Yeah, I've not been updating much lately. Since the bill passed, not so much urgent stuff to be aware of. I'll update here and there, rarely, as especially interesting things on the health care/single payer topic come up.
Sunday, April 18, 2010
Thursday, April 15, 2010
the prices of care, not the amount of care delivered, are the primary difference between the United States and other countries
Saturday, April 3, 2010
The data contradict claims by some that medical malpractice litigation is to blame for rising health care costs. Changing the liability system to the detriment of patients will not curb health care costs....
Between 2000 and 2009, health care spending rose 83 percent while medical malpractice payments fell 8 percent.
Wednesday, March 31, 2010
Monday, March 29, 2010
Sunday, March 28, 2010
I met the author, Kevin Zeese, of this article at the Healthcare-Now national meeting in St. Louis. Great article, Kevin.
Go and read the article and remember: "Those who recognize the need for real reform should not get stuck within the framework of the status quo. Now that the Democrats have further enshrined the insurance industry, some will urge that we work within that framework to improve the law. Tinker with insurance regulation, increase subsidies and increase penalties for not purchasing insurance. The framework of the law is insurance domination of health care. We need to change the framework, not work within it."
Friday, March 26, 2010
Here's the exposed loophole for today: "The new health care reform bill bans retroactive decisions by insurers in policies sold to individuals, except in cases of fraud. However, as it stands the ban would not apply to group policies, such as the one held by the Galeotti family, which cover some 150 million Americans."
The other day it was the fact that children aren't really protected from the pre-existing conditions clause from day one. Even newborns who didn't pre-exist at all have been denied for pre-existing conditions. Will this continue?
I believe the loopholes will just keep on coming to light. Obama's talking points? I don't give them much credence. After all, the insurance industry wrote the health insurance bill!
Ezra says there is no penalty for not buying health insurance and not paying the fine (at least for now). And he also admits that for most people (who don't get their insurance through employment), it will make more sense to forgo health insurance when they are well, and then purchase it when they realize they are seriously sick (even if they DO pay the fine for non-insurance).
So long as legal challenges to the individual mandate are in the news, we might as well be clear about what the mandate is, and how it works.
The individual mandate is a requirement that all individuals who can afford health-care insurance purchase some minimally comprehensive policy. For the purposes of the law, "individuals who can afford health-care insurance" is defined as people for whom the minimum policy will not cost more than 8 percent of their monthly income, and who make more than the poverty line. So if coverage would cost more than 8 percent of your monthly income, or you're making very little, you're not on the hook to buy insurance (and, because of other provisions in the law, you're getting subsidies that make insurance virtually costless anyway).
Most people will never notice the mandate, as they get insurance through their employer and that's good enough for the government. But of those who aren't exempt and aren't insured, the choice will be this: Purchase insurance or pay a small fine. In 2016, the first year the fine is fully in place, it will be $695 a year or 2.5 percent of income, whichever is higher. That makes the mandate progressive.
And what happens if you don't buy insurance and you don't pay the penalty? Well, not much. The law specifically says that no criminal action or liens can be imposed on people who don't pay the fine. If this actually leads to a world in which large numbers of people don't buy insurance and tell the IRS to stuff it, you could see that change. But for now, the penalties are low and the enforcement is non-existent.
The theory behind the mandate is simple: It's there to protect against an insurance death spiral. Now that insurers can't discriminate based on preexisting conditions, it would be entirely possible for people to forgo insurance until, well, they develop a medical condition. In that world, the bulk of the people buying insurance on the exchanges are sick, and that makes the average premiums terrifically expensive. The mandate is there to bring healthy people into the pool, which keeps average costs down and also ensures that people aren't riding free on the system by letting society pay when they get hit by a bus.
The irony of the mandate is that it's been presented as a terribly onerous tax on decent, hardworking people who don't want to purchase insurance. In reality, it's the best deal in the bill: A cynical consumer would be smart to pay the modest penalty rather than pay thousands of dollars a year for insurance. In the current system, that's a bad idea because insurers won't let them buy insurance if they get sick later. In the reformed system, there's no consequence for that behavior. You could pay the penalty for five years and then buy insurance the day you felt a lump.
Luckily, consumers aren't usually that cynical, and the experience of places such as Massachusetts suggests that individual mandates encourage people to buy insurance even when it might make sense for people to simply pay the penalty. But for all the furor over the individual mandate, the danger in the bill is much more that it is too weak and too good a deal than that it is too strong and too punitive a tax.