hasn't worked very well in the states that have tried it. To make it work, significantly more funding would be needed than the GOP currently is offering. It may be possible to make this work if we focus only on covering things that can't be paid for out-of-pocket. If there's no political way to enact a public option, this would be the next best approach - IF it is adequately funded. Perhaps Snowe or Brown could be persuaded to go along with doing this.

And there is absolutely NO excuse for the GOP's inability to come up with a plan to trim Medicare benefits. If those Evil Big Gummint Democrats can do it, the GOP can surely do better than punting. Given the third rail politics involved, an ideal way to enact cuts here is to combine it with an overall healthcare reform package. The Democrats are already on board. Maybe at least Gregg (he's a big deficit hawk) could be persuaded to do something to actually cut government spending.

Naturally Right

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Originally posted by Melanerpes
looking at the Democrats' plan - according to the politifact article.
The following things should have been mentioned in the "What's controversial" section

Requirements for comprehensive coverage. Under the Democratic plan, people won't be able to buy high-deductible, catastrophic plans that only kick in for major medical expenses.

This is a and I think almost everyone would accept that it makes sense to get this kind of coverage
You continue to live in a Fantasy World. Even "catastrophic" plans are outside the price range of tens of millions of Americans. You really don't seem to understand what even modest medical care costs; virtually any medical problem quickly gets to "catastrophic" level; a one day stay in the hospital in New York state costs more than $3,000. How many people can easily afford to pay say a weeks' stay "out of pocket"?

Your bizarre insistence that there is some large group of Americans that really, really, really want to pay a bunch of money out of pocket for medical costs needs a reality check.

Naturally Right

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Originally posted by Melanerpes
looking at the GOP plan.

It seems that the main thing that it does is to enact some measures to stimulate competition in the insurance industry. I would go further and eliminate the anti-trust exemption that the insurance currently enjoys, and enact whatever else is needed to create maximum competition in all insurance markets. Time for the nanny-state big deficit hawk) could be persuaded to do something to actually cut government spending.
"Eliminate the anti-trust exemption" because it's "time for the nanny state to remove the umbilical cord"?????????????????

You do realize that these ideas are contradictory; removal of the anti-trust exemption would increase government regulation of the insurance industry.

Civis Americanus Sum

New York

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Originally posted by no1marauder
You continue to live in a Fantasy World. Even "non-catastrophic" plans are outside the price range of tens of millions of Americans. You really don't seem to understand what even modest medical care costs; virtually any medical problem quickly gets to "catastrophic" level; a one day stay in the hospital in New York state costs more than $3,000. How many ...[text shortened]... ally want to pay a bunch of money out of pocket for medical costs needs a reality check.
He was advocating "catastrophic plans" not "non-catastrophic plans." The week's stay in the hospital would be covered (or mostly covered) under a catastrophic plan.

Naturally Right

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Originally posted by sh76
He was advocating "catastrophic plans" not "non-catastrophic plans." The week's stay in the hospital would be covered (or mostly covered) under a catastrophic plan.
I made a typo obviously.

The point remains; there is little demand for plans which cover only "catastrophic" (as defined by the insurance companies) medical costs. The only reason people would buy them is to save some money and they would get inferior coverage in return. Contrary to Mel's assertion, the insurance companies love selling high deductible plans which leave to the consumer the costs of preventative care. But that type of gambling with the consumer's health is a poor idea as regards overall medical costs.

M

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Originally posted by no1marauder
You continue to live in a Fantasy World. Even "non-catastrophic" plans are outside the price range of tens of millions of Americans. You really don't seem to understand what even modest medical care costs; virtually any medical problem quickly gets to "catastrophic" level; a one day stay in the hospital in New York state costs more than $3,000. How many ...[text shortened]... ally want to pay a bunch of money out of pocket for medical costs needs a reality check.
I would define "catastrophic" to mean that which a person cannot be reasonably expected to pay out-of-pocket. So if a medical problem "quickly gets to catastrophic levels", then a true catastrophic insurance plan should be covering it. I would favor whatever regulatory scheme would be necessary to get this done. If this turns out to be impossible for the insurance industry to handle, this would likely provide overwhelming political support for a single-payer plan.

When I refer to non-catastrophic costs, I'm thinking mainly about the more routine (non-hospital) care that people regularly get and expect insurance companies to cover. But it could also include one or two-day hospital stays (maybe they'd choose to go somewhere besides New York and save the system some money). People could easily afford to pay $6000 in a given year out-of-pocket if you consider that it would be greatly offset by paying lower premiums. In addition, there should be subsidies available for those who are relatively poor.

I know you how much you adore the insurance industry. It may well be possible to combine a single-payer government approach to catastrophic and high-cost chronic care with the idea of having (non-poor) people pay out-of-pocket for their routine costs. But it seems that this is politically impossible. At present, the insurance industry is going to have to be a part of any healthcare reform. But let's not give them any more gravy than absolutely necessary.

M

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Originally posted by no1marauder
"Eliminate the anti-trust exemption" because it's "time for the nanny state to remove the umbilical cord"?????????????????

You do realize that these ideas are contradictory; removal of the anti-trust exemption would increase government regulation of the insurance industry.
Yes - you are correct - the insurance companies would have to comply with the same anti-trust regulations that everyone else does - what I'm saying is that the nanny-state should no longer be giving special treatment to this industry by allowing them to carve out near-monopoly status in the great majority of the insurance markets.

HG

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Originally posted by USArmyParatrooper
Here's the no BS nuts and bolts of the Democratic and Republican plans.

The Democratic Plan
http://www.politifact.com/truth-o-meter/article/2010/feb/26/health-care-reform-simple-explanation-updated/

Politifact.com expresses skepticism about a public option ending up in the final bill, which is understandable. However, support for a public ...[text shortened]... act.com/truth-o-meter/article/2010/feb/26/gop-health-care-reform-simple-explanation-updated/
Thanks for the post with the information. Deeply appreciated

Naturally Right

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Originally posted by Melanerpes
I would define "catastrophic" to mean that which a person cannot be reasonably expected to pay out-of-pocket. So if a medical problem "quickly gets to catastrophic levels", then a true catastrophic insurance plan should be covering it. I would favor whatever regulatory scheme would be necessary to get this done. If this turns out to be impossible for the ...[text shortened]... any healthcare reform. But let's not give them any more gravy than absolutely necessary.
I adore the insurance industry?????

LMFAO!!!!

HG

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Just an FYI, we have a high risk plan in Oregon.
The cost for me is approx. 700.00 per month for 3000.00 deductible.
The last 18 months of COBRA was 776.00 if I remember right, that's no dental, or vision.
This is the first year I hit that "magic" mark where it was actually tax deductible.... boohoo.

w

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Originally posted by no1marauder
You continue to live in a Fantasy World. Even "catastrophic" plans are outside the price range of tens of millions of Americans. You really don't seem to understand what even modest medical care costs; virtually any medical problem quickly gets to "catastrophic" level; a one day stay in the hospital in New York state costs more than $3,000. How many peop ...[text shortened]... ally want to pay a bunch of money out of pocket for medical costs needs a reality check.
So Americans can't afford health care eh? Well then, lets just make it "free" via at the tax payers expense. That should solve all our problems.

K

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Originally posted by whodey
So Americans can't afford health care eh? Well then, lets just make it "free" via at the tax payers expense. That should solve all our problems.
Some of them, at least.

w

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Originally posted by KazetNagorra
Some of them, at least.
Sure, all we need is to destroy the evil insurance companies and have Uncle Sam take over full control of health care and then all our worries will be over. Over night health care will then be affordable for all!! I'm sure the government will manage it in such a way that will not drive up further a $15 quadirilicanmilican deficit.

Of course, if it were not for those evil conservatives our we would have our medical utopia. ðŸ˜