Supreme Court and the Individual Mandate

ChicagoGranny wrote:

49er wrote:Those of you who opposed the Romney/Obama plan (Obama plan was modeled after Romney's Massachusetts plan), what do you propose as an alternative so that we have universal coverage on par with other countries?

49er

Sloop wrote:

49er wrote:Those of you who opposed the Romney/Obama plan (Obama plan was modeled after Romney's Massachusetts plan), what do you propose as an alternative so that we have universal coverage on par with other countries?

49er

Well that's it in a nutshell. We don't WANT universal coverage ON PAR WITH OTHER COUNTRIES. What we want is:
A. To maintain our current quality of care -- the BEST medical care in the world
B. To lower health care costs
D. To eliminate intr-state health insurance barriers
C. To enact tort reform to greatly restrict out of control frivolous lawsuits
D. To encourage Health Insurance companies to provide "group" packages for the uninsured

Here is an expansion on the above ideas (from a Republican website):

-- Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
-- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
-- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
-- Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
-- Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today's system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.
-- Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
-- Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
-- Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
-- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.

49er wrote:Those of you who opposed the Romney/Obama plan (Obama plan was modeled after Romney's Massachusetts plan), what do you propose as an alternative so that we have universal coverage on par with other countries?

49er wrote:
Finally, having the greatest healthcare system in the world which I think is debatable isn't worth a darn if you can't access it.

Sloop wrote:A. To maintain our current quality of care -- the BEST medical care in the world

Sloop wrote: Here is an expansion on the above ideas (from a Republican website):

-- Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
-- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
-- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
-- Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
-- Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today's system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.
-- Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
-- Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
-- Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
-- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.

49er wrote: If I need emergency care, i will only get treatment in the ER to stabilize and nothing more. That is not true access and you darned right know it.

49er

Sloop wrote: That is simply not true. Hospitals are FULL of people, without insurance, who got admitted with some ailment via the Emergency Room.

Sloop wrote:

49er wrote:Those of you who opposed the Romney/Obama plan (Obama plan was modeled after Romney's Massachusetts plan), what do you propose as an alternative so that we have universal coverage on par with other countries?

49er

Well that's it in a nutshell. We don't WANT universal coverage ON PAR WITH OTHER COUNTRIES. What we want is:
A. To maintain our current quality of care -- the BEST medical care in the world
B. To lower health care costs
D. To eliminate intr-state health insurance barriers
C. To enact tort reform to greatly restrict out of control frivolous lawsuits
D. To encourage Health Insurance companies to provide "group" packages for the uninsured

Here is an expansion on the above ideas (from a Republican website):

-- Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
-- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
-- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
-- Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
-- Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today's system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.
-- Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
-- Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
-- Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
-- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.

Sloop wrote:That list doesn't even begin to touch on the tremendous debt to our country that ObamaCare has incurred. Within the first year, the CBO had to DOUBLE its estimate of from 700 Billion Dollars up to 1.4 Trillion. That is just what happened one year after the law went into effect. Do you want guess how out-of-control these costs will be in 10 years?

No, Obamacare’s Cost Didn’t Just Double. Sigh.
Jonathan Cohn March 15, 2012 | 9:40 am

Sorting through the deceptive attacks on health care reform gets old, even for me. But on Wednesday the Republicans and their allies made a claim so obviously misleading that they, and the media outlets parroting them, must have known they spreading false information.

The basis for the claim is the Congressional Budget Office’s latest projections for the Affordable Care Act, which critics (and I!) like to call Obamacare. When Congress first passed the law, in the spring of 2010, CBO made official estimates of how much the law would cost, how many people would get insurance as a result, and so on. It updated that estimate one year later and has, now, updated it one more time.

The CBO distributed its report in the morning and, by 11 a.m., Republican offices on Capitol Hill were spitting out press releases about it. According to the Republicans, CBO had discovered that Obamacare was going to cost $1.76 trillion over the next ten years. “The CBO’s revised cost estimate indicates that this massive government intrusion into America’s health care system will be far more costly than was originally claimed,” Tom Price, chairman of the House Republican Policy Committee, said. Within a few hours, both Fox News and the Washington Times were carrying online stories making the same claim. According to the Fox News account, CBO was “showing that the bill is substantially more expensive—twice as much as the original $900 billion price tag.”

If CBO had truly determined that health care reform’s cost will be twice the original estimates, it would be huge news. But CBO said nothing of the sort.

To figure out the cost of health care reform, CBO looks at each of the law’s component parts and, for accounting purposes, groups them into different categories. It calls one category “gross cost of coverage expansions”—that’s the amount of money the federal government will spend to help people get insurance, mostly by offering Medicaid to more people or giving people subsidies they can use to help offset the cost of private insurance. Last year, CBO estimated that the gross cost of coverage expansion from 2012 through 2021 would be $1.445 trillion. Now CBO thinks the gross cost will be $1.496 trillion. The number shifted, in part, because the CBO has changed its projections for economic growth. (MSNBC’s Tom Curry has a nice explanation of this.) But, in the context of such a large a budget projection, that’s barely any difference at all.

In the this latest estimate, CBO extends its projection out one more year, to capture the expenses from 2012 to 2022, in order to capture a full decade. In 2022, CBO says, the gross cost of coverage expansion will be $265 billion. Add that to the $1.496 and you get (with rounding) the $1.76 trillion—the one in the press releases and the Fox story.

But there is nothing new or surprising about this. It’s only slightly more money than the previous year’s outlays. The ten-year number seems to jump only because the time frame for the estimate has moved, dropping one year, 2011, and adding another, 2022. Obamacare has virtually no outlays in 2011, because the Medicaid expansion and subsidies don’t start up until 2014, which means the shifting time frame drops a year of no implementation and adds one of full implementation.

Still, doesn’t that just validate what the law’s critics have always said, that the administration was playing games to hide the program’s true impact on the deficit? Hardly. Remember, this is just the raw cost of expanding insurance coverage we’re talking about here—in other words, the money the federal government is sending out the door. The new law also calls for new revenue, in the form of taxes and penalties. It also reduces spending, mostly through Medicare, to help offset the cost of the coverage expansion. When the Affordable Care Act became law, CBO estimated that the net result of all these changes, taken together, would be to reduce the deficit. Now, with this revised estimate, CBO has decided the law will reduce the deficit by even more money.

Yes, you read that right: The real news of the CBO estimate is that, according to its models, health care reform is going to save even more taxpayer dollars than previously thought.

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